What is the pelvic floor – and why train it?

An often-overlooked muscle group

The pelvic floor is a layer of muscle and connective tissue stretched like a hammock between the pubic bone and the tailbone. It supports the bladder and bowel, holds the sphincters and – contrary to what many think – is closely tied to sexual function in men too. Because you can't see it and rarely engage it consciously, it tends to be neglected. Yet like any other muscle, it can be strengthened specifically.

Its role in erection and control

During an erection, certain pelvic floor muscles (mainly the ischiocavernosus and bulbospongiosus) help keep blood in the penis and maintain pressure. If these muscles are weak or poorly controlled, that can affect firmness. The same muscles play a role in the timing of ejaculation – which is why pelvic floor training is also a starting point for questions of control.

What the research shows

The idea isn't new – it's been studied. In a randomised controlled trial by Dorey and colleagues (British Journal of General Practice, 2004) with 55 men, erectile function improved significantly more after three months of pelvic floor exercises than in men who only received lifestyle advice. After six months, 40% of participants regained normal erectile function, and a further 35% or so improved noticeably. The authors rated pelvic floor training as an effective treatment option for erectile dysfunction.

An important note: in the study, the training was additionally supported by a biofeedback device. But the core exercise itself – consciously tightening, holding and releasing – is the same one you can do without any device.

What matters in training

Correct activation is key: a gentle lift inward and upward, as if stopping the flow of urine or holding back wind. Keep your belly, glutes and thighs deliberately relaxed and let your breath flow calmly – don't push, don't hold your breath. As with any muscle training, consistency matters more than intensity: short, calm sessions over weeks achieve more than rare, strained attempts. First effects typically show after a few weeks, not a few days.

This article is for information and does not replace medical advice.

Sources - Dorey G. et al.: Randomised controlled trial of pelvic floor muscle exercises and manometric biofeedback for erectile dysfunction. British Journal of General Practice, 2004; 54(508):819–825. - Dorey G. et al.: Pelvic floor exercises for erectile dysfunction. BJU International, 2005; 96:595–597.