Many of my male patients ask me what they can do about PE – premature ejaculation.  It’s a very common condition yet it isn’t as widely addressed by doctors – or television commercials – as erectile dysfunction (ED).  But, the truth is, PE is the #1 sexual complaint of men.

It tends to be more common in younger men, but at least 1/4 of men over 50 experience it frequently.  In younger men, PE can have many causes.  But, generally in older men, there’s an important physical factor that’s often overlooked.  And it’s something you can remedy just by spending a little time each day doing a special type of exercise.

Control Premature Ejaculation with Pelvic Floor Strengthening

For a man to get a diagnosis of true PE, ejaculation has to occur within 1 minute of sexual activity.  As men get older, the muscles of their pelvic floor can become weaker.  As a result, the organs of the pelvic floor, including the prostate and testes, can “prolapse”, or fall forward.  These include the bowel, bladder, prostate and testes.

Falling forward into a wrong anatomic position, these organs can start to function improperly.  As a result, several chronic conditions can develop including:

• Premature ejaculation – frustrating to your romantic life and may be accompanied by pain

• Chronic heaviness or cramping in the pelvic area

• Incomplete emptying of the bowel or bladder

• Prostatitis – inflammation of the prostate tissues which can change the flow of urine or semen through the urethra.

A prolapsed pelvic floor can happen, especially in older men, for reasons that may include:

• Lack of pelvic muscle strengthening exercise

• Obesity – a large belly acts as a weight that pulls on pelvic structures

• Lifting heavy weight improperly can stretch and pull pelvic structures

• Lower back/pelvic/hip injuries with resultant nerve damage

• Surgery in the prostate or bladder area that results in nerve damage or scar tissue

• Chronic constipation – straining can stretch and weaken pelvic tissues

• Chronic coughing.  If you have COPD, asthma, or smoke, and you cough chronically, you may also be chronically straining the ligaments and tendons throughout your body.  Chronic coughing is often felt more in the pelvic floor and lower back areas.

• Body changes with aging.  As you get older, ligaments, tendons, supporting structures of your body start to break down as they lose collagen.  Decrease of hormones, dietary deficiencies, lifestyle habits can speed up and worsen this process.

How To Re-Strengthen Your Pelvic Floor

Now that you know your PE could likely be due to weak pelvic floor structures, I’d like to tell you how to do specific pelvic floor exercises that will help re-strengthen them.  After a few weeks, your pelvic floor should start to return to its normal anatomic position and you should see some improvement in your ejaculation times.

Research presented at the European Congress of Urology recently revealed that the best way to improve PE symptoms is through the same type of PE exercise I recommend to my patients.    These are isometric exercises that specifically target the pelvic floor.  But they also help strengthen the lower back and even the large surrounding gluteal muscles that help you stand.

They’re often referred to as “Kegels” and are also used in Gynecology to treat uterine prolapsing/pelvic floor weakness in women after multiple childbirths.  They’ve been research proven to strengthen and lift the pelvic floor.  They work by tensing and relaxing the muscles of the pelvic floor.

Researchers out of the University of Rome asked 40 men with PE to do pelvic floor isometrics.  When the study began, the average ejaculation time was 31.7 seconds.  At the end of the 12-week study, with these exercises, 33 out of the 40 men had improved.  Ejaculation times had increased to 146.2 seconds – about 2-1/2 minutes longer.  With continued exercise, ejaculation times can further improve.

Here’s how to do Kegel’s:

1. Empty your bladder and bowel.

2. Lie on your back with your knees bent, feet flat on the floor, knees a few inches apart.

3. Lift your hips slightly off the floor as you squeeze and tighten your pelvic floor muscles to the count of 10.  These are the same muscles you use to keep from urinating.  You’ll feel your buttock muscles squeeze inward.  Relax then repeat a series of 10.

4. Start with twice a day, then increase to 3 times a day.

If you feel that you’re not doing these exercises correctly, you can purchase a device called a Super Kegel Exerciser.  You can sit, stand, or lie on your back and place the device between your upper thighs.

Squeeze your thighs together to close the device to the count of 10 and release.  Then repeat to do 20 sets.  As in doing Kegel’s manually, it’s best to use the device at least twice a day.  Once your muscles start to strengthen, you can work your way up to 40 reps twice a day.

Other Things You Can Do To Strengthen Your Pelvic Floor

One of the causes of pelvic floor weakening is purely related to tissue changes that come with aging.  With getting older, collagen stores throughout your body start to break down.  That is, if you don’t take care to re-build them through targeted nutrition and other lifestyle changes.

Researchers at the University of Texas have found that a certain tissue protein – fibulin 5 – starts to break down in the natural process of aging due to increasing levels of an enzyme called MMP9.  Fibulin 5 is normally abundant in the ligaments, tendons, and other supporting structures throughout your body.

Fibulin 5 proteins are what create collagen and strong tissues as well as wrinkle-free skin.  They are what keep knees and other joints in alignment and working properly.  They are also crucial in supporting the pelvic floor organs. So, it’s easy to see how a deficiency in this protein could lead to a whole host of inadequate support problems throughout your body.

Eating a diet high in chicken and vitamin C helps replenish this protein and build more collagen.  You can also take collagen supplements, or hyaluronic acid, which helps build collagen as well.  You’ll not only be helping your pelvic floor structures stay strong, but you’ll be helping to strengthen every ligament and tendon in your body.  As a bonus, you’ll notice a smoother, less wrinkled, younger-appearing face.

On the flip side, avoid the “dangerous  3” to help keep your pelvic floor strong. These are:

• Smoking
• Eating a diet high in refined sugar
• Drinking a lot of alcohol

The 3 significantly contribute to the breakdown of collagen throughout your body.  Smoking seriously depletes Vitamin C, and all of them create a high degree of inflammation which degrades collagen and sets you up for disease.

So, for those of you who suffer with PE, take a little time to add some pelvic-specific exercise to your fitness routine.  In addition, make the recommended beneficial dietary and lifestyle changes noted here to re-strengthen your pelvic floor.  If you’re consistent with your effort, in a few short weeks, you should notice some significant improvement in your PE symptoms and your love life.

Stay Well,
Mark Rosenberg, M.D.

Lifelong premature ejaculation can be treated by pelvic floor exercises, http://www.sciencedaily.com/releases/2014/04/140413135910.htm

Pelvic Floor Muscle Exercises for Men, http://www.mydr.com.au/cancer-care/pelvic-floor-muscle-exercises-for-men