Is it normal to maintain contracted pelvic floor muscles during sexual intercourse to achieve and maintain an erection?

From the Guidelines

Contracting the pelvic floor muscles during sexual activity is not typically recommended to achieve and maintain an erection, as it can lead to increased muscle tone and potentially cause pelvic floor dysfunction 1.

Key Points to Consider

• Chronically contracting the pelvic floor muscles can lead to increased muscle tone, potentially causing pelvic floor dysfunction.
• Relaxation techniques, such as those taught in pelvic floor physical therapy, may be beneficial in reducing unnecessary muscle contraction.
• Cognitive behavioral therapy and pelvic floor exercises may be useful to decrease anxiety and discomfort and can lower urinary tract symptoms 1.
• Medications like alpha-blockers, such as tamsulosin 0.4mg daily, may be prescribed to help relax the pelvic floor muscles, although this is typically reserved for cases of pelvic floor dysfunction or benign prostatic hyperplasia.

Important Considerations

• The evidence base for interventions to treat sexual dysfunction in cancer survivors is weak, and high-quality studies are needed 1.
• A thorough evaluation, including screening for possible psychosocial problems or mental health issues, should be conducted for individuals with concerns about their sexual function 1.
• Pelvic floor physiotherapy may be beneficial for patients experiencing symptoms of a potential pelvic floor dysfunction, including persistent pain and urinary and/or fecal leakage 1.

From the Research

Pelvic Floor Muscles and Sexual Intercourse

• The role of pelvic floor muscles in male sexual dysfunction, including erectile dysfunction, has been studied in several research papers 2, 3, 4, 5.
• According to a study published in 2014, involuntary or voluntary ischiocavernosus muscle contractions after erection can lead to increased intracavernous blood pressure, which helps build and maintain penile rigidity 3.
• However, another study published in 2022 suggests that exercises should be monitored to avoid situations involving hyperactivity or increased tone of the pelvic floor muscles, as this can have negative effects on erectile dysfunction and premature ejaculation 2.

Maintaining Contracted Pelvic Floor Muscles during Intercourse

• There is no direct evidence to suggest that maintaining contracted pelvic floor muscles during sexual intercourse is necessary or beneficial for achieving and maintaining an erection 2, 3, 4, 5.
• In fact, a study published in 2019 found that the ability to contract pelvic floor muscles did not influence sexual function in women with pelvic floor disorders, and that greater mobility of the bladder neck was correlated with lower sexual function 6.
• It is recommended that a multifaceted approach be chosen by physical therapists when evaluating and treating erectile dysfunction and premature ejaculation, taking into account both musculoskeletal dysfunction and behavioral contributions 2.

Pelvic Floor Rehabilitation and Sexual Dysfunction

• Pelvic floor rehabilitation, including exercises and manual physical therapy, has been shown to be beneficial in improving erectile dysfunction and premature ejaculation in men 2, 3, 4, 5.
• A study published in 2016 found that pelvic floor physical therapy can potentially improve the treatment of various male sexual dysfunctions, including erectile dysfunction and dysfunction of ejaculation and orgasm 4.
• However, further research is needed to validate the effectiveness of physical therapy interventions in treating sexual dysfunction 5.