Men's pelvic health · Hawaii Island
Pelvic floor physical therapy for erectile dysfunction in Hawaii Island
The pelvic floor muscles help maintain an erection by holding blood in the penis. When they are weak or poorly coordinated, pelvic floor training improves erectile function, and in trials it has matched medication for some men.
- TRICARE, HMSA, and HMSA QUEST in-network
- No state referral requirement; some plans need one
- Video visits anywhere in Hawaii Island
About the condition
Pelvic floor and erectile dysfunction: what is going on.
Two pelvic floor muscles, the bulbospongiosus and ischiocavernosus, compress the veins that drain the penis and help maintain rigidity. Men whose pelvic floor is weak, or who hold it chronically tight, often have erections that are hard to maintain, premature ejaculation, or both. After prostate surgery, pelvic floor training is also part of penile rehabilitation. Vascular, hormonal, and psychological causes are evaluated by a physician; the muscular contribution is what physical therapy treats.
A randomized trial published in BJU International found that pelvic floor training with biofeedback restored normal erectile function in 40 percent of men with erectile dysfunction and improved it in another 35 percent, a result comparable to medication.
Common experiences
What people with pelvic floor and erectile dysfunction often describe
These are the patterns Dr. Shalem hears most often. Any of them is a reason to book a discovery call.
Difficulty maintaining an erection
Premature ejaculation
Erectile changes after prostate surgery
Pelvic pain or tension alongside sexual symptoms
Partial response to medication
Wanting a non-drug option
Treatment
How physical therapy addresses it.
The program teaches precise pelvic floor activation and relaxation, builds strength and endurance in the muscles that support erection, addresses overactivity when that is the problem, and integrates the training into sexual activity. It works alongside medical treatment and the urologist's plan.
What a video visit looks like
Visits are private and one-on-one. Dr. Shalem guides a self-assessment on camera and progresses the program by patient report, with no examination required.
Coverage in Hawaii
Insurance and pricing
Bring your plan name to the discovery call and we confirm your physical therapy benefit before the first visit.
TRICARE
In-network (TRICARE West). TRICARE Select members can book directly with no referral. TRICARE Prime members need a referral from their primary care manager, and we tell you exactly what to ask for.
HMSA
In-network with HMSA PPO and HMO plans. Some HMSA plans require a referral from your primary care provider; we check yours before the first visit.
HMSA QUEST
In-network with HMSA QUEST (Hawaii Medicaid). We confirm coverage before your first visit.
Private pay
Available for any other plan. HSA and FSA cards accepted.
Referrals
Hawaii allows you to start physical therapy without a physician referral. Your insurance plan may still ask for one (TRICARE Prime and some HMSA plans do), and we check that for you before the first visit.
Every district of Hawaii Island is seen by video, from Hilo and Puna to Kona, Kohala, and Kau.
Questions
Questions people ask about pelvic floor and erectile dysfunction
How it works
How a virtual visit works
Visits are private and one-on-one. Dr. Shalem guides a self-assessment on camera and progresses the program by patient report, with no examination required.
Discovery call
15 minutes, free, by phoneA short call to hear what is going on, explain how visits work, and check insurance or pricing. No pressure to book.
Evaluation
60 minutes, by videoDr. Shalem takes a full history, watches how you move and breathe, and guides the self-assessments she needs to build a plan.
Your plan
Same visitYou leave the evaluation with a plain-language explanation and a short home program, usually a few minutes a day.
Follow-ups
45 minutes, every 1 to 2 weeksProgress checks, program updates, and techniques you can do yourself, for as long as they are useful.
For a video visit you will need
- A phone, tablet, or laptop with a camera
- A private room
- A mat or towel
- About an hour
Questions
Pelvic floor and erectile dysfunction questions in Hawaii Island
Does this replace medication?
For some men it reduces or removes the need. For others it works alongside medication. That decision belongs with the patient and their physician.
How long does it take?
Most trials ran three to six months of regular training. Many men notice change within six to eight weeks.
Is this treatment embarrassing?
Visits are clinical, private, and from home. Nothing is shown on camera. Most men find it far easier than they expected.
Do I need a referral for physical therapy in Hawaii?
Hawaii allows you to start physical therapy without a physician referral. Your insurance plan may still ask for one (TRICARE Prime and some HMSA plans do), and we check that for you before the first visit.
What insurance do you take in Hawaii?
TRICARE: In-network (TRICARE West). TRICARE Select members can book directly with no referral. TRICARE Prime members need a referral from their primary care manager, and we tell you exactly what to ask for. HMSA: In-network with HMSA PPO and HMO plans. Some HMSA plans require a referral from your primary care provider; we check yours before the first visit. HMSA QUEST: In-network with HMSA QUEST (Hawaii Medicaid). We confirm coverage before your first visit. Private pay: Available for any other plan. HSA and FSA cards accepted.
Your physical therapist
Dr. Elana Shalem, DPT
Doctor of Physical Therapy, University of St. Augustine for Health Sciences, Miami. Licensed in Hawaii.
Dr. Shalem treats pelvic health for women and men, from pregnancy and postpartum recovery to bladder, bowel, and pelvic pain conditions and recovery after prostate or pelvic surgery, and general orthopedic conditions of the back, neck, hips, knees, shoulders, and feet. Visits are one-on-one and unhurried, and she explains what she is seeing in plain language.
More about Dr. ShalemPrefer to write? Send a message.
Questions about insurance, pricing, or whether physical therapy is the right next step? We reply within one business day.
Start with a free 15-minute call.
Tell us what is going on, hear how Dr. Shalem would approach it, and decide from there.