Chinese medicine is a traditional holistic medical practice originating from China, employing multiple natural therapeutic approaches, such as acupuncture and herbal medicine, in treating various medical problems. But can it help with erectile dysfunction?
According to conventional Western medicine, erectile dysfunction (ED) may have physical and psychological causes or a combination of both. Common physical causes include cardiovascular disease, diabetes, hypertension, and obesity – conditions that undermine proper blood vessel function and penile blood flow, while some damage penile nerve function. Common psychological causes include anxiety, stress, depression, or unresolved relationship problems.
The most common first-line therapy for ED caused by physical factors, is a class of drugs called ‘PDE5 inhibitors’, such as Viagra and Sialis, which increase penile blood flow during sexual arousal. When it comes to psychological causes, usually psychological treatment, psychotherapy, or sex therapy is advised.
A comprehensive systematic review of a few hundred studies found that short-term use of ED medications (up to 12 weeks) improved erectile function in 67% to 89% of ED patients – results which are quite encouraging. However, it has also been found that some patients do not respond to ED medications, while others cannot use them due to additional health problems or to medications that interact with ED drugs. Likewise, some men don’t comply with long-term drug treatment, and others prefer not to use conventional Western medicine and seek other treatment options.
How Does TCM Approaches Erectile Dysfunction?
According to TCM philosophy, the human body comprises an inner system that strives to be in a state of continuous balance and harmony, which is maintained by two elements called Yin-Yang. These elements represent two opposite yet complementary forces, which may result in disease if in a state of prolonged imbalance. In addition, according to TCM, the entire universe (including our bodies) contains a vital energy called Qi, which is the driving force of life. Qi flows in the body through designated energy channels, nourishing tissues and organs. From a TCM perspective, each organ in the body symbolically represents an entity having a unique function (that doesn’t necessarily equate with the “normal” physiological function of that organ), a specific emotion, a mental characteristic, etc. Therefore, although the organs in TCM have the same names as those in Western medicine, they refer to different functions and qualities.
Accordingly, in TCM, the ability to achieve and maintain an erection is associated symbolically with two primary organs:
- The liver is considered the organ which “controls” the penis and “stores the blood” and is responsible for the smooth flow of Qi in the body.
- The kidneys – responsible for storing Jing – the “life essence,” which is associated with sexual potency and the sex drive.
Treating ED According to TCM Philosophy
For thousands of years, Chinese medicine has developed an integrated therapeutic approach for treating ED, based on nutrition, acupuncture, herbs, and other modalities, to balance the function of organ systems and energy flow in the body by stimulating its natural healing processes.
Acupuncture is an ancient TCM modality employing thin needles that stimulate nerve-rich areas in the skin to influence energy systems, tissues, glands, organs, and body functions as means of treating various health problems. However, research into the use of acupuncture for treating ED is limited, and studies conducted so far have been small.
Most studies focused on acupuncture for the treatment of ED from psychological causes. A meta-analysis (2019) of 22 clinical studies, of which 14 examined the treatment of psychological ED, found that acupuncture had beneficial effects on erectile function. However, acupuncture combined with ED medication Sialis was more effective. In comparing acupuncture alone to acupuncture combined with herbal medicine, the latter showed enhanced efficacy. Another study suggested that acupuncture combined with psychological therapy may be better at reducing ED symptoms than psychotherapy alone. Likewise, scientific evidence indicated that acupuncture may improve ED associated with antidepressant use.
Medicinal herbs have been used for medical purposes since the dawn of humankind. In TCM, several medicinal herbs have been employed for centuries for enhancing sexual performance and for treating ED. Although some of these herbs were studied in clinical trials, because studies were small, there is still inconclusive scientific evidence regarding their efficacy. Other medicinal herbs have not been studied scientifically, and their efficacy is based on traditional Chinese medicine alone.
- Panax Ginseng Root– also known as Korean ginseng, this herb has been widely used in TCM for, inter alia, enhancing Qi and the kidney Yang element, increasing vitality and energy levels, reducing stress, balancing cholesterol and blood sugar levels, and as a treatment for ED and low mood. Panax ginseng may increase penile blood vessel levels of the molecule nitric oxide, consequently improving penile blood flow and ED symptoms, though more studies are needed to verify these effects.
- Epimedium(horny goat weed) – A well-known Chinese medicinal herb for treating ED, used to enhance kidney Yang. From a scientific perspective, few small studies found that icariin, one of the primary active constituents, may inhibit the enzyme PDE5 and consequently improve penile blood flow. However, larger clinical studies are needed to support this herb’s efficacy.
- Ligusticum(chuanxiong) – This herb is used in TCM to promote blood and Qi flow, improve blood circulation, and relieve pain. In an animal model study, the main active constituent, Ligustrazine, demonstrated blood vessel relaxation effects in the penile erectile bodies. However, large clinical studies are needed to support its efficacy for ED treatment.
- Cnidium Fruits(She Chuang Zi) – In TCM, Cnidium is regarded as having kidney yang enhancing effects. It has been used for many years in the treatment of ED and for increasing libido. Active constituents such as imperatorin, xanthotoxin, and ostholes have demonstrated vasodilating effects in animal model studies, possibly via increasing the production of nitric oxide in the blood vessels of the penile erectile bodies.
- Tribulus Fruits– Tribulus grows primarily in North China and has been recognized as an aphrodisiac since ancient times. It is considered in TCM a kidney young enhancer and as nourishing the “life essence” (Jing). Many animal studies have demonstrated that Tribulus may improve erectile function, and few studies have shown that it may enhance libido. Its mechanism of action has not been fully elucidated, though some studies indicated Tribulus may increase low blood testosterone levels.
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