Efficacy of pelvic floor muscle training in the management of premature ejaculation: a systematic review and meta-analysis of randomized controlled trials
Abstract
Background: Premature ejaculation (PE) is a prevalent sexual dysfunction (5%-15%), and pelvic floor muscle training (PFMT) has been proposed as a non-pharmacological alternative to improve intravaginal ejaculatory latency time (IELT).
Aim: To evaluate the efficacy of PFMT in the management of PE through a systematic review and meta-analysis of randomized controlled trials.
Methods: Randomized controlled trials involving men diagnosed with PE were included, searched in CINAHL, Clinical Trials, CENTRAL, Embase, MEDLINE, PEDro, SciELO, Scopus, and Web of Science up to October 2025, with no restrictions on time or language. The Rayyan software was used for study screening, and risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool by 2 independent reviewers (F.A.O. and L.B.L.) Statistical analysis was performed using Review Manager 5 with a random-effects model. The primary outcome was IELT, which was reported as both mean and median, and the estimated values were standardized for the meta-analysis. Sensitivity analysis evaluated the impact of heterogeneity and risk of bias on the effect of PFMT.
Outcomes: Five studies were included in this review and assessed in the meta-analysis. A total of 236 men participated in the studies, and 216 were randomized across the groups included in the meta-analysis. Pelvic floor muscle training and sphincter control training (SCT) showed a smaller effect on IELT compared with control interventions using dapoxetine or combined…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 236 participants or records.
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