Pelvic floor exercises, sometimes called Kegel exercises, are often suggested for premature ejaculation (PE). The idea is appealing, but the evidence is limited. This page explains what the pelvic floor does, what the research does and does not show, and when a physiotherapist can help. It is general information and not a medical assessment.
01
What the pelvic floor does
The pelvic floor is a group of muscles at the base of the pelvis. In men they support the bladder and bowel, help control urination and play a part in erection and ejaculation. Some of these muscles contract rhythmically during ejaculation. This is why people wonder whether training them could give more control.
02
What the research shows (and its limits)
- Studies of pelvic floor training for PE have generally been small, and some had no comparison group, so they cannot show how much of any change was due to the exercises.
- Pelvic floor training is not described as a standard first-line treatment in the main guidelines from the International Society for Sexual Medicine (ISSM) and the European Association of Urology (EAU).
- We are not aware of research on how well it works for South African men, and we do not quote a success rate.
- It may be more useful for some men than for others, and we cannot say in advance who will benefit.
In short, it is a reasonable option to discuss, but it should not be seen as a proven solution. See the overview of treatment options.
03
How the exercises are done
The basic idea is to find and tighten the pelvic floor muscles, hold briefly, relax fully and repeat. Many people describe the feeling as trying to stop the flow of wind or to lift the base of the pelvis. Some guidance suggests identifying the muscles by briefly stopping the flow of urine once, but doing this repeatedly while urinating is not recommended, because it can interfere with normal emptying of the bladder.
- Breathe normally. Do not hold your breath.
- Keep the buttocks, thighs and abdomen as relaxed as you can.
- Relax fully between each contraction. Relaxing is as important as tightening.
- Stop if you feel pain.
Exact programmes, such as how many repetitions and how often, are best set by a qualified physiotherapist after assessment. We do not give a fixed programme here.
04
Common mistakes
- Squeezing the buttocks, thighs or stomach instead of the pelvic floor.
- Holding the breath or straining.
- Never fully relaxing the muscles, which can leave them tight.
- Doing too much, too soon, or pushing through pain.
- Expecting results within days.
05
Who should see a pelvic floor physiotherapist
A physiotherapist trained in pelvic floor work can check which muscles you are using, whether they are weak or too tight and teach a programme that suits you. This is especially useful if you are not sure you are doing the exercises correctly, if you have pelvic or groin pain, urinary symptoms, or erection problems. Pain and urinary symptoms are also reasons to see a doctor. See when to see a doctor.
06
How long before judging results
Muscle training usually takes weeks, and many programmes are judged over about two to three months. This is a general guide and not a research finding. If you notice no change, or things get worse, speak to a professional. You can combine pelvic floor work with behavioural techniques or counselling.