Impotence

Introduction	Back to Top
Impotence is the most common male sexual dysfunction reported. This refers to the condition in which the penis fails to erect during coitus or the erection is not strong enough or cannot sustain long enough for completing the entire coitus process. In traditional Chinese medicine, this disease belongs in the categories of “impotence”, “dysfunction of external genitals”, “external genitals erection failure” etc.

Etiology/Pathogenisis	Back to Top
Impotence is the most common male sexual dysfunction reported. This refers to the condition in which the penis fails to erect during coitus or the erection is not strong enough or cannot sustain long enough for completing the entire coitus process. In traditional Chinese medicine, this disease belongs in the categories of “impotence”, “dysfunction of external genitals”, “external genitals erection failure” etc.

Primary Treatments with Medicinal Herbs	Back to Top
Wu Zi Yan Zong Wan LinYu Qun, et al. used Wu Zi Yan Zong Wan to treat sexual impotence caused by panic induced kidney injury. The principles used for the treatment were warming and recuperating the kidney-yang, regulating the flow of qi, and tranquilizing the mind. They achieved encouraging results with this treatment.(3) Modified Wu Zi Yan Zong Wan and a medicinal meal for promoting the generation of vital essence were used to treat male infertility. The formula was modified according to each individual's symptoms. It consisted of Gou Qi Zi (Wolfberry Fuit), Tu Si Zi (Dodder Seed), Fu Pen Zi (Raspberry), Wu Wei Zi (Schisandra Fruit), Che Qian Zi (Plantain), Jin Yin Zi (Cherokee Rose-hip), Sang Shen Zi (Mulberry), and Xian Lin Pi (Epimidium). The decoction was orally taken once a day for 1 month as a therapeutic course of treatment. The results showed full recovery for 28 cases, improvement in 13 cases, and no effectiveness in 8 cases. The total effectiveness rate was 83.7%.(4)

Other Treatments with Medicinal Herbs	Back to Top
Yang Huo Decoction Li Xue Xin used a modification of a Yang Huo Decoction in the treatment of impotence. Method used: In case of spleen and kidney Yang deficiency with stagnant coagulated damp phlegm type, Lu Jiao Jiao (Antler Glue), Bai Jie Zi (White Mustard Seed), Gui Zhi (Cinnamon Twig), Gan Jiang (Dried Ginger), Ban Xia (Pinellia), Chen Pi (Citrus), Yin Yang Huo (Epimedium), Jiu Xiang Chong (Aspongopus), Shou Di (Cooked Rehmannia), Shan Yao (Dioscorea), and Ma Huang (Ma-huang). For symptoms defined as “decline of the fire from the gate of life” and cold accumulation in penis, the herbs used were Lu Jiao Jiao (Antler Glue), Fu Zi (Aconite), Bai Jie Zi (White Mustard Seed), Yin Yang Huo (Epimedium), Ba Ji Tian (Morinda), Gan Jiang (Dried Ginger), Shou Di (Cooked Rehmannia), Wu Yao (Lindera), Rou Gui (Cinnamon Bark) powder, Ma Huang (Chinese Ephedra herb), and Xiao Hui Xiang (Fennel Fruit). A decoction of this formula was taken once daily. Results for 35 cases were: 26 cases significantly improved, 5 cases improved, and 4 cases had no effectivness. The rate of effectiveness was 91.3%.(5) Jiao Tai Pill Hu Yin Gui treated impotence with a modified Jiao Tai pill. This formula consists of Huang Lian, Rou Gui, Yin Yang Huo, Ba Ji Tian, Zao Ren, Bo Zi Ren, and Mai Dong. The dose consisted of a 1-part water decoction daily, divided into 3 administrations. 7 days constituted one course of treatment. Standards for efficacy are defined as follows: effective: lasting 1-2 minutes from copulation to ejection; significantly effectiveness: 2-3 minutes; and full recovery: longer than 3 minutes with satisfactory sexual activity. The results showed that among 86 cases, 25 cases had fully recovered, 7 cases showed significant effectiveness, 17 cases were improved, and 7 cases had no effectiveness. The total effective rate was 92%.(6)

