Erectile dysfunction ED is the inability to keep an erection firm enough to perform a sexual function.
It is a very common condition; 30 million men in America suffer some level of erectile dysfunction.
As people age, it becomes more common, affecting up to 50% of men above 70 years old.
Erectile function is performed by a combination of nerve and vascular functions. The damage of any of them may produce erectile dysfunction.
Almost 50% of diabetic men will experience some degree of erectile dysfunction.
Traditional Chinese Medicine has a long story of treating erectile dysfunction. For ancient Chinese culture, virility was so important that they developed a lot of Chinese herbal drugs with formulation and remedies to treat impotence that improves sexual and reproductive functions.
First, let's see an introduction from a Western Medicine point of view, and then we will see how amazing it works in Traditional Chinese medical therapy.
Western Medicine Etiology
How the erectile function works from an anatomical point of view:
First, some anatomy:
The penis contains two chambers (Corpus cavernosum), a spongy tissue that fills the chambers that have smooth muscle cells, spaces, veins, arteries, and fibrous tissue. The urethra allows urination and ejaculation, surrounded by the corpus spongiosum.
The erection starts with sensory or mental stimulation or both. Impulses from the nerve system stimulate the relaxation of the corpus cavernosum smooth muscle cells
Usually, erectile dysfunction has a physical cause. However, any condition that causes nerve injury or reduces blood circulation into the penis can produce ED.
Diseases that damage nerves, arteries, or smooth muscle can have erectile dysfunction: diabetes, alcoholism, multiple sclerosis, atherosclerosis, vascular disease, etc.
Surgeries like prostate or bladder surgeries for cancer will damage the nerves and arteries around the penis, inhibiting erectile function.
Same habits that produce heart disease, like smoking, being overweight, lack of exercise, etc.
Medication side effects; common medications like antidepressants, antihistamines, appetite suppressants, or drugs for high blood pressure.
Psychogenic erectile dysfunction is only 10-20% of cases of erectile dysfunction, anxiety, stress, and fear of failure.
ED Treatment with Western Medicine:
Many options exist, from medication, counseling, lifestyle changes, surgeries, and vacuum devices to improve erectile function. But first, the root cause of erectile dysfunction should be discussed and treated.
The most famous medications to treat erectile dysfunction are Viagra, Cialis, or Levitra. They all work by relaxing the smooth muscles and increasing blood flow in the penis during sexual, mental, or physical stimulation.
If you have any Heart condition or are taking Nitrates medication, you should not take any of these medicines to treat ED because they may produce a dangerous drop in your blood pressure.
This can be a problem if you have any heart condition, high blood pressure, diabetes, high cholesterol, etc.
Typical side effects are dizziness, fainting, chest pain, nausea, arm pain, and decreased vision. In addition, some occasions may produce prolonged erections that, if not treated, can cause permanent damage.
Before taking these medications, you should always discuss this with your primary health provider.
Another popular medication is Testosterone; if the problem is nerve or circulatory damage, it won't work.
In most cases, surgery should be the last option. They usually are done to implant a prosthesis that allows the erectile function mechanically, but the possible side effects are malfunction or infections.
The other common surgery is to repair the arteries that improve erectile function eliminating the blood circulation problem. This surgery is best for men younger than 30.
This includes stopping smoking and drinking alcohol, improving your diet, start doing physical exercise, and changing with your doctor, medications that produce erectile dysfunction doing physical activity, and changing medications with your doctor.
Sometimes the root of the problem is believed to be psychological; in these cases, counseling could be a good solution.
ED in TCM Traditional Chinese Medicine:
According to the TCM theory, five elements rule the body, and five organs and viscera are related to those elements. The kidneys belong to the water element and are in charge of the reproductive system. The kidneys store the Pre-heaven essence or Jing, which is the inherited essence from parents, to nourish the fetus and control its growth after birth. It also rules on sexual maturation and fertility. It determines our constitution, strength, and vitality. It is the basis of our sexual function, erectile function in charge of producing sperm in men and ova and menstrual blood in women.
Insufficiency of Jing or essence will lead to infertility and erectile dysfunction.
According to Traditional Chinese medicine, the usual reasons for erectile dysfunction are:
As a man ages, he loses the Kidney essence, "The Fire of the Gate of Life." This essence is limited, and if we lose it or waste it, and if there is no more, erectile function can not be performed.
