Male pelvic floor massage for ED

When you think about a massage, you’re probably envisioning aromatherapy, soft music, and a massage therapist ready to work out all the knots in your back. A male pelvic floor massage isn’t quite like a regular massage — for starters, there usually isn’t spa music or lavender-scented oil — but it does involve relieving muscle tension. Pelvic floor massage for men can be used to treat a range of conditions, including erectile dysfunction (ED), allowing you to get harder, stronger erections. It can also reduce pelvic pain, constipation, and pain in your back and hips. Ready to learn more about male pelvic floor physical therapy? We’ve got everything you need to know about this evidence-backed ED treatment.   

According to Justin Houman, MD, FACS — a urologist and professor at Cedars-Sinai Medical Center — a male pelvic floor massage is a targeted manual therapy technique designed to release tension, improve blood flow, and restore proper function in the pelvic floor muscles. 

Your pelvic floor muscles sit at the base of the pelvis and support the bladder, prostate, rectum, and penis, Dr. Houman explains. In those born with a penis (for the sake of brevity, we’ll refer to these as “men” for the remainder of this article), these muscles play a role in urinary control, erectile function, and ejaculation. 

“A pelvic floor massage often involves gentle internal — via the rectum — and external manipulation of the muscles, fascia, and trigger points,” Dr. Houman says. 

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Yes! Male pelvic floor massage can help treat erectile dysfunction in some cases. 

But to understand how, we first need to understand how erections work. Following arousal, your hormones, nerves, blood vessels, and brain work together to increase blood flow to your penis and decrease blood flow out of it, resulting in an erection. 

How do the pelvic floor muscles come into play? Dr. Houman explains that, when the pelvic floor muscles are tight, weak, or poorly coordinated, they impair the body’s ability to trap blood inside the penis during an erection. “Massage can help by releasing trigger points that interfere with nerve signals, improving circulation to the penile tissues, and normalizing muscle tone, allowing for better rigidity and stamina,” he says. Several studies suggest pelvic floor massage could be an effective treatment for ED. In a small study, patients with ED were treated with pelvic-floor exercises, biofeedback, and electrical stimulation. Nearly half (47%) regained normal erections, and 24% saw improved erections. In a case series published in 2024, patients with ED performed 10 minutes of pelvic floor exercises and 10 minutes of pelvic floor massage twice weekly for one month. Erection hardness and erectile function improved in all three patients that were studied. In another case report of a 69-year-old man with urinary symptoms and erectile dysfunction, prostate massage resulted in him regaining a self-reported 60% to 70% of his erectile function. 

ED can have different causes, and some cases — like those caused by low testosterone or psychological factors — probably won’t improve with pelvic floor massage alone. “Erectile dysfunction is often caused by multiple factors, so pelvic floor massage is usually part of a broader treatment plan,” Dr. Houman says. 

In addition to improving erectile function, male pelvic floor massage can offer other benefits. Of course, if you are experiencing any pelvic symptoms, make sure you are working closely with your healthcare provider so that you can understand the role of massage in your overall treatment since you may need antibiotics in some cases or even further testing.

Some of the potential benefits of male pelvic floor massage include: 

• Reducing chronic pelvic pain. In patients with chronic prostatitis — inflammation of the prostate gland — and/or chronic pelvic pain syndrome, prostate massage has been shown to have some clinical benefit. In one study, forty percent of patients with these conditions who were treated with both antibiotics and prostatic massage had lasting improvements. Additionally, a scientific review found that manual therapy to release trigger points in the pelvic floor has been shown to improve symptoms of  pelvic pain, as well as urinary tract symptoms. Again, in some cases, you may need antibiotics or further testing so be sure to work closely with your healthcare provider. If you are experiencing any symptoms.

•  Improving bowel function. If you find things aren’t moving through your bowels as easily as they once did, pelvic floor massage may be helpful. Pelvic floor dysfunction is associated with constipation, so improving your pelvic floor function can help things move more easily.  

• Helping with lower back and hip mobility. Dr. Houman notes that pelvic floor tension can radiate to the low back and hips, so pelvic floor massage to release trigger points and normalize muscle tone can also improve tightness in these areas of the body. 

Wondering what happens when you get a male pelvic floor massage for ED? Below, Dr. Houman explains step-by-step what will happen.

• Assessment. First, your healthcare provider — a pelvic floor-trained physical therapist or a urologist — will evaluate your strength, coordination, and areas of tension by touching both internal and external areas in your pelvic region. 

• Preparation. You’ll be in a comfortable, private setting for the massage. Dr. Houman says patients are usually lying on their back with knees bent for this treatment.  

