In her 2009 book Heal Pelvic Pain, Amy Stein states that "studies have shown that more than 90 percent of men who suffer pelvic pain also experience sexual dysfunction, and that more than half of them improved their sexual function through massage of the pelvic floor muscles and relaxation techniques." Rosenbaum and Owens agree, reporting that "manual techniques, including massage, stretching, and soft tissue and bony mobilizations are important components of treatment." īelow are several categories of male sexual dysfunction, including Erectile Dysfunction, Painful Ejaculation, Premature Ejaculation, Pain in the Penis, Chronic Scrotal / Testicular Pain, Anodyspareunia/Male Dyspareunia: Painful or Difficult Receptive Anal Sex, and Pelvic Pain as Sexual Pain. "Recently, musculoskeletal factors have been recognized as significant contributors to the mechanism of pelvic pain and associated sexual dysfunction, and in particular, pelvic floor muscle hypertonus has been implicated" according to an article in the Journal of Sexual Medicine. Conversely, chronic tension or persistent weakness can lead to dysfunction and pain, as well as a diminished sensory experience and lack of sexual feelings. Maintaining good muscle tone and the ability to fully contract and relax these muscles improves sexual functioning and and enhances the perception of pleasure. "In women and men, the pelvic floor is an active sexual organ." Its role in sexual dysfunction, however, is often underestimated or overlooked. The muscles of the pelvic floor are essential to healthy sexual function.