Patient Case Share: Pelvic Floor Muscle Coordination and Delayed Ejaculation (Patreon)

In today’s case share, we’re looking at real-time ultrasound of a male pelvic floor during contraction attempts. Patient consent was obtained to share details of his case with you. Below is an anatomy image that shows the highlighted muscles I’m referencing in the video.

This patient experiences delayed ejaculation and reduced penile sensitivity. When we assessed his pelvic floor muscles, specifically the bulbospongiosus and external urethral sphincter, we observed limited contraction and poor coordination.

These muscles play key roles in orgasm and ejaculation. They create the rhythmic contractions that contribute to pleasurable sensation and help propel semen during climax. When pelvic floor muscle function and awareness are disrupted, sexual function can be affected, including the ability to ejaculate comfortably and efficiently.

Our treatment approach focuses on:

Improving fine motor coordination of the pelvic floor

Supporting nervous system regulation to enhance sensation and pleasure

Building interoceptive awareness so he can better feel and respond to arousal cues

He was using sildenafil (Viagra) as a precaution for erections, although he doesn’t have erectile dysfunction. We discussed how Viagra can sometimes prolong erection duration and inadvertently delay orgasm, which may be contributing to his current concerns.

Additionally, sEMG (surface electromyography using a rectal sensor) findings point to elevated baseline neural activity in his pelvic floor. So we’re incorporating:

Focused breathing

Mindfulness practices

Relaxation strategies

These help quiet the system, reduce muscle tension, and improve his ability to access pleasure and remain present through his arousal cycle.

With coordinated pelvic floor training, better awareness, and calming strategies to support his arousal gradient, we’re working toward smoother and more pronounced pelvic floor responses during orgasm, ultimately supporting his ejaculation and sexual satisfaction.

Medical disclaimer: This content is for educational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Always consult your healthcare provider regarding your specific needs.