Hi! It’s Dr Kiran here from The Doctor Service. I’ve got a special guest in today, Sally Sheppard from Poole in Dorset who is a specialist physio and specialises in pelvic floor dysfunction including in men.
So Sally, first question is what can you do for men with erectile dysfunction?
Pelvic floor exercises can be really helpful for erectile dysfunction and it’s been shown that six months of following some very simple pelvic floor repetitions can cure erectile dysfunction for 40% of those men following the program.
Wow that’s a huge revelation to me because as a GP, we don’t refer people for erectile dysfunction for physio. it just doesn’t happen. So I think if I don’t know probably most of the GPs don’t know and therefore our patients don’t know about this.
How effective is it really compared to say taking viagra?
So I suppose the thing you’ve got to remember is that weakness could be happening for lots of reasons and to regain your strength again is then putting it back into a physical condition that would all see benefits in the long term. Of course you need to take the tablet in order to get the result but I could see where you could actually use the two together.
How long does it take to see results?
I think within the first month, you would start to recognize that your body was changing because when muscles feel stronger the exercises start to get easier.
That’s quite quick.
By three months a muscle that’s been regularly exercised begins to demonstrate some permanent changes providing you continue with the exercises. And by six months, one would hope that you’ve established routine because something that you find easy to do you remember a bit like brushing your teeth. And you’re able to keep that muscle fit.
How does someone do the exercises, and are they easy to do?
Would you like me to teach you? On Camera?
Yeah! Ok let’s have a go.
Uncross your legs. So we’re just doing a quick show on how to do these exercises. So if this is your bottom there’s an opening to your back passage, that’s surrounded by muscle.
It’s not your gluts, it’s not your bum cheeks, you’re not about to look like you’re riding a horse. So it’s actually about the schpincter which surrounds the area where stool passes through. If you were in a situation where you were desperate to pass wind right now and you thought you really shouldn’t because you’re on camera, you’re going to tighten up that sphincter.
But you’re not going to let anyone see, so you’re not going to let your bum cheeks actually move.
So everyone knows what I’m doing right now. I’m squeezing tight.
If you look really carefully in his eyes you can just see the change!
I’m squeezing now. What’s this doing?
This is tightening up your pelvic floor muscles around the back passage that you can relax. As you do that, those muscles are also connected, going forward so they run from the back passage, forwards, under the scrotum and to the base of the penis. So if you were passing urine and you tried to stop the flow, you’d have to do exactly the same action as you just tried because it’s that action that we would constrict your flow of urine.
Why does that make erections better?
The anatomy of the blood supply to the penis is influenced during the erection by the strength of this muscle. Think of it as a safety valve. If these muscles are fit but then blood will remain in the penis.
It’s essentially like weight training for the penis.
Yes. because you’re making the muscles stronger and you’re driving more blood flow and then you get strong erections as a result.
In the long-term you should really be doing this and when we talk about
women, it’s more common we talk about pelvic floor exercises all the time to help them with incontinence.
Does this help with incontinence?
Well the research that was done in 2005 for Erectile Dysfunction also found that men who were suffering with post micturition, (loss of urine), 65% were cured by following this same routine of pelvic floor contractions which I should add back for you before this.
What is post-micturition?
When the bladder empties, the urine has to pass down the urethra which is the length of the penis and then out and sometimes the force at which that is passing towards the end of micturition dwindles, and some urine will remain in the urethra. As the man thinks he’s finished and leaves the bathroom, gravity will then get hold of that little bit of urine and discharge it. It’s very embarrassing, just a small amount of liquid can tell you that you feel wet and if it’s become visible and there is the fear of the odour.
You’re getting more than just stronger erections.
You’re helping to manage the dribbling events and preventing leakage. So you get multiple benefits in this.
How often do I need to do the exercises?
In the study men were told just twice a day they needed to do three contractions when laying down for example in bed or on the sofa, or on the floor, But that’s less convenient. Three contractions in sitting and three in standing. It is harder to do them in standing, easier to do them in laying but probably more convenient to do them in sitting.
The study that was really supportive for females doing these exercises for up to three times a day repetitions. So actually it could be like a couple bonding exercise! It’s not just a female problem. It’s a male problem too and both men have been men and women get benefits from it
Male incontinence will affect one in ten men
Wow okay. So there’s a lot of people out there that suffering from this.
Are there any specific sports that can help make your pelvic floor stronger?
If you choose to squeeze your pelvic floor during certain activities then rather than it being a direct benefit, you could use a certain activity like being in the gym – e.g. when using leg presses, If you contract your pelvic floor at the same time, then you’ve got two for the price of one. There aren’t really any sports thaat just give you that pelvic floor strength coincidentally. You have to think of recruiting this muscle behind the gym when they talk about your pelvic floor as well?
Is the pelvic floor part of your core muscle groups?
It is, because it’s a deep muscle and it does want to work with your core, which is essentially your transverse abdominal muscles going across your tummy and your diaphragm. They work as a team but you do have to
e careful that you don’t over use for example your diaphragm and hold your breath because it then increases the pressure that your pelvic floor has to work against. So you’re breathing through your pelvic floor contraction needs to be easy and comfortable
How can our viewers and listeners find out more?
If our listeners and viewers want to find out a bit more about you where can they go so to find a specialist in your area, there’s an association of
specialist physiotherapists in this field called POGP, which is hysiotherapists in obstetrics gynaecology and pelvic dysfunction, and their website would help you find a specialist in your area.
We’ve got more than just tablets to treat erectile dysfunction.
Sally Sheppard from Poole Hospital, Dorset is a specialist in physio, specialising in pelvic floor dysfunction including men.