Erectile Dysfunction & Oriental Medicine

One condition always brings men to the clinic: when their penis isn’t working. Erectile dysfunction (ED) is the inability to attain or sustain a penile erection satisfactory for sexual intercourse. ED affects up to 20 to 25 million men in the US. The prevalence of partial or complete ED is > 50% in men aged 40 to 70 and prevalence increases with aging. In this article, we examine ED in the context of Oriental Medicine (OM) and explore treatment principles. 

Biomedicine Pathology, Etiology & Treatment

According to the Merck Manual, most erectile dysfunction is related to vascular, neurologic, psychologic and hormonal disorders; drug use can also be a cause. Evaluation typically includes screening for underlying disorders and measuring testosterone levels. Treatment options include oral phosphodiesterase inhibitors, intraurethral or intracavernosal prostaglandins, vacuum erection devices, and surgical implants. The major causes of ED are:

  • Vascular disorders – most common is atherosclerosis of cavernous arteries of the penis, often caused by smoking and/or diabetes.
  • Neurologic disorders – stroke, partial seizures, multiple sclerosis, peripheral and autonomic neuropathies, and spinal cord injuries.
  • Drugs – Anti-hypertensives, anti-psychotics, anti-depressants, sedatives, diuretics, steroids, alcohol, methadone, heroin, cannabis, and tobacco.
  • Other – Aging, hyperprolactinemia, hypogonadism, hypothyroidism, hypopituitarism, orchitis, prostatitis, psychogenic (anxiety, loss of interest, boredom, depression, fear of sexual incompetence, marital discord or guilt over unconventional sexual impulses), excessive fatigue or stress.

Finally, any endocrinopathy associated with testosterone deficiency may decrease libido and cause ED. However erectile function only rarely improves with normalization of serum testosterone levels.

Oriental Medicine Pathology, Etiology & Treatment

In oriental medicine (OM) terms penile erectile function is connected to the Kidney and the Liver. Kidney Yang controls the functional aspect of an erection and Kidney Jing the ability to reproduce while the Liver channel passes through the external genitals. The weakness of the Kidney reduces the physiological “Fire of Desire” while the stagnation of Liver Qi reduces the physical ability.

Sexual function depends not only on sound physiological health but also on the psychological state. Thus the emotional aspects of the Heart, Liver and Kidney systems can all influence sexual ability. Mental stress can obstruct the flow of Liver Qi which can have a dismal effect on the functioning of the ‘Ancestral Tendon of the Liver’ (as the penis is sometimes known). Anxiety and extremes of emotion, which destabilize Heart and Shen can interfere with erectile function.

Another OM aspect of ED is related to Kidney dysfunction from fear or shock. In this case, severe fright damages the Zhi (willpower) and the Shen (spirit) profoundly, such that timidity and nervousness become constant personality traits. Such traits do not lend themselves to confident and effective sexual encounters.

Oriental Medicine Patterns & Treatments Principles

Liver Qi Stagnation

Frustration, anger, resentment, prolonged emotional turmoil and stress disrupt the circulation of Liver Qi and because the Liver channel passes through the penis, insufficient Qi arrives to enable an erection. This type of ED is often found in men stressed by overwork or facing the emotional conflicts of a midlife crisis and also seen in younger men overwrought with sexual anxiety or frustration.

Clinical Features

  • Inability to get/sustain an erection, loss of libido
  • Tightness/fullness in the chest, hypochondriac discomfort or tightness, vague aches and pains, frequent sighing, dizziness, irritability, depression
  • Abdominal distention, flatulence, alternating constipation and diarrhea
  • The tongue is normal or dark, maybe with red edges and pulse is generally wiry

Treatment Principles

  • Regulate and soothe Liver Qi
  • Support Yang

Damp Heat

The Damp Heat that causes ED is most commonly a disorder of overconsumption of alcohol and rich foods. It can also be generated in the lower jiao by any long term Heat in the system, such as Heat generated by yin deficiency, qi stagnation or by prolonged stagnation of Dampness. In some cases, it may be due to an unresolved or poorly treated external Damp-Heat pathogen. In this case, the Damp Heat often lingers in the lower jiao as low-grade infection (chronic prostatitis). In every case, Damp-Heat weakens and softens the tendons (which include the penis).

Clinical Features

  • Inability to get/sustain an erection
  • Loose stools or alternating constipation/diarrhea, concentrated urine
  • Heaviness and aching in lower limbs, lethargy, afternoon fatigue
  • Possible excessive sweating in groin area and scrotum, itching or pain in genitals
  • The tongue has a greasy yellow coat, especially over the root. Pulse is likely deep and slippery or soft and slippery – possibly rapid.