Excessive Sexual activity
Traditional Chinese medicine books refer to "sexual activity" as ejaculation. Most books, from ancient to modern, teach that an excess of ejaculation will deplete the Kidney Essence and will produce male erectile dysfunction.
For average men in good health, there are some recommendations:
Times per day or week
1/every 3 days
1/every 5 days
1/every 10 days
1/every 30 days
These are recommendations for ordinary healthy guys. Of course, if someone is stronger than average, he won't be affected if he overdoes it, but guys with health problems should reduce their ejaculation ratio to fasten their recovery of erectile function.
Excessive worry will affect the Heart and Spleen, and it may affect the blood flow disturbing erectile function. Also, constant fear and anxiety feelings will deplete the kidney energy producing erectile dysfunction.
Excessive physical activity
Too much physical activity without proper rest, like excessive running, may deplete Spleen and Kidney Yang and will produce erectile dysfunction.
Excessive consumption of carbohydrates, sugars, and fried food may increase the production of Dampness or Phlegm, which may produce sexual dysfunction.
To treat diabetic ED, this is essential, and the patient must reduce or eliminate carbohydrate consumption if he wants to recuperate his normal erectile function.
Working too many hours without proper food and rest for many years will deplete Kidney Essence. It is a typical cause of erectile dysfunction in middle age men.
Traditional Chinese medicine always encourages us to pay attention to recovery.
If you work hard, you need to rest, or you will burn out.
Traditional Chinese Medicine: Chinese Herbs for Erectile Dysfunction
In Traditional Chinese medicine, Kidney energy is fundamental to having a healthy libido, fertility, and erectile function. We can be divided into two big groups:
Kidney Yang deficiency:
Kidney yang deficiency symptoms:
Low libido, low sperm count, thin watery ejaculation, erectile dysfunction, cold intolerance, cold hands and feet, weak and sore low back and knees.
Kidney yang rules on sexual desire. Therefore, to improve erectile function need to improve Kidney Yang.
Tonify the Kidney and warm Yang.
We use Chinese Herbs like Wu Zi Yan Zong Wan, You Gui Wan, or Jin Kui Shen Qi Wan will help with erectile function recovery by warming the Kidney yang.
Acupuncture treatment with points like Du 4 and 20, Ren 4, Kid 7, or Bl 23 will help build up the kidney yang and recuperate the erectile function.
Treating this particular condition can take several months to achieve the desired result. Therefore, it is recommended to minimize ejaculation during the treatment to achieve better and fasters results.
Kidney Yin Deficiency:
Kidney Yin deficiency symptoms:
Scanty ejaculation, dry mouth, dizziness or tinnitus, insomnia, weakness, or painful low back or knees. A strong desire for sexual function but difficult to perform, especially while stressed or fatigued.
This is very common in men who overwork and don't have proper rest/recovery.
The most famous Chinese herb formula for Kidney Yin deficiency is Liu Wei Di Huang Wan. If erectile dysfunction is due to Kidney Yin deficiency, it will work.
Acupuncture treatment for this condition can be points like Ren 4, Kid 6, Sp 6, Ht 6, or Kid 7.
This male sexual dysfunction will need a long time to recover, probably several months. Very important to reduce sexual activity while treating erectile dysfunction.
Men who work long hours and are under pressure and men with a history of drug abuse, especially cocaine and marihuana, are more prone to develop Kidney Yin deficiency.
Damp Heat in the Lower Jiao
Damp Heat symptoms:
Difficult urination, turbid urine, itching genitals, erectile dysfunction, loose stools, lethargy, urethral discharge, heaviness feeling on legs, history of genital herpes, thick ejaculation, etc.
This condition is typical in men with acute or chronic prostatitis and with a history of alcohol abuse.
To treat impotence, the most famous Chinese herbal formula for this condition are Er Miao San, Bi Xie Fen Qing Yin, or Zhi Bai Di Huang Wan. These formulas resolve Damp Heat in the lower jiao and genital system and tonify the Kidney.
Traditional Chinese medicine TCM can use acupuncture points like Sp 4 with Pc 6, Lu 7 with Kid 6, Liv 5 and 3, Sp 9 and 6, Ren 2 and 3, etc for improving erectile function in cases of Damp Heat affecting the erectile function.
In this case, to treat ED, the patient must limit alcohol intake drastically.
