Systematic Review – Pelvic Floor Muscle Training for ED and PE
Citation
Myers C, Smith M. Pelvic floor muscle training improves erectile dysfunction and premature ejaculation: a systematic review. Physiotherapy. 2019;105(2):235–243. Registered in advance at PROSPERO (CRD42016047261).
Study Overview
Rather than a single trial, this is a systematic review — the authors searched multiple medical databases for all published studies testing pelvic floor muscle training (PFMT) as a treatment for erectile dysfunction (ED) and premature ejaculation (PE), then pooled and appraised what those studies found together.
Methodology Summary
The reviewers searched CINAHL, Cochrane, InFormit, Ovid Medline, PEDro, and Scopus from database inception through January 2018, plus hand-searched conference abstracts and citation lists. Two reviewers independently assessed study quality using a standardized appraisal tool. Only studies in adult men with ED or PE — excluding men with a history of neurological injury or major urological surgery — were included.
Key Findings
- For erectile dysfunction, pooled results across the included studies showed "cure" (return to normal erectile function) in roughly 35–47% of men, with a further 28–40% reporting some improvement.
- For premature ejaculation, "cure" rates across studies ranged from about 55–83%, with a further 5–11% reporting improvement.
- The review's overall conclusion was that pelvic floor muscle training appears effective for both ED and PE.
- No single optimal training protocol (frequency, duration, or exact technique) could be identified across the studies reviewed.
Limitations
- The individual studies feeding into this review were generally small, and several had low-to-moderate methodological quality — limited detail on study design, and in some cases no comparison group.
- Because protocols varied study to study (some added biofeedback or electrostimulation, others did not), the review can't say precisely how well pelvic floor exercises work on their own, unsupervised, without those additions.
- As with any systematic review, results are only as strong as the underlying studies — this analysis highlights promising overall direction rather than definitive, high-certainty proof.
- The review does not address penis size or enlargement; ED and PE relate to function, not length or girth.
Practical Meaning
This review is useful because it looks across the evidence base rather than relying on any single trial (such as the Dorey ED study or the Pastore PE study, both summarized elsewhere on this site). Its overall message — that pelvic floor muscle training has a reasonable evidence base for both ED and PE, while the field still lacks a standardized protocol — is a fair, cautious summary of where the research actually stands as of its search date (January 2018).
It supports pelvic floor training as a legitimate, low-risk option worth discussing with a clinician for men with ED or PE, without overstating certainty about exact success rates for any individual.