Pelvic Floor Therapy Solution?

[quickdraw Junior Member Find all posts View Profile Close quickdraw]

I am in my early forties and have had lifelong PE. I have been married five years and the problem is still severe. It has not been uncommon to ejaculate during foreplay or even cuddling. I have been on this site intermittently for about four years. For the past couple of years I have been on Zoloft and use Promescent, which has definitely helped, but not to my satisfaction.

While on this site and elsewhere I have been reading about pelvic floor disfunction. I had never noticed my pelvic floor before but after thinking about it it did seem somewhat tense, though I also recognized it could just be in my in my head as an attempt to locate the problem. Though I also have low back pain and urine hesitancy and slow urine flow, all symptoms of a pelvic floor problem. All this being said, I found a pelvic floor physical therapy offce near where I live. They spend most of their time dealing with women’ issues post partum, but also deal with men who have pelvic pain or incontinence issues. I made an appointment and had my first visit yesterday.

It was extremely productive. After a thorough consultation of my past the therapist did a physical examination, and yes, it was an internal examination. She found that I have a very weak and tense pelvic floor and that it could very easily have been a lifelong problem. Much to my chagrin she spent a good bit of time massaging inside. It was certainly uncomfortable, but not painful. She had me kegel and reverse kegel and could tell that I was contracting when I should not have been (so all of this time I have been doing RKs without any benefit). She definitely thinks the weak/tense pelvic floor could be causing my pe, but did not outright say it was, which I appreciated, and made me trust her more. She gave me some exercises to do over the next week and I will be seeing her once a week for six to twelve weeks.

This is by far the most positive I have felt about resolving this issue. It will take a lot of time and work to resolve (which Pegasus will appreciate) the issue but will easily be worth it if it gets rid of my pe. Actually having a diagnosis makes me feel much better. I would recommend to any of you who may have similar symptoms to see a pelvic physical therapist and get checked out.

I plan on updating here once a week after my therapy sessions.

[Dangler Senior Administrator☼ Wizard ☼ White Tiger Award 2015 Find all posts View Profile Close Dangler]

Excellent !!

Thanks for sharing, and keeping us informed.

[stew Member Find all posts View Profile Close stew]

Would mind posting the workouts she gives you?

[quickdraw Junior Member Find all posts View Profile Close quickdraw]

UPDATE: Week 2

Just had my second visit to the pelvic physical therapist. Again it went well and I am optimistic, though it will be a long process. Just to recap the therapist has diagnosed me as having a tense and weak pelvic floor.

Today, we did bio-feedback. This involves inserting a tube-like device inside my sphincter that reads the tone level of my pelvic floor and reads the strength of my kegels, the ability to hold them and the ability to release (It's not uncomfortable, btw). A sensor is also placed on my abs to read the degree to which I am using my abs to contribute to the kegel; you are not supposed to use your abs to help kegel. I could watch the feedback on the computer screen as I was performing the kegels. It first showed that my tone is high compared to what it should be at a resting state - this is a result of the pelvic floor being tense. The readout showed that my kegels are not only weak, but that my ability to release them and go back to a resting state is not good. Also, it showed that my abs are used a great deal to compensate. She gave me a set of exercises in addition to those last week to help relieve stress in my lower back (another issue I have as a result of the pelvic floor issue) that she thinks will help me strengthen my kegels, relieve the back discomfort, and allow me isolate my kegels without using my abs.

Because I am not able to easily isolate my abs from the kegel she wants to wait a week before giving my a kegel routine. This made me worry about guys on this site who may not be aware of a tense and/or weak pelvic floor doing K/RKs and are not doing them properly and making things worse or at the very least not any better. Before going to therapy I was doing K/RKs and thought that would help, but now have found out that I can't do them with any success until I isolate my pelvic muscles from my ab muscles. I found that isolating the correct muscles is not as easy as we think, and the biofeedback clearly showed that.

Also, for those wondering, a sign of a tense pelvic floor is when you are standing and you notice that you tense up your butt muscles. After last weeks appointment I now realize that I do it all of the time. I can discuss that a little more if anyone is interested. She said that rehabilitating my pelvic floor very well could clear up my PE, but that if it doesn't, it at the very least will allow me to help control it with the correct ability to K/RK.

Again, I will respond each week with updates.

[Pegasus AdministratorPE Gym EditorPEGym Hero ☺ Admin of the Month Mar 2015 Find all posts View Profile Close Pegasus]

Excellent .
Did you mention seeing this stuff online?
Where abouts are you?
Many members find it difficult to find a physio who does male pelvic work.

[quickdraw Junior Member Find all posts View Profile Close quickdraw]

Yes, I was very lucky to find her. It is in the Washington DC area. If someone is in the area and interested PM me.

[Ellford Senior Member Member of the Month Sept 2019 Find all posts View Profile Close Ellford]

Great thread - keep it up!

After being on this site and reading all sorts of stuff, I've discovered I too have an imbalance, as I'm able to kegel like crazy and with extreme force, yet I'm not able to reverse kegel, or if I do, my lower abs are flexed when I do it (just like you mentioned).

Ive become "consciously aware" when I'm kegel in for no reason throughout the day and relax when I become aware of it.

[quickdraw Junior Member Find all posts View Profile Close quickdraw]

UPDATE: WEEK 4

I skipped last weeks update because there was not much to report.

More of the same therapy, internal massage and biofeedback. Outside of therapy I am doing stretches, breathing, internal massage, and just started kegels.

While it is improving, I still have a very tense pelvic floor. Since I've had this since my teenage years I assume it will take awhile. Because that area is so tight, it is very hard to get the appropriate effect from breathing exercises. For example, for some reason whenever I exhale after a deep breath, when one's sphincter muscles would normally relax, mine tighten (that is how messed up my pelvic floor is); so I'm trying to figure that out. The biofeedback shows that when asked to kegel, I can't hold it tight for more than a second or two, before I lose that contraction; this is due to the tight pelvic floor (the therapist says a normal guy should easily be able to hold a strong kegel for twenty). All of this actually worries me for those on here who have a tight/weak pelvic floor and are doing things like kegels. I always thought that I was holding a strong kegel when I practiced on my own, but the biofeedback clearly shows a slow but steady loss of contraction soon after attempting a kegel. My point is, that many guys may think they are doing effective exercises, but aren't at all.

One thing I realized today that is part of the problem is posture and weight distribution. Apparently your weight should be centered down through the ankles. I realized that my distribution is slightly forward from that.

These are just some general thoughts. Looking to hear from others and entertain any questions.

[Wolfering Junior Member Find all posts View Profile Close Wolfering]

Also, for those wondering, a sign of a tense pelvic floor is when you are standing and you notice that you tense up your butt muscles. After last weeks appointment I now realize that I do it all of the time.

Oh, thanks for sharing that! I've actually noticed that since starting to do some K/RK routines that unconsciously I am always tensing my anus and butt muscles to a certain degree and needed to consciously relax them. A while later I'd notice they'd be tensed up again.

I've found a physical therapist near me that also does male pelvic floor work. I'm gonna give her a call on Monday.

[Panda900 Junior Member Find all posts View Profile Close Panda900]

Exelent thread!

Quickdraw, what about RK and abdomen contraction? I can easily kegel and realise PF muscles to a neutral state but i cant reverse kegel without good abs contraction? I thought it is normal but not sure anymore. Any info about that?
Thanks!

[compass Member Find all posts View Profile Close compass]

Great read. Keep updating this is good stuff ��

[Schmukk Member Find all posts View Profile Close Schmukk]

UPDATE: WEEK 4

I skipped last weeks update because there was not much to report.

More of the same therapy, internal massage and biofeedback. Outside of therapy I am doing stretches, breathing, internal massage, and just started kegels.

While it is improving, I still have a very tense pelvic floor. Since I've had this since my teenage years I assume it will take awhile. Because that area is so tight, it is very hard to get the appropriate effect from breathing exercises. For example, for some reason whenever I exhale after a deep breath, when one's sphincter muscles would normally relax, mine tighten (that is how messed up my pelvic floor is); so I'm trying to figure that out. The biofeedback shows that when asked to kegel, I can't hold it tight for more than a second or two, before I lose that contraction; this is due to the tight pelvic floor (the therapist says a normal guy should easily be able to hold a strong kegel for twenty). All of this actually worries me for those on here who have a tight/weak pelvic floor and are doing things like kegels. I always thought that I was holding a strong kegel when I practiced on my own, but the biofeedback clearly shows a slow but steady loss of contraction soon after attempting a kegel. My point is, that many guys may think they are doing effective exercises, but aren't at all.

One thing I realized today that is part of the problem is posture and weight distribution. Apparently your weight should be centered down through the ankles. I realized that my distribution is slightly forward from that.

These are just some general thoughts. Looking to hear from others and entertain any questions.

Hey thanks for this post. I have an incredibly tense pelvic floor as well and notice that my anus is more or less always contracted throughout the day.

I had a question regarding the biofeedback when you kegel etc. Is holding a 20s kegel for normal guys refer only to a front kegel, or does it also involve the anus contracting. I understand theres a slight difference between the 2, although theyre all connected as a pelvic floor.

[quickdraw Junior Member Find all posts View Profile Close quickdraw]

Great, hope it goes well. Let us know the details, will be interested in any different treatments.

[quickdraw Junior Member Find all posts View Profile Close quickdraw]

Hey thanks for this post. I have an incredibly tense pelvic floor as well and notice that my anus is more or less always contracted throughout the day.

I had a question regarding the biofeedback when you kegel etc. Is holding a 20s kegel for normal guys refer only to a front kegel, or does it also involve the anus contracting. I understand theres a slight difference between the 2, although theyre all connected as a pelvic floor.

I asked this for you yesterday, and the answer is sort of mixed. It is both sinceit is all connected to the pelvic floor and it also probably depends on were you are stronger. Right now I am stronger doing a back kegel, however, I try to think about contracting the whole pelvic floor when I kegel.

[quickdraw Junior Member Find all posts View Profile Close quickdraw]

UPDATE: Week 5

This week was better than last. The biofeedback showed that the tenseness in my pelvic floor is reducing. A normal tenseness is in the range of 3-4; not sure how high the number goes though. I have almost gotten there. When I first started I was at about a 12-13, which she said was in the moderate area of the high range.

As for strength, I am still fairly weak, though she wanted to focus on the tenseness first. As I’ve mentioned before, breathing properly is crucial in dealing with the tenseness. I contract a lot when breathing so I’ve had to learn a lot about doing that correctly, though without the biofeedback its very hard to tell when and how much you are contracting. So when at home, and without being to graphic, I stick my finger in my arse (never imagined myself doing it, but you get used to it fairly quickly) and feel the pressure on my finger while breathing. On the deep inhale, imagine pushing your gut over the top of your belt. On the exhale, for a few seconds imagine lightly taking a piss and a crap at the same time, and then relaxing.
My issue is on the release of a kegel, in that it is very slow. Though I have found that with doing the above the release of the kegel is definitely getting quicker.

It is amazing how much you take the way you breathe for granted and not know that the way you do can cause these problems, though it is mostly an outgrowth of a tensed up pelvic region.