Liver qi stagnation
Liver Qi Stagnation symptoms:
Erectile dysfunction in young men gets worse with emotions like anger and frustration. Typically men over stressed out from work or responsibilities. A sensation of tightness in the chest, frequent sighing, depression, abdominal bloating, Irregular Bowel Movements, premature ejaculation, etc.
To correct erectile dysfunction and treat ED, we move Liver qi and eliminate stagnation; we use Traditional Chinese herbs like the formula Xiao Yao San or Chai Hu Shu Gan San. These formulas improve erectile function when the root is Liver qi stagnation.
Acupuncture is very useful and improves erectile function drastically when the origin of the erectile dysfunction is due to the liver qi. We use points like Ren 6, Li 4 with Liv 3, Liv 5 and 14, GB 34, 13, etc.
Heart & Gall Bladder Qi Deficiency
Heart & Gall Bladder Qi Deficiency symptoms:
In addition to erectile dysfunction, the patient will suffer from insomnia, palpitations, timidity, anxiety, and panic attacks. In addition, the beneficial patient usually feels very nervous about intimate relationships.
Treating erectile dysfunction and promoting sexual function in patients with Heart and Gall Bladder deficiency with Traditional Chinese medicine implies the use of herbal formulas like Da Bu Yin Wan or Bai Zi Yang Xin Wan to tonify the Heart and Gall Bladder and acupuncture points likeHt 7, Shenmen, Ren 6, Du 20, St 36, Liv 3, Bl 18 and 19, Si 3, etc. to treat male sexual dysfunction and to improve erectile function.
Spleen Qi and Heart Blood deficiency
Spleen Qi and Heart Blood Deficiency symptoms:
This pattern affects sexual health in two ways; first, there is not enough blood to nourish the heart, and the patient will suffer from emotional problems, and second is that since there is not enough blood flow, it will be difficult to fill up the penis with blood.
This pattern has a strong psychological component.
Chinese herbs improve erectile function in this case with formulas like Gui Pi Tang or Bai Zi Yang Xin Wan. And we use acupuncture points like Ren 4, Bl 20, Bl 23, Sp, 6, St 36, and Ht 7 to stimulate Ht, Sp, and Kid.
Liver Blood Deficiency
Liver Blood Deficiency symptoms:
In addition to erectile dysfunction, the patient will present with dizziness, blurred vision, depression, insomnia, and possibly numbness in the legs or arms.
An excellent formula to promote erectile function recovery with this pattern would be Shao Yao Gan Cao Tang Jia Wei, and a good set of acupuncture points would be BL j18, Liv 8, St 36, and Pc 6 to nourish Liver Blood.
These are just some possible pattern examples. In real life, there are more; usually, they come in combinations and must be treated accordingly.
Studies on Acupuncture & Herbs on Male Sexual Dysfunction:
Traditional Chinese medicine TCM has a long history of improving fertility in both men and women with acupuncture treatment and Chinese herbs.
For example, this study shows that TCM is an effective alternative therapeutic method for ED. Moreover, here we can see plenty of references that probe its efficacy.
Li, H., Jiang, H., & Liu, J. (2017). Traditional Chinese medical therapy for erectile dysfunction. Translational Andrology and Urology, 6(2), 192-198. https://doi.org/10.21037/tau.2017.03.02
Acupuncture alone without Chinese herbs also has proved its efficacy in promoting a healthy erectile function. In this review from a Chinese database and also in PubMed, we can see the evidence of the effectiveness of acupuncture treatments.
Zhou X, Yang JY, Shi R, Ding MR, Shen P. [Rules of acupoint selection in the treatment of erectile dysfunction with acupuncture and moxibustion based on data mining technology]. Zhongguo Zhen Jiu. 2022 Feb 12;42(2):215-20. Chinese. doi: 10.13703/j.0255-2930.20201228-0009. PMID: 35152590.
In Traditional Chinese medicine TCM, there are a huge amount of books from ancient and modern times with references on how to treat ED; it is a very effective medicine and worth trying.
Where to Find Good Chinese Medicine Doctors
It is essential to choose wisely your practitioner.
In the US, a formal education guarantees a minimum of quality, basically that the professional will not damage you. But if you need successful treatment, you should choose professionals with experience and further education than the basics from the school.
In Soul Acupuncture & Herbal, in Fort Lauderdale, Florida, we have the best education and training possible; we have learned from the best acupuncturist and learning and worked with the best herbalist in the country.