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Mens Health - erectile dysfunction

Updated: Apr 17, 2023

Erectile dysfunction / ED

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What is erectile dysfunction?

Erectile dysfunction is the inability to get or maintain an erection to allow for satisfactory sexual intercourse. In both Chinese and Western medicine, there are many causes of erectile dysfunction, also known as ED. Both medical traditions accept that there can be both physiological and psychological causes for the change in the quality of your erection – that is to say a problem in the body or one in the mind.

While it is generally accepted that erectile dysfunction increases with age, Chinese medicine theory believes that through the employment of acupuncture, herbal medicine, and health maintenance exercises and practices, a strong and satisfactory erection can be achieved at any age. Generally speaking, Chinese medicine puts an emphasis on health maintenance rather than healing disease, though it certainly does that quite well. So, a key part of any treatment is going to emphasise this principle when working to improve the quality of a man’s erection.

It is important to note that other diseases, like diabetes and atherosclerosis, and some medications can cause ED and a decrease in man’s satisfaction with his erection.

What are the symptoms of erectile dysfunction?

Erectile dysfunction (ED) symptoms are:

  • Inability to get an erection

  • Inability to keep an erection

  • Decreased sexual desire is commonly a related symptom

What causes erectile dysfunction?

The causes of erectile dysfunction can be both physical and psychological. An erection begins in the brain with sexual arousal. The brain releases chemicals to tell the nerves to relax the muