Lifelong premature ejaculation can be treated by pelvic floor exercises

Mon, 14 Apr 2014

A trial presented at the European Congress of Urology in Stockholm reported yesterday for the first time that pelvic floor exercises can be effective in treating premature ejaculation in men who have had lifelong problems.

Premature Ejaculation (PE) affects a significant minority of men at some point in their lives. There are a variety of treatments, some more effective than others, with some men not responding to treatment. Perceptions of PE are often subjective, with some men believing they have PE inappropriately, but the International Society of Sexual Medicine defines PE as “ejaculation within a minute”.

A team led by Dr Antonio Pastore (Sapienza University of Rome), group took 40 men (aged 19-46) who were suffering from PE and trained them to exercise their pelvic floor muscles over a 12 week period. They also measured their time-to-orgasm over this period. Previously, the men had tried a variety of therapies, without any significant improvement. At the start of the trial the average ejaculation time was 31.7 seconds, but by the end of the 12-weeks of pelvic floor exercises this had risen to 146.2 seconds2– a more than 4-fold increase.

33 of the 40 men improved within 12 weeks. Only 5 men showed no significant improvement. 2 had dropped out of the trial early, after showing an improvement. 13 of the 33 patients continued the trial up to the 6 month mark, and they confirmed that they maintained their extended ejaculation time.

Pelvic floor exercises are often used to help male incontinence, especially after surgery such as operations for prostate cancer. Previously pelvic floor exercises had been tested in temporary impotence, but this is the first time that they have been tested over a longer term in men with lifelong impotence.

According to Dr Pastore: “This is a small study, so the effects need to be verified in a bigger trial. Nevertheless, the results are very positive. The rehabilitation exercises are easy to perform, with no reported adverse effects. Previously the men in the trial had tried a variety of treatments, including creams, behavioural therapy, SSRIs and psychological treatments – with little success. However, we found that 33 of the 40 men in our trial improved their ejaculation time within 12 weeks. We also found that the fact that the men were able to improve their sex-lives through their own efforts helped their self-confidence.

This technique seems to offer significant benefits over many existing techniques, including cost-savings and lack of side-effects. Although the exact exercises are still to be standardized, the results obtained in our patients with lifelong PE suggest that it may be considered as a therapeutic option for patients with premature ejaculation”.

Speaking for the European Association of Urology, Professor Carlo Bettocchi (Bari) said;

“This is an interesting study. Premature ejaculation is a real problem for many men, and any way which we can find to help this condition is welcome. This method particularly welcome because it is the sufferers themselves who overcome the problem through their own efforts – which will have additional psychological benefits”.

The study has been accepted for publication after peer-review.

References: Sharlip, I. D., Hellstrom, W. J., & Broderick, G. A. (2008). The ISSM definition of premature ejaculation: A contemporary, evidence-based definition. Journal of Urology, 179(suppl), 340, abstract 988

Pastore A.L. et al (2014). Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: A novel therapeutic approach, Abstract at the 29th Annual EAU Congress.