It can. In a small 2014 study, most men with lifelong premature ejaculation gained control after 12 weeks of pelvic floor rehabilitation. The evidence is still thin, but it’s a safe option worth knowing about.
I’ll be honest: I used to think only women had a pelvic floor, so the idea of a physiotherapist for it would never have crossed my mind. It turns out it’s a real specialty, and men see these therapists too.
What a pelvic floor physiotherapist does
Pelvic floor physiotherapists (physical therapists in the US) are specially trained to work on the muscles under the pelvis. Those muscles can be weak, but also too tight or spastic, and that matters as much. Cleveland Clinic’s pelvic health program, for instance, sees men for urinary problems, urgency and pelvic pain, including pain in the penis or testicles.
A first visit usually looks like any physio appointment: questions about your history and what you’ve already tried, an examination, then a plan. Nothing mysterious, and nothing you have to figure out alone.
What the research found for premature ejaculation
The study that gets cited is an Italian one from 2014. Forty men with lifelong premature ejaculation went through 12 weeks of pelvic floor rehabilitation with professionals. At the end, 82.5% had better control, and their average time went from about 32 seconds to about 146 seconds.
That’s encouraging. It’s also a small pilot study with no comparison group, and the six-month follow-up covered only 13 men (about 113 seconds on average). The American Urological Association doesn’t make a recommendation for this kind of approach on its own. So: promising, safe, not proven.
Why the pelvic floor is involved at all
Ejaculation ends with rhythmic contractions of the pelvic floor muscles, so it makes sense that better awareness and control of those muscles could help. I write about the strengthening side in do Kegel exercises help premature ejaculation. A professional can also tell you whether your problem is weakness or too much tension, which is hard to judge on your own (more on that in can a weak or tight pelvic floor cause premature ejaculation).
My take
If you can access a pelvic floor physio, it’s a reasonable thing to try, especially if you also have urinary symptoms or pelvic pain, which are worth a doctor’s look anyway. Training these muscles is a big part of how I work too, just on my own and at my own pace.
Sources
- Lifelong premature ejaculation can be treated by pelvic floor exercises, European Association of Urology, on Pastore et al., 2014
- Pelvic floor rehabilitation for patients with lifelong premature ejaculation, Pastore et al., Therapeutic Advances in Urology, 2014
- Pelvic Floor Rehabilitation, Cleveland Clinic
- Disorders of Ejaculation: AUA/SMSNA Guideline, American Urological Association, 2020
The whole theme in one read: Premature ejaculation treatments: what works and what doesn’t