Other Treatments	Back to Top
Massage Treatment Bai Duan used massage to treat impotence of psychological origin. Method: The patient's head was patted by the lateral surface of both hands of the practitioner. He then pushed his palms from the interscapular region downward to the heels of both feet. This maneuver was repeated several times. Then he rubbed both palms from the lateral loin to the interscapular region for several cycles. He used the thumb from the Xin Shu point on both sides to the San Shu point several times. He then rolled the fist on the loin region for 2 minutes. Rolling the fist from San Shu point to Zhi Bian point for several cycles, Ming Men, San Shu, and Zhi Shi rubbed on with the eminence of the little finger for 1 minute. With the middle finger, he knocked on the loin Yang Gui many times. He rubbed on the buttock with both palms; then rubbed with the thumb from the medial side of sacral tubercle to the perineal region for several cycles. He rubbed the point on both Yang Gu and Tai Xi for 1 minute each, and rubbed Gui Yuan, Zhong Ji, and Quan Qu for 2 minutes. After that, he pushed from the anterior superior iliac protuberance towards the penis several times. The lower abdomen was rubbed with a single palm for 1 minute, then, using the palm, he shook on Shen Qu for 1 minute. He pushed and rubbed on the abdomen clockwise several times; slightly beating on it with the fourth finger from the umbilical region to the symphysis pubis many times. He then pointed on both sides of Zu San Li and San Yin Jiao, 1 minute for each point. Then the treatment was finished. Each session lasts 20 minutes. 10 times constituted one course of treatment. Results for the 38 cases treated showed that 41 cases fully recovered and 3 had no effect.(7)

Acupuncture & Acupressure	Back to Top
Zou Jiang Hou treated impotence with acupuncture on the Hui Yin point. The method used was to precisely locate and press on the point with left hand, holding the needle with right hand and directly inserted into the skin 1-1.5 cun. The sensation of numbness and fullness irradiated to perineal region after De-Qi. Bilateral Hui Yin point connected to electro-acupuncture therapeutic apparatus and stimulated with continuous wave in the frequency within the tolerance of the patient. The needles were maintained in place for 30 minutes. Among the 40 cases treated, 33 (82.5%) cases had fully recovered, 28 cases recovered after 1-2 courses of treatment. and 5 cases after 3 courses. 6 (15%) cases improved, and 1(2.5%) case had no effect. The total effective rate was 97.5%.(8) An acupuncture treatment for impotence was conducted by Xian Jia Zhang. The method used: he inserted the needle directly on 1 cun lateral to Qugu. The needle was inserted obliquely and downward on point Guan Yuan and Zhong Ji until a sensation of soreness, fullness, and slight pain in penis and balanus was felt. The needle was kept in place for 30 minutes and was manipulated every 10 minutes. The methods of manipulation include upward lifting, downward insertion, rotation, and ordinary reinforcing and reduction. Points used in combination with different conditions: Deficiency in kidney yang combined with Shenshu and San Yin Jiao; heart and kidney yin deficiency combined with Xin Shu, Shen Shu, Zu San Li, and San Yin Jiao; both heart and spleen deficiency combined with Xin Shu, Pi Shu, Zhong Wan, Zu San Li, and San Yin Jiao; liver qi stagnancy combined with Xing Jian, Qu Gu, Ji Mai, and Hui Yin; downward flow of damp heat combined with Qu Quan, Zu San Li, Shen Que, and Zhong Wan. The manipulation methods used for all were lifting, inserting, and rotation. Results showed that among the 76 cases treated, 57 cases were resolved, 7 cases significantly improved, and 5 cases improved. The total effective rate of this study was 90.8%.(9)

Footnotes	Back to Top
¹ Research literature on ancient Chinese medicine's diagnosis and treatment of impotence. Journal of Nanjin University of TCM. 1999;15(5): 311-314. ² Traditional Chinese medicine's impotence pathogeny and new inquiry into symptom study: supplemented with 717 cases of epidemiology investigation and analysis. China Journal of Medicine and Drug. 1999;14(6):33-37. ³ Lin Yu Hao, et al. Treating 95 cases of male reproductive function decrease with differential diagnosis. Journal of Anhui College of TCM. 1992;8(3):4-6. ⁴ Liu Zuo Wen. Treating 49 cases of male infertility with modified Wu Zi Yan Zong Wan combined with a medicinal meal for promoting the generation of vital essence. Journal of Popular Medicine of Chinese Ethnic Minorities. 1999;(6);327-329. ⁵ Li Xue Xing. Treating 35 cases of impotence with modified Yang He Tang. Hebei Journal of TCM. 1998;20(5):305-306. ⁶ Hu Yin Gui. Treating 86 cases of impotence with modified Jiao Tai Wan. Journal of Applied TCM. 1999;15(8):19. ⁷ Bai Duan Clinical observation on treating 41 cases of psychological impotence with massage. Journal of Massage and Physical Excercise Therapy. 1998;(3):9. ⁸ Zhu Jin Hong. Treating 40 cases of impotence with acupuncture at Hui Yang point. Shanghai Journal of Acupuncture. 1999;18(1):9. ⁹ Sai Jia Zhang, et al. Clinical observation on treating 76 cases of impotence with acupuncture. Journal of Acupuncture. 1998;23(3):231-232.