Pelvic floor exercises can help some men with diabetes and erectile dysfunction, but they’re a supporting player, not a cure. A 2026 randomised controlled trial in men with diabetes found that pelvic floor muscle training improved erectile function. Diabetes-related ED is mostly driven by damage to blood vessels and nerves, though, so the exercises work best alongside blood-sugar control and medical treatment, not instead of them.
If you’ve already read our guide to pelvic floor exercises for erectile dysfunction, you know the general evidence is decent. This article covers what changes when diabetes is part of the picture: why ED is more common, what the exercises can and can’t do, and how to fit them into a realistic plan.
Health disclaimer: This article is for general information only and isn’t medical advice. Any doses mentioned are amounts used in research or listed on product labels, not a personal recommendation. Supplements and medications can cause side effects and interact with other drugs or health conditions, so check with your doctor or pharmacist before starting anything new, especially if you’re pregnant, breastfeeding, on medication or managing a health condition. Stop and get medical help if you have a reaction. See our full medical disclaimer.
Why Diabetes Makes ED So Common
ED is one of the most common complications of diabetes. A large 2017 meta-analysis by Kouidrat and colleagues in Diabetic Medicine pooled 145 studies and found that roughly half of men with diabetes had some degree of ED. That’s about three and a half times the odds of men without diabetes.
There are three main reasons:
- Blood vessel damage. Years of high blood sugar damage the inner lining of blood vessels (the endothelium). An erection depends on the arteries in the penis widening quickly, and damaged vessels don’t do that well.
- Nerve damage. Diabetic neuropathy can affect the nerves that trigger and maintain an erection, the same way it can affect sensation in the feet.
- Related conditions. Diabetes often travels with high blood pressure, high cholesterol, excess weight and low testosterone. Each of these adds to the problem, and some blood-pressure medicines can too.
This matters because it tells you where pelvic floor exercises fit. They don’t repair blood vessels or nerves. What they do is strengthen the muscles that help hold blood in the penis once it’s there.
How Pelvic Floor Exercises Help an Erection
Two pelvic floor muscles sit at the base of the penis: the ischiocavernosus and the bulbospongiosus. When they contract, they press on the veins that drain blood out of the penis. That raises pressure inside the erectile tissue and helps keep an erection firm.
Stronger, better-coordinated muscles can make a borderline erection more rigid and longer-lasting. For a man with diabetes whose blood flow is reduced but not gone, that extra help can make a real difference. For a man with severe vascular or nerve damage, it usually won’t be enough on its own.
What the Research Says
The evidence here is thinner than for ED in general, so it’s worth being clear about what we know.
| Study | Who took part | What it found |
|---|---|---|
| Dorey et al., 2004 (British Journal of General Practice) | 55 men with ED for at least 6 months | Pelvic floor exercises with biofeedback clearly beat lifestyle advice alone. About 40% regained normal function and roughly a third more improved. Not designed to study diabetes specifically. |
| Randomised controlled trial, 2026 (Journal of Physiotherapy) | Men with diabetes and ED | Both low-intensity shockwave therapy and pelvic floor muscle training each reduced ED. This is the most direct evidence for this group so far. |
| Kouidrat et al., 2017 (Diabetic Medicine) | Meta-analysis of 145 studies | About half of men with diabetes have ED; the odds are roughly 3.5 times higher than in men without diabetes. |
The honest summary: pelvic floor training is low-risk, has reasonable general evidence, and now has at least one trial specifically in men with diabetes showing benefit. It’s still a small evidence base, and nobody should expect it to replace medical care.
A Simple Routine to Start With
If you’ve never done these before, start with our guide to Kegel exercises for men to make sure you’re contracting the right muscles. The quick test: squeeze as if you’re stopping the flow of urine and lifting your testicles slightly, without tightening your buttocks, thighs or stomach.
A typical starting routine:
- Slow holds: squeeze and hold for 5 to 10 seconds, then fully relax for the same time. Do 10 reps.
- Quick flicks: squeeze hard for 1 second, relax for 1 second. Do 10 reps.
- Frequency: 2 to 3 sets a day, spread across lying down, sitting and standing.
Breathe normally throughout and never hold your breath. Full relaxation between reps matters as much as the squeeze. If you get pelvic pain, stop and get assessed, because an overly tight pelvic floor needs a different approach.
Most studies ran for 3 to 6 months before measuring results. Our article on how long ED exercises take to work gives a realistic timeline.
What Matters More Than the Exercises
With diabetes, the biggest levers usually sit outside the pelvic floor:
- Blood sugar control. Keeping HbA1c in your target range slows the vessel and nerve damage that drives ED in the first place.
- Aerobic exercise. Regular cardio improves blood vessel function and insulin sensitivity. See our guide on cardio for erectile dysfunction for how much it takes.
- Weight, blood pressure and cholesterol. In a 2004 trial in JAMA, Esposito and colleagues found that about a third of obese men with ED regained normal function after two years of weight loss and more activity.
- Smoking. Stopping helps blood vessels everywhere, including the penis.
- Medication review. PDE5 inhibitors such as sildenafil and tadalafil still help many men with diabetes, though often less than in men without it. A doctor can also check testosterone and review blood-pressure medicines.
Pelvic floor training fits well alongside all of these. It’s free, it takes a few minutes a day, and it has no drug interactions.
When to See a Doctor
See your GP or diabetes team if:
- ED is new, or getting steadily worse.
- You also have chest pain, breathlessness on exertion or leg pain when walking. ED can be an early sign of heart and circulation problems, and that risk is higher with diabetes.
- You have numbness, tingling or other signs of neuropathy.
- Your blood sugar has been hard to control.
- You want to try ED medication, especially if you take nitrates for chest pain.
A pelvic health physiotherapist can also check that you’re doing the exercises correctly. Many men aren’t, at first.
FAQ
Can diabetic erectile dysfunction be reversed?
Sometimes partly. Better blood sugar control, weight loss and exercise can improve erectile function, especially early on. Long-standing nerve or vessel damage is harder to reverse, but treatment can still restore usable erections for many men.
Do Kegel exercises work for men with diabetes?
They can help. A 2026 randomised trial in men with diabetes found pelvic floor muscle training reduced ED. Results are usually modest, and they’re best combined with medical treatment and lifestyle changes.
How long until pelvic floor exercises help with ED?
Most trials measured results after 3 to 6 months of daily practice. Some men notice firmer erections sooner, but give it at least 12 weeks before judging.
Can I do pelvic floor exercises alongside Viagra or Cialis?
Yes. There’s no interaction, and the two work in different ways: the medicine improves blood flow and the exercises help hold it in. Talk to your doctor about which medicine and dose suits you.
The Bottom Line
Pelvic floor exercises are a sensible, low-risk add-on for men with diabetes and ED, and there’s now trial evidence in this exact group. They work by helping trap blood in the penis, not by fixing the vessel and nerve damage diabetes causes. Pair them with good blood sugar control, regular cardio and a proper check-up, and give them at least three months.