Men's Pelvic Condition
Erectile Dysfunction
By Dr. Anthony J. Gordon, Doctor of Acupuncture | Last reviewed September 2026
Erections are harder to get, harder to keep, or not as firm as they used to be. Maybe pills help only partly. Maybe you also have pelvic tension, perineal pain or changes in sensation. The pelvic floor muscles play a direct role in erections, and when they are too tight or poorly coordinated, function suffers in ways that medication alone does not fix.
Prefer to talk it through? Call (516) 597-5400. Most new patients are seen within one to two weeks.
Overview
Understanding Erectile Dysfunction
An erection depends on healthy blood flow, working nerves, hormones and a pelvic floor that contracts and relaxes at the right times. The ischiocavernosus and bulbospongiosus muscles at the base of the penis help trap blood to maintain firmness. The pudendal nerve carries sensation and signals to these muscles.
When the pelvic floor is weak, erections can be harder to maintain. More often in the men Dr. Gordon sees, the pelvic floor is overactive: tight, tender and unable to relax. That tension can change blood flow patterns, irritate the pudendal nerve, and come with perineal pain, urinary symptoms, painful ejaculation or a semi-firm flaccid state. Stress and performance anxiety tighten these muscles further.
ED can be an early sign of heart disease, diabetes or hormonal problems, so a medical evaluation with your physician or urologist is important. Dr. Gordon's focus is the pelvic floor and nerve contributors, which are often overlooked and can be treated directly.
Erectile Dysfunction at a Glance
Also called
ED, impotence
Who it affects
Men of all ages, more common with age, but increasingly seen in younger men with pelvic floor tension
Medical causes to check
Cardiovascular disease, diabetes, low testosterone, medications
Pelvic contributors
Pelvic floor overactivity or weakness, pudendal nerve irritation, stress and bracing
Often seen with
Chronic prostatitis, hard flaccid syndrome, perineal pain, painful ejaculation
The Gap in Care
What Tests Check, and What They Can Miss
Checking blood flow, hormones and heart health is essential. But when those check out, or medication only partly helps, the pelvic floor and its nerves are worth checking.
What routine testing is looking for
- Blood flow and cardiovascular risk
- Testosterone and hormone levels
- Diabetes and metabolic health
- Medication side effects
What often keeps symptoms going
- A pelvic floor that is too tight to function normally
- Weak or poorly coordinated erection muscles
- Pudendal nerve irritation from sitting or cycling
- Perineal pain or tension that accompanies erections
- Stress that keeps the pelvic floor clenched
These are assessed with a pelvic floor and nerve examination.
Signs & Symptoms
Does This Sound Like You?
Symptoms vary from person to person. These are the patterns Dr. Gordon sees most often.
Difficulty getting an erection
Needing more stimulation or time than before, or not achieving an erection reliably.
Difficulty keeping an erection
Losing firmness during intercourse or before finishing.
Reduced firmness
Erections that are partial or feel less full than they used to.
Pelvic or perineal pain
Aching or tightness in the perineum, groin or base of the penis, before, during or after sex.
Changed sensation
Reduced sensitivity, numbness or tingling in the penis.
Painful ejaculation or urinary symptoms
Discomfort with orgasm, slow flow or urgency alongside erection changes.
Root Causes
The Four Drivers Dr. Gordon Looks For
Most people have more than one of these in play. Finding which one leads makes treatment more efficient.
Pelvic floor overactivity
A tight pelvic floor cannot contract and relax normally, which affects how erections build and hold, and often brings perineal pain.
Weak or uncoordinated erection muscles
The ischiocavernosus and bulbospongiosus help maintain firmness. If they are weak or poorly timed, erections fade sooner.
Pudendal nerve irritation
Compression from prolonged sitting, cycling or tight muscle can reduce sensation and signaling to the penis.
Stress and performance anxiety
Stress tightens the pelvic floor and interferes with the relaxed state needed for arousal, which can create a self-reinforcing cycle.
