When it comes to male sexual health, most people think about hormones, blood flow, or performance anxiety—but few understand the crucial role that nerves play. Specifically, the nerves that travel through your sacrum (the base of your spine) are key players in initiating and maintaining erections, sensation, and ejaculation. If you’re experiencing changes in your sexual function, your nervous system—and especially your pelvic nerves—could be at the root of it.
At Pelvic Path Physical Therapy in Marin County, we specialize in pelvic health and can help men better understand and improve their pelvic nerve function.
Understanding the Sacral Nerves
The sacrum houses a network of nerves that influence pelvic organs, sexual arousal, and pelvic floor muscles. Here are the key players:
- Pelvic Splanchnic Nerves (S2–S4): These parasympathetic nerves are responsible for initiating an erection by dilating blood vessels to the penis.
- Pudendal Nerve (S2–S4): This major somatic nerve controls sensation in the penis and motor function in the pelvic floor muscles that help maintain an erection and support ejaculation.
- Pelvic Plexus: A network of autonomic nerves that relays messages between the brain, spinal cord, and genitals.
- Muscles like the Bulbospongiosus & Ischiocavernosus: Innervated by the pudendal nerve, these muscles contract rhythmically during orgasm.
Common Causes of Nerve-Related Sexual Dysfunction
Several conditions and lifestyle factors can impair these nerves and lead to symptoms like erectile dysfunction (ED), pain, or numbness:
- Disc Herniations at L5–S1 or S1–S2: Can compress sacral nerves, altering erection and sensation.
- Pelvic Trauma or Surgery: Scar tissue can disrupt nerve signals.
- Prostatectomy (prostate removal): May damage nerves necessary for erection.
- Pelvic Floor Dysfunction: Tight, weak, or uncoordinated muscles can affect nerve function and blood flow.
- Chronic Sitting or Cycling: May compress the pudendal nerve, causing pain or numbness.
- Metabolic Conditions like Diabetes: Can lead to nerve degeneration and vascular damage.
How Physical Therapy Can Help
You don’t have to navigate these challenges alone. At Pelvic Path, our specialized physical therapists assess and treat the full neuromuscular system. Here’s how we help:
Comprehensive Evaluation:
- Nerve tension and mobility testing
- Pelvic floor muscle assessment
- Postural and movement analysis
- Lifestyle and history review (e.g., sitting habits, surgeries)
Tailored Treatment Plan:
- Manual therapy to address nerve entrapment and soft tissue restrictions
- Neuromuscular re-education to improve coordination and activation
- Breathwork and relaxation techniques to reduce sympathetic nervous system overdrive
- Electrical stimulation or biofeedback to improve muscle control and brain-body connection
- Coordination with urologists or functional medicine providers for a full-spectrum plan
When to Seek Help
If you’re dealing with any of the following, pelvic physical therapy could be part of your solution:
- Erectile dysfunction (especially when medications aren’t enough)
- Pelvic or perineal pain
- Post-surgical changes (e.g., after prostate surgery)
- Numbness or tingling in the groin or penis
- Difficulty achieving or maintaining an erection
Looking for Pelvic Physical Therapy in Marin?
At Pelvic Path Physical Therapy in San Rafael, CA, we work with men seeking answers, relief, and better performance. Whether you’ve been Googling “pelvic therapy near me” or “physical therapy Marin,” know that you’ve found a team that’s ready to support you.
Book an appointment with us today and take control of your pelvic and sexual health.
