Erectile dysfunction (ED), defined as the consistent inability to attain or maintain penile erection sufficient for satisfactory sexual performance, has become a global health issue with a high prevalence and considerable impact on the quality of life of sufferers and their partners. In addition, ED may share a common pathologic mechanism with cardiovascular diseases, metabolic syndromes, and other endocrine disorders. The cause of ED is complicated and may be divided into three categories: psychogenic causes, organic causes (including endogenous, vascular and drug causes) and mixed causes.
Currently, research focuses on the dysfunction of endothelial cells of the cavernous body of the penis and disordered release of NO. To date, several phosphodiesterase type-5 inhibitors have been developed. Despite the advances in clinical and basic research which have led to several new options, the ideal treatment of ED has not been identified [12].
TCM has been used to treat sexual dysfunction such as ED in China for more than 2,000 years. Many studies show that TCM treatment could significantly improve the quality of erection and sexual activity of ED patients [13–17]. TCM achieves better regulation, especially with regard to ED patients’ anxiety, fatigability, changing hormonal levels, insomnia, and gastroparesis.
Correct syndrome differentiation (“Bian Zheng”) was the prerequisite for achieving the hoped-for efficacy of TCM for treating ED. Syndrome differentiation is one of the essential characters of TCM. It means analyzing and judging the data obtained from the four diagnostic methods (inspection, auscultation and olfaction, inquiry, and pulse-taking and palpation) so to differentiate the nature, location, and cause of disease. So pattern differentiation is the premise and foundation of treatment.
In the past, traditional treatments based on syndrome differentiation (an overall analysis of signs and symptoms) placed importance on the kidneys and liver. Herbs and acupuncture points to invigorate qi can enhance physical fitness, and to warm the kidneys can regulate sex hormones, increase sexual drive, invigorate the spleen, regulate the stomach and improve the overall situation. Herbs and acupuncture points used for a stagnated liver provides tranquilisation and helps stabilize the mind, which can improve mental processes and emotional wellness. This treatment can not only increase the effects but also improve the patient’s overall condition and quality of life. More research also shows that using the concepts of integrative Chinese medicine, sexual dysfunction, especially ED with premature ejaculation, should be treated concurrently based on syndrome differentiation of the heart.
This approach does not conflict with the concept of TCM that the heart controls mental activities, blood circulation, and eroticism. Concurrent treatment of the heart and kidneys can coordinate these organs. Thus, the concept of integrated medicine offers a perfect, traditional treatment for erectile dysfunction and premature ejaculation.
According to the latest pharmacological research on TCM, many Chinese herbal medicines (e.g., ginseng, epimedium and pilose antler) function as the male sex hormone. According to domestic and international research, ginsenoside and red ginseng extracts can stimulate penis tissue to produce NO and phosphodiesterase type-5 inhibitors. Additionally, ginsenoside and red ginseng extracts can also regulate the function of sex glands and increase semen volume to reinforce sexuality. Epimedium and Lycium berry can inhibit nitric oxide synthase and are helpful for improving endothelial cell function in the penis and promoting the formation of NO.[18] Research has shown that Chai Hu Shu Gan San can increase the duration of erection in the male rat and can increase NO content in penis tissue. Medicine that promotes blood circulation, such as Tao Ren Si Wu and Jin Kui Shen Qi Wan, can help to regain an erection that was lost or achieve a repeat erection. Therefore, the treatment of ED with TCM has practical effects and is supported by scientific research.
In ED, acupuncture also has shown moderate efficacy, with an early study in 1999 of 16 men with ED treated with twice weekly acupuncture for 8 weeks demonstrating an improvement in erectile function in 39 % of men [19]. The potential mechanism of acupuncture for ED is that it may modulate the nitric oxide related to the treatment of ED [20].
Overall, TCM treatment for sexual dysfunction can not only increase the effects of simultaneous treatments but also improve the patient’s overall condition and quality of life.
Dr. Jing Fan treats at the AOMA acupuncture clinics. Request an Appointment with us today!
References:
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