It is a common problem for men over 40, but not one that is often talked about.
According to The Merck Manual, half the men between 40 and 70 experience Erectile Dysfunction (ED) at some point. ED is diagnosed when a man has consistent trouble developing or sustaining an erection for successful sexual intercourse.
Also known as impotence, it is a condition that is stressful, affects self-confidence and can contribute to relationship problems. However, it is also a condition that, in many instances, is treatable.
Holistic approach to treatment
From a Traditional Chinese Medicine (TCM) perspective, the ability to develop and maintain an erection is primarily the responsibility of the kidney and liver, with involvement from the heart and spleen, which are closely related. The kidney’s main function is to store “jing”, an essence that contains all the critical ingredients needed to make new life, and controls the maturation of sexual instinct. Insufficient kidney jing, qi or yang therefore, affects sexual function directly. As the liver meridians pass around the external genitals, a stagnation or obstruction of liver qi can also reduce a man’s ability to achieve and maintain an erection.
Another organ that often plays a part is the heart. Since sexual function is dependent on a man’s psychological state, deficient heart qi or heart blood as a result of anxiety or stress, for example, can result in ED.
To treat ED, it is first necessary to ascertain its cause. TCM classifies male infertility into six categories, each with its own clinical features.
- Kidney Yang Deficiency
Symptoms: coldness, fatigue, pale face, copious of clear urine
- Kidney Yin Deficiency
Symptoms: nights sweats, anxiety, irritability, fidgety
- Liver Qi Stagnation
Symptoms: emotional imbalance, chest discomfort, fullness around the rib area
Symptoms: itchiness and a foul smell in the scrotum area, soreness in the lower limbs, yellow urine
- Qi and Blood Deficiency
Symptoms: fatigue, chronic illness
- Heart and Spleen Deficiency
Symptoms: insomnia, palpitation, poor appetite
Generally speaking, the main cause of ED for men in their 30s and 40s is stress – perhaps due to the financial responsibility of buying a home or caring for a young family. The underlying cause of ED in these cases is often liver dysfunction and qi stagnation. As men move into their 50s, ED is more likely to be the result of kidney deficiencies and blood stagnation.1
TCM’s approach to treating ED is holistic, taking the view that a healthy body is a body in balance. As problems with sexual health are linked with imbalances of the kidney, liver and heart, therapies focus on restoring balance and a smooth flow of qi in these vulnerable systems. Once balance has been restored to the body, all functions, including sexual functions, improve.
Boosting bedroom performance
Diet is often the first line of defence when it comes to good health, and here too, diet plays a role. In general, a diet addressing ED should avoid foods that cause too much heat and dampness in the body, and include foods that nourish the blood, energy and yang. There are also specific foods that can improve sexual health2.
- Ginseng, often called “the king of herbs”, is perhaps the herb that has the most scientific support behind its use in cases of erectile dysfunction. The most often quoted is a 2002 study published in the Journal Of Urology3 involving 45 patients who took Ginseng three times a day for sixteen weeks, with a two week break in between. At the end of the study, 60 percent reported improved erectile function.
- Tongkat Ali, or Eurycoma longifolia jack, has long been used as an aphrodisiac and remedy for sexual disorders. Research done in 20124 suggests it might increase sexual libido, semen quality and quantity, and improve erectile function.
- Maca5 is a Peruvian herb used traditionally to enhance virility and fertility, and to improve energy. A 2009 Italian study6 where 50 men were given maca for 12 weeks concluded that maca supplements have a small but significant effect on the sexual health and well-being of men with mild erectile dysfunction.
- Oats are among the most effective tonic herbs for the nervous system and have long been used as an aphrodisiac to increase sex drive. Although there is some evidence for the use of oats as a herb for erectile dysfunction, its basis remains mostly folkloric.
- Vitamin E has been referred to as the ‘brain and bedroom’ vitamin. Vegetables rich in Vitamin E, such as the goji berry, asparagus and spinach, aid testosterone, oestrogen and progesterone production, which stimulate sexual responses such as clitoral swelling and vaginal lubrication.
The herb or combination of herbs prescribed by a TCM physician is based on the root cause of the individual’s ED. Herbs that are commonly prescribed for treating ED by invigorating the kidneys, for example, include cistanches herba, cervi cornu and epimedii folium. Some of these herbs also help nourish the blood and essence.
Cordyceps, a premium herb, nourishes the lung and kidney meridians. Since the kidneys are primarily responsible for fertility, consuming Cordyceps can help strengthen the kidneys, enhancing fertility.
Beyond diet, Qigong, a gentle, calming exercise, can also help men with ED. Qi refers to the vital energy in a person and Gong means practice or work. Together Qigong refers to intentionally enhancing the flow of Qi through the body’s meridians, or energy channels. There are specific exercises that target ED, including the Cyclical Circulation Practice of Mao-you Period (卯酉周天功), which directs qi to the dan tian, or lower abdomen.
Depending on the root cause of a man’s ED, acupuncture may also help. The acupuncturist targets specific points throughout the entire body to address imbalances. While small, a pilot study in 20037 found that 68.4 percent of 20 men suffering psychogenic erectile dysfunction reported improved erections following acupuncture. Ask your acupuncturist to show you an acupuncture point, located on the inner ankle, known as taixi or great stream. Massaging this point with your partner may enhance sexual desire and energy and can be a form of foreplay.
1 Lade, H. (27 May, 2012). Male Sexual Dysfunction by Will Maclean. Retrieved from The Acupuncture Clinic: https://www.theacupunctureclinic.co.nz/male-sexual-dysfunction-by-will-maclean/
2 Wiley, M. (2016). Restore Your Sexual Function With This Traditional Chinese Medicine Approach. Retrieved from Easy Health Options: http://easyhealthoptions.com/a-traditional-chinese-medicine-approach-to-restoring-sexual-function/
3 Wilson, M. (2015). Ginseng for Erectile Dysfunction. Retrieved from Morning Steel Web site: http://morningsteel.com/ginseng-for-erectile-dysfunction/
4 Ismail, S., Wan Mohammad, W., George, A., Nik Hussain, N., Musthapa Kamal, Z., & Liske, E. (1 November , 2012). Randomized Clinical Trial on the Use of PHYSTA Freeze-Dried Water Extract of Eurycoma longifolia for the Improvement of Quality of Life and Sexual Well-Being in Men. Retrieved from US National Library of Medicine, National Institutes of Health: https://www.ncbi.nlm.nih.gov/pubmed/23243445
5 Gonzales, G., Córdova, A., Vega, K., Chung, A., Villena, A., & Góñez, C. (1 January, 2003). Effect of Lepidium meyenii (Maca), a root with aphrodisiac and fertility-enhancing properties, on serum reproductive hormone levels in adult healthy men. Retrieved from US National Library of Medicine, National Institutes of Health Website: https://www.ncbi.nlm.nih.gov/pubmed/12525260/
6 Zenico, T., Cicero, A., Valmorri, L., Mercuriali, M., & Bercovich, E. (April, 2009). Subjective effects of Lepidium meyenii (Maca) extract on well-being and sexual performances in patients with mild erectile dysfunction: a randomised, double-blind clinical trial. Retrieved from US National Library of Medicine, National Institutes of Health: https://www.ncbi.nlm.nih.gov/pubmed/19260845
7 Engelhardt, P., Daha, L., Zils, T., Simak, R., König, K., & H., P. (October, 2003). Acupuncture in the treatment of psychogenic erectile dysfunction: first results of a prospective randomized placebo-controlled study. Retrieved from US National Library of Medicine, National Institutes of Health: https://www.ncbi.nlm.nih.gov/pubmed/14562135