Your First Visit
How Dr. Gordon Evaluates Erectile Dysfunction
The initial evaluation runs 60 to 75 minutes. You leave with a clear picture of what is driving your symptoms, a written plan, a realistic timeline, and in most cases your first treatment.
Records and history review
Dr. Gordon reviews your medical workup, including cardiovascular, hormone and medication history, and what treatments you have tried.
Pelvic and hip assessment
Assessment of the perineum, groin, inner thighs, hips and lower abdomen for tension, trigger points and nerve sensitivity.
External pelvic floor assessment
The pelvic floor muscles are examined from the outside, with no internal exam. With you draped for comfort, gentle pressure around the perineum, sit bones, tailbone and inner thighs checks tone, tenderness and trigger points.
Lifestyle and load screen
Dr. Gordon looks at sitting, cycling, training, stress and sleep, which all influence pelvic floor function.
Plan and coordination
A clear plan, plus communication with your urologist or pelvic floor PT when that helps your care.
When to see a physician first
- Fever or chills with pelvic or urinary symptoms
- Inability to urinate
- Visible blood in the urine or semen
- Sudden, severe testicular pain or swelling
- A new lump in the testicle
- New numbness in the saddle area or loss of bladder or bowel control
If you have any of these, contact your doctor or go to the nearest emergency department.
Bring to your first visit
Records
Recent lab results, imaging reports and specialist notes. These can also be faxed ahead.
Treatment history
A short list of what you have tried and what did or did not help.
Clothing
Something comfortable and loose fitting.
Treatment
How Dr. Gordon Treats It
These are the tools Dr. Gordon uses most often for erectile dysfunction, chosen from your exam findings.
Primary approach
Intrapelvic & Extrapelvic Dry Needling
Dr. Gordon holds ASE certification in both intrapelvic and extrapelvic dry needling. Treatment focuses on releasing an overactive pelvic floor and the muscles at the base of the penis, along with hip and inner thigh tension. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum.
Learn about pelvic floor treatmentNerve focus
Neuro-Functional Acupuncture
Electro-acupuncture along the pudendal and sacral nerve pathways to support nerve signaling and sensation.
See servicesBetween visits
Pelvic Floor Balance & Team Coordination
Guidance on relaxing or strengthening the pelvic floor as needed, cycling and sitting habits, and stress, coordinated with your urologist or physician.
Referring provider? Contact the clinicWhat to Expect
A Typical Recovery Arc
Visits 1 to 3
Identify the pattern
Dr. Gordon determines whether tension, weakness or nerve irritation is leading and begins treatment.
Visits 4 to 8
Improve function
Many men notice less pelvic tension, better sensation and more reliable erections as the pelvic floor normalizes.
Visits 9 to 12 and beyond
Maintain progress
Visits are spaced out with a home plan that keeps the pelvic floor balanced.
Most patients are seen weekly or every other week during active care. Individual results vary with how long symptoms have been present and how reactive they are. Progress is reassessed at every visit.
Not sure how to describe it? Put your pain or discomfort into words before your visit
"Dr. Gordon is thoughtful, thorough and incredibly knowledgeable. He has significantly helped me with pain management and pelvic floor issues. I am grateful to have his expertise in my corner."
Dina Isola, Google Review
Erectile Dysfunction Questions
Answers About Erectile Dysfunction
Still unsure whether this is the right fit? Reach out before you book and Dr. Gordon will talk through your history with you.
Yes. The pelvic floor muscles help maintain firmness, and the pudendal nerve carries sensation and signals. Tension, weakness or nerve irritation in this area can all affect erections.
Yes. ED can be an early sign of heart disease, diabetes or hormone problems. A medical evaluation is important, and Dr. Gordon's care can work alongside it.
Yes. Continue any medication prescribed by your physician. Many men use both approaches together.