• External release. The healthcare provider will massage your external regions, like the inner thighs, lower abdomen, and perineum. This is done to release any tension in those areas. 

• Internal massage. Next, your provider will use a gloved, lubricated finger and insert it into the rectum. They’ll identify and gently release tight muscles like the puborectalis, pubococcygeus, and iliococcygeus muscles, all of which are part of the pelvic floor. 

• Trigger point work. Sustained pressure is applied to any internal or external tight spots until the muscle relaxes. 

• Stretching and breathing. You’ll be taught how to breath through the diaphragm in coordination with muscle release to reset pelvic floor tone. 

• Strengthening. Once the tension in your pelvic floor is released, targeted Kegel-style exercises are introduced, which can improve erection quality. 

So, can you do a pelvic floor massage on yourself? Yes, but Dr.  Houman emphasizes it’s best to first learn how to do it from your healthcare provider to ensure you’re using the proper techniques. External massage can be done at home using your hands or a soft massage ball on the thighs, abdomen, and perineum. Internal massage can only be done using a curved pelvic wand designed for trigger point release, but it’s important you follow guidance from your healthcare provider to avoid injury, Dr. Houman says. He notes that many men do transition to a home maintenance program once they’ve gotten comfortable with the techniques used.    

If you’re looking to treat erectile dysfunction, male pelvic floor massage is just one of the many options you may want to explore. Treatments like prescription medications, penis pumps, and lifestyle changes can be done in addition to male pelvic floor massage (or instead of pelvic floor massage if you and your provider decide it’s not for you). Some options to explore are:

• Oral prescription medications. There are multiple oral ED medications on the market, mostly belonging to a class of drugs called phosphodiesterase 5 inhibitors (aka PDE5 inhibitors). These drugs help you achieve better erections in part by increasing blood flow to the penis. Some of the oral ED medications you might want to explore with your healthcare provider include: 

  • Viagra. This is perhaps one of the most well-known ED drugs on the market. It’s a branded version of a drug called sildenafil, and it usually takes effect within 30 to 60 minutes. 

  • Cialis. Another well-known ED medication is Cialis, which is the branded version of tadalafil. It can be taken daily or as needed. Effects can last up to 36 hours, but that doesn’t mean you’ll get spontaneous erections during that time (like most other ED medications, it’ll only work when you’re aroused). 

  • Ro’s Daily Rise Gummies. These gummies from Ro contain tadalafil, the active ingredient in Cialis. This off-label formulation is designed to be taken every day and allow you to get erections whenever, wherever. Even though it is off-label, the active ingredient has been approved for erectile dysfunction.

  • Ro Sparks. This powerful little tablet contains both sildenafil and tadalafil, the active ingredients in Viagra and Cialis, respectively. Another off-label formulation, Ro Sparks are designed to get you hard in 15 minutes on average and keep you ready for sex for up to 36 hours. While Ro Sparks is off-label, its active ingredients have been separately approved for the treatment of ED.

• Penis pumps. These devices usually work by placing the penis inside a chamber. A vacuum or hand pump then creates suction in the chamber, which increases blood flow to the penis, allowing for better erections. A small study on men with diabetes and erectile dysfunction found that 75% were able to achieve an erection sufficient for satisfactory sex when using a penis pump after just two months. 

• Lifestyle changes. Erectile dysfunction can be caused by lifestyle factors like  excessive alcohol consumption, tobacco consumption, and poor diet. If you think your ED may be lifestyle-related, consider making changes to your diet and cutting back on alcohol and tobacco to see if there’s any improvement. Another lifestyle change worth exploring is increasing your exercise. Research has found that individuals who exercise regularly see significantly improved erectile function. 

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Male pelvic floor massage can be an effective treatment for erectile dysfunction. It offers myriad other benefits as well, like alleviating certain types of pelvic pain and constipation. A healthcare provider can help you determine if it’s likely to be an effective treatment for you. 

• Male pelvic floor massage is a technique to release tension, improve blood flow, and restore function in pelvic floor muscles. These muscles play a role in erectile function and ejaculation, so if you’re experiencing ED, it’s worth considering whether pelvic floor massage could help. 

• Research has found that male pelvic floor massage can be an effective treatment for ED. It’s usually part of a broader treatment plan, since ED can have different causes. If your ED is caused by inadequate blood flow or nerve issues, pelvic floor massage may be helpful.  

• It’s best to consult a professional for pelvic floor massages. A urologist or physical therapist specializing in pelvic floor therapies can teach you the proper techniques for pelvic floor massage.  

There are many potential ED treatments. In addition to pelvic floor massage, prescription ED medications, lifestyle changes, and penile implants can help you get your erections back. Speak to a healthcare provider to discuss which option might be right for you.