Can a weak or tight pelvic floor cause premature ejaculation?

For a long time I thought only women had a pelvic floor. When I found out men have one too, and that it’s involved in ejaculation, a lot of things started to make sense.

What it has to do with ejaculation

The pelvic floor is a group of muscles under the pelvis. It supports the bladder and bowel, helps you hold urine, and plays a part in sex: it helps keep blood in the penis during an erection, and it’s involved in ejaculation.

Ejaculation happens in two steps. First, semen is moved into the urethra. Then it’s pushed out by rhythmic contractions of the pelvic floor muscles. That second step is a reflex, but the muscles doing it are muscles you can learn to feel and influence.

The “weak” side

The idea here is that better control over these muscles gives you more say in the reflex. The study usually cited is a small Italian one from 2014: 40 men with lifelong premature ejaculation did 12 weeks of pelvic floor rehabilitation, and 82.5% ended up with better control, their average time going from about 32 seconds to about 146. Promising, but small, with no comparison group. I go into it in do Kegel exercises help premature ejaculation.

The “tight” side

The other side gets less attention. The Sexual Medicine Society of North America explains that men who have better control over their pelvic floor may be able to delay ejaculation by relaxing those muscles, while men with an overactive, overly tight pelvic floor may not be able to relax them, which could lead to premature ejaculation. For that kind of problem, pelvic floor physical therapy (stretches and relaxation work) is considered the reference approach.

So the question isn’t only “strong or weak”. A muscle that never lets go can be as much of a problem as one you can’t feel.

What I’d take from it

Nobody can tell you from a website which one applies to you. If you have pain in the pelvis, pain when you ejaculate, or trouble urinating, see a doctor or a pelvic floor physiotherapist: those signs point to the tight side and deserve a proper check.

In the way I train, both sides count: learning to feel those muscles, and learning to let them go.

Sources

• Pelvic Floor Muscles, Cleveland Clinic
• Ischiocavernosus muscle, Kenhub (anatomy reference)
• Premature Ejaculation: From Physiology to Treatment, 2019, via PubMed Central
• Lifelong premature ejaculation can be treated by pelvic floor exercises, European Association of Urology, on Pastore et al., 2014
• How Can Overly Tight Pelvic Floor Muscles Impact One’s Sexual Health?, Sexual Medicine Society of North America