Not always. Many men with ED have a pelvic floor that is too tight. Strengthening a tight pelvic floor can make things worse. Dr. Gordon assesses which direction you need before recommending exercises.
Most men start with eight to twelve sessions with reassessment. Dr. Gordon gives you an estimate at your first visit.
Long hours on a poorly fitted saddle can compress the pudendal nerve and blood vessels. Dr. Gordon looks at your riding setup and habits as part of the plan.
Before You Book
General Questions
The clinic is an out-of-network practice. The initial evaluation is $300 and follow-up visits are $250. After each visit you receive a detailed superbill to submit to your PPO plan for possible reimbursement. FSA and HSA cards are accepted, and the clinic can run a complimentary benefits check before your first appointment. The check is a courtesy, so please confirm your coverage with your plan. See Insurance & Fees for details.
The first evaluation is 60 to 75 minutes and usually includes treatment. Follow-up visits run 45 to 60 minutes.
Yes. Call (516) 597-5400 or send a message through the contact page. This is especially helpful if your case is complex and you want to understand the approach before committing to a full evaluation.
1508 Union Turnpike, Suite 133, North New Hyde Park, NY 11040, with free parking on site. The clinic is an easy drive from Manhasset, Great Neck, Garden City, Lake Success, Floral Park and Mineola. Early morning, evening and weekend hours are available.
Most people feel a quick muscle twitch or a deep ache that lasts a few seconds. That twitch is a normal sign the trigger point is releasing. Mild soreness for 24 to 48 hours afterward, similar to a hard workout, is common. Depth, angle and stimulation are adjusted to your comfort.
Both use the same fine, sterile, single-use needles. Dry needling targets specific trigger points and tight bands in muscle based on your exam. Neuro-functional acupuncture targets nerve pathways, often with gentle electrical stimulation, to calm nerve sensitivity. For erectile dysfunction, Dr. Gordon commonly uses both.
When performed by a trained, licensed provider with detailed knowledge of anatomy, it has a strong safety record. Tell Dr. Gordon if you take blood thinners, have a bleeding disorder, are pregnant or have a weakened immune system so he can plan accordingly.
It is a technique that reaches the deep pelvic floor muscles, including the levator ani, obturator internus and coccygeus, to release trigger points and restore normal muscle function. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum. Dr. Gordon holds ASE certification in this technique, which few practitioners in New York have.
Yes. Your privacy and comfort come first. When undressing is needed for the area being treated, you are fully draped. Needles are placed through the skin only, and nothing is ever inserted into the vagina or rectum. You can pause or stop at any time.
Yes. Many men put off care for pelvic and genital symptoms because the topic feels awkward. Dr. Gordon keeps things straightforward and clinical, explains every step, and treats adults of all genders and identities in a respectful, welcoming setting.
It helps to have had a medical workup so serious causes have been checked. If you have not seen a urologist for these symptoms yet, call the clinic to talk through the best order of steps.
About Dr. Anthony J. Gordon
Dr. Anthony J. Gordon is a Doctor of Acupuncture licensed in New York and board certified. He holds ASE certification in intrapelvic and extrapelvic dry needling, along with advanced certifications in Functional Dry Needling and Neuro-Functional Acupuncture. With more than 18 years of clinical experience and over 3,000 complex cases treated, he focuses on pelvic, spinal and orthopedic conditions that have not responded to standard care, and works closely with each patient's physicians and physical therapists.
Read Dr. Gordon's full bioBook an Evaluation for Erectile Dysfunction
Book an evaluation with Dr. Gordon and find out whether pelvic floor tension or nerve irritation is affecting your erections.
Early morning, evening and weekend appointments available. Free on-site parking.
Symptoms
Common Symptoms of Erectile Dysfunction
Further Reading
Erectile Dysfunction and the Pelvic Floor: The Muscle Side of ED
From the blog: Two small pelvic floor muscles help an erection reach full firmness. How weak or tight muscles can add to ED, and why a urologist visit always comes first.