Treatment Principle

  • Clear Dampness and Heat

Kidney Deficiency

Kidney deficiency is an important cause of ED. It can involve either Jing, Yang or Yin deficiency or a combination. It can be inherited or may develop as a result of overwork, age, chronic illness or excessive ejaculation.

Kidney Yang Deficiency

Kidney Yang is the basis of sexual desire and also plays a role in the mechanics of getting and sustaining an erection.

Clinical Features

  • Low libido, inability to get/maintain an erection
  • Listlessness and fatigue, pale complexion, cold intolerant, cold extremities, urinary frequency, nocturia or edema of lower limbs with scanty urine
  • Weak, cold and sore lower back and knees
  • The tongue is pale wet and swollen, the pulse is deep and thready or slow and weak

Treatment Principles

  • Tonify the Kidneys
  • Warm and support the Yang

Kidney Yin Deficiency

Kidney Yin is damaged through overwork (especially while under stress), late nights, shift work, insufficient sleep, febrile diseases, insufficient hydration and the use of some prescription, recreational and in this case, tonic drugs. Kidney Yin deficiency type ED is fairly common in young men (in their 30s and 40s) who consume large quantities of hot-natured yang tonic herbs like red ginseng and deer horn to increase sexual potency.

Clinical Features

  • ED or premature ejaculation worse when the patient is stressed or fatigued. Maybe frequent desire for sex but the inability to initiate or maintain an erection or there may be erotic dreams with spontaneous emission.
  • Soreness or weakness of lower back and knees (possibly exacerbated by sex)
  • Dry mouth and throat, insomnia, restlessness, facial flushing, molar flush, night sweats, five palm heat
  • The tendency to dry stools and constipation
  • The tongue is  red and dry with little or no coat, the pulse is thready and rapid

Treatment Principle

  • Nourish and Strengthen Kidney Yin

Notes

  • This pattern can be constitutional or a complication of chronic Liver Qi stagnation that generates Heat, or lingering Damp Heat, both of which may consume Yin. It may develop in men who work long hours under significant pressure or in men who have a history of excessive sexual activity and drug use (Marijuana and cocaine are particularly dangerous to Kidney Yin).
  • Also, drugs like Viagra or Cialis that enable men to have erections can prove counterproductive for patients in this category. The excessive sexual desire they experience combined with the drug-assisted ability to have frequent sexual intercourse can lead to further exhaustion of Yin.

Heart Blood & Spleen Qi Deficiency

Overwork, physical and mental exhaustion, worry, irregular diet, and too much raw or sweet food can damage the Spleen when then fails to generate sufficient Qi and Blood. Similarly, any situation that overwhelms the Spleen’s ability to replace Qi and Blood, like prolonged or severe illness, can lead to Qi and Blood deficiency. The primary weakness in this pattern is in the Spleen, which is unable to generate enough blood to nourish the Heart and stabilize the Shen. The instability of the Shen can then be the basis of ED with psychological components. Weakened or scattered Shen cannot lead Qi to the penis or if an erection occurs it can easily be lost.

Clinical Features

  • Inability to get or maintain an erection, possibly associated with performance anxiety; ED worse with fatigue – erections obtained during sleep or masturbation.
  • Pale complexion, fatigue, low spirits, insomnia, dream disturbed sleep, forgetfulness, palpitations with or without anxiety, panic attacks.
  • The tongue is pale with a thin white coat, the pulse is thready and weak

Treatment Principle

  • Tonify and nourish Heart and Spleen
  • Support Yang

Heart and Gallbladder Qi Deficiency

This pattern describes an anxious or timid personality type, traits that may be congenital or acquired. When congenital it can be the result of a significant shock or prolonged fearful situation experienced by the mother during pregnancy or weakness of the parental Kidney Jing. When acquired it is the result of some sudden and violent or extreme shock or fright. Other, more insidious events, like emotional or physical abuse during childhood, may contribute. It may also sometimes follow other debilitating illnesses that plunder Qi. This pattern also underlies the impotence of psychogenic origin.

