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Exercises may help men with premature ejaculation

By Bridgett Novak

NEW YORK (Reuters Health) - Regularly practicing pelvic floor exercises helped improve lifelong premature ejaculation issues in a small group of men, a new study has found.

According to the American Urological Association, premature ejaculation affects about one in five U.S. men younger than 60.

"Pelvic floor muscles are actively involved in sexual function, and it is natural to assume that by improving the function of these muscles, one will improve one's sexual performance and outcome," said Yuchin Chang, a physical therapist at Professional Physical Therapy and Training in Summit, New Jersey. She was not involved in the new research.

For the study, presented at the European Association of Urology's annual meeting in Stockholm, Sweden, researchers used the International Society of Sexual Medicine definition of premature ejaculation as that which occurs "within a minute."

Forty men who reported having lifelong premature ejaculation problems were trained to exercise their pelvic floor muscles for 12 weeks. They also measured their time to orgasm throughout the study period.

The men, ages 19 to 46, had previously tried a variety of treatments, including creams, behavioral therapy and antidepressants, without any significant improvement.

Researchers taught the participants techniques similar to those used to help people with incontinence, including how to contract their perineal muscles to improve their strength and endurance.

They also stimulated men's pelvic floor muscles using an electric anal probe and used a strategy called biofeedback to prompt them to practice the perineal exercises. As part of the biofeedback process, electrodes are positioned on the patient's pelvic floor and converted into sounds or graphics that the patient sees or hears.

The men performed all the exercises three times a week, for 20 minutes each session.

Thirty-three participants, or 82 percent, noted improvement. Another two experienced improvement but dropped out before the end of the 12-week program. Five had no improvement.

At the start of the trial, men's average time to ejaculation during intercourse was 32 seconds. By the end of the first six weeks, the 33 successful patients had an average time to ejaculation of just over two minutes. After 12 weeks, their average time to ejaculation had increased more than four-fold, to almost two and a half minutes.

Thirteen of the men continued to perform the exercises once a week and tracked their results for another six months. All reported that they maintained longer ejaculation times for the entire six months.

"These men, who had suffered from premature ejaculation their entire lives, were able to improve their ejaculation time in just 12 weeks and maintain that improvement for another six months," lead researcher Dr. Antonio Pastore, a urologist at Sapienza University of Rome, told Reuters Health in an email.

Researchers said the exercises are a bit more complicated than those used for incontinence, such as so-called Kegel exercises.

"These exercises are designed to retrain/re-educate the pelvic floor muscles to either contract or lengthen properly on command and depending on the need," Chang said. "For instance, to retrain the muscles to contract, one should try to contract their pelvic floor muscles as if they are holding their urine, and hold it for 10 seconds, for 10 repetitions, like the Kegel exercises. But that is just part of what is needed for men with premature ejaculation."

The exercises might not help at all if men don't learn to do them correctly, she noted.

"It is best for men who suffer from premature ejaculation to be properly guided by a pelvic floor physical therapist," Chang said.

"Patients need at least four weeks of training (12 sessions) to learn the specific rehabilitation techniques and exercises described in this study," Pastore added.

Chang said the Herman and Wallace Pelvic Rehabilitation Institute keeps a list of certified pelvic rehabilitation practitioners where men can look to find a physical therapist. The directory is online here: http://bit.ly/1faOywv

"The pelvic floor exercises, if done properly, should help men with premature ejaculation. And they are more cost-effective and without the potential side effects of the currently used drugs," she said.

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