Erectile dysfunction: where the pelvic floor fits
Erectile dysfunction is common, and it isn’t only about blood flow or hormones. The pelvic floor muscles help create and maintain an erection. When those muscles are weak, too tight or poorly coordinated, they may be part of the problem. Physical therapy addresses that part, alongside the care you get from your doctor.
Or call (929) 590-3445. Talk to a clinician first. No referral needed.
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Medically reviewed by Dr. Adam Gvili, PT, DPT, on November 2, 2026
Does this sound familiar?
- Erections that aren’t as firm as they used to be, or fade too soon
- Problems that started with pelvic pain or after a period of stress
- Pain during or after ejaculation
- Erection problems that come and go with no clear pattern
- You’ve been told your tests are normal, or medication only partly helps
See a doctor first
New erectile problems should always be checked by a doctor. ED can be an early sign of heart disease, diabetes or other conditions, and some medications affect erections. Physical therapy is not a substitute for that evaluation.
How the pelvic floor is involved
Two pelvic floor muscles wrap around the base of the penis. When they contract, they help keep blood in the penis and support firmness. If they’re weak, they may not do that job well. If they’re constantly tight, they can restrict blood flow and cause pain, which also makes erections harder. That’s why strengthening isn’t always the answer, and why we assess before prescribing exercises.
How we evaluate
On your free 15-minute call, tell us what’s going on. We’ll be straightforward about whether we think the pelvic floor is involved. At your first 45-minute visit, your physical therapist will take a full history, assess posture, breathing, hips and the pelvic floor muscles, and explain what they find.
The pelvic floor is a group of muscles that sit inside the pelvis, so the most accurate way to assess and treat them is directly. If it would help, your therapist may suggest an internal exam: one finger, in the rectum, always at your comfort. We explain each step before we do it, check in with you throughout, and you can pause, stop or say no at any time. Most people expect it to be uncomfortable and are surprised by how manageable it is.
What treatment can involve
- Strengthening or relaxing the pelvic floor, depending on what we find
- Coordination and endurance training
- Treating related pelvic pain
- Breathing and stress-related tension work
- A short daily home program
Your team
Dr. Adam Gvili, PT, DPT, Founder. Every visit is 45 minutes, one-on-one, with your own physical therapist.
Dr. Joseph Mendoza, PT, DPTPelvic Floor Physical Therapist
Dr. Sam Vargas, PT, DPTPelvic Floor Physical Therapist
Frequently asked questions
It’s not a replacement, and we never advise stopping medication. For some men, the pelvic floor is part of the problem, and treating it can work alongside what your doctor prescribes.
Erectile problems in younger men are more common than most people think. Stress, pelvic pain and pelvic floor tension can all play a part. A doctor should still check you first.
Not without an assessment. If your pelvic floor is already tight, more Kegels can make things worse.
Completely. Your visit is one-on-one with your physical therapist. These are hard things to talk about. We talk about them every day.
No. You can book directly. If you’re already seeing a doctor, let us know who they are. We’ll keep them in the loop, because the best care happens when your whole team is working together.
We’re an out-of-network practice. We’ll give you a superbill to submit to your insurance for possible reimbursement. A superbill is a medical receipt with procedure codes that shows your insurer what happened during your session. If your insurance needs supporting documentation, we’ll send it promptly. What you get back depends on your plan.
Going deeper: erectile dysfunction
Why men wait years
Many men put off asking for help because of embarrassment. A free 15-minute call is a low-pressure way to ask questions first.
ED and pelvic pain
Pelvic pain and erectile problems often show up together. If you also have pain, see our male pelvic pain and chronic prostatitis / CPPS pages.
After prostate surgery
Erectile changes after prostate surgery are a separate topic. Talk with your surgeon, and ask us on your free call.
Working with your urologist
We’re happy to coordinate with your doctor, with your permission.
If you’re recovering from prostate surgery, see pelvic floor therapy before and after prostatectomy. You can also see all the conditions we treat.
Talk to a clinician first
Start with a free 15-minute call. Tell us what’s going on and ask anything. No commitment.
Or call (929) 590-3445. Talk to a clinician first. No referral needed.