Clinical Features

  • Inability to get/sustain an erection
  • The patient is anxious, timid, shy, easily startled and may appear very nervous and maybe very uneasy about intimate relationships
  • Palpitations and insomnia
  • The tongue is thin with a greasy coat, the pulse is wiry and Thread

Treatment Principle

  • Benefit the Heart, Gallbladder, and Kidney, calm the Shen
  • Support Yang

Conclusion

While modern drug therapy claims good success in increasing the ability to achieve erections it does nothing to address the underlying causes of ED. Chinese medicine allows us to pinpoint the root causes of men’s sexual health issues. In addition to counseling and acupuncture, patent or customized herbal formulas can provide effective and convenient treatments so that patients can regain their potency in a natural way and enjoy an healthy sex life. Do not hesitate to contact us if you are concerned about your sexual health.

Acupuncture for Mental Health

Everyone encounters emotional distress or major upheavals in our lives that can trigger a wide range of unexpected feelings, major disruptions to our daily functioning (sleep, exercise and diet), or clinical disorders (depression, anxiety, and PTSD). In Chinese medicine, mental health problems are viewed as imbalances between the yin and yang energies of the body, including consideration of lifestyle, diet, and constitution. Our body is made up of a living energy called Qi, and this energy circulates the body, including the major organs, through channels or meridians. Emotional and physical disruptions produce imbalance of qi in the meridians that acupuncture can address. Acupuncture can be an adequate modality for treating mental health issues because treatments plans are customized and designed to address root causes of patterns by helping to restore balance at all levels, body and mind.

This is how acupuncture helps:

  • Acupuncture raises the level of endorphins in the brain. Endorphins are neurotransmitters naturally produced in the brain to fight pain. They can also positively affect the mood.
  • Acupuncture can lower blood pressure, induce relaxation, increase circulation, decrease anxiety and treat sleeplessness to help patients better regulate their emotions and responses to stress.
  • Acupuncture can help regulate serotonin, a chemical in the brain that affects our emotional state.

No one needs to go through recovery alone. Your acupuncturist is here to help you regain balance in your body and mind.

Herbs & Mental Health

Chinese herbology can relieve emotional distress by treating the root cause of the mental state. In conjunction with acupuncture, herbal therapy can help restore balance in the body and mind. Chinese herbal medicine is often prescribed in these two ways:

  • Patent formulas – used to treat common for anxiety, PMS, headaches, depression, low energy, palpitations.
  • Custom formulas – no two patients and pain manifestation and type are alike; this is why our pharmacy can prepare custom formulas tailored to each case.

Upon requesting for herbal medicine, please inform us of all medications you are currently taking as some herbs may have adverse reactions to certain pharmaceuticals.

What About Diet & Mental Health?

A very large body of evidence now exists that suggests diet is as important to mental health as it is to physical health,” says Felice Jacka, president of the International Society for Nutritional Psychiatry Research. “A healthy diet is protective and an unhealthy diet is a risk factor for depression and anxiety.”

Sport Medicine & Oriental Medicine

Swimming great Michael Phelps, NFL Pro Bowler Tony Richards, Tour de France winner Vincenzo Nibali, and 18-time NBA All-star Kobe Bryant are just a few of the elite athletes who receive regular acupuncture, cupping and/or tuina treatments.

How can you benefit from the same level of support at your own level of fitness? Through acupuncture’s ability to:

  • Reduce inflammation, increase circulation and relax tense muscles.
  • Speed up healing of sprains, strains and soft tissue injuries such as bruises and tendonitis.
  • Naturally boost energy levels.

What about cupping & sports?

US Swimmer Michael Phelps made the headlines with cupping marks during the 2016 Olympics. Cupping involves placing a glass or plastic cup in problem areas and creating a vacuum inside the cup – suction is created on the skin surface. Stationary or massage cupping is a top modality to:

  • Remove toxins and alleviate inflammation.
  • Ease stiff muscles, particularly when using massage cupping.
  • Promote the healing of any injury or pain, from sports or other causes.
  • Alleviate respiratory congestion.

Ask us if cupping could benefit you!

Herbs & Sports

In 1993 when the Chinese women’s track and field team broke multiple world records, the world found out that all the members consumed a special drink made from Cordyceps Sinensis. The modern practice of herbal medicine, diet and supplementation can contribute to:

  • Enhanced performance in sports and daily life.
  • Faster healing and recovery for injuries such as broken bones, sprains, and strains.
  • Less fatigue from strenuous workouts or overtraining.

Ask during your consultation about how herbs and supplements can support your active lifestyle and contribute to a balanced training regimen in any sport or activity.

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Rén Shēn / Ginseng Radix


Qi Tonic - Tonifies source Qi, strengthens Spleen and Stomach, tonifies Lungs, generates fluids, benefits Heart Qi and clams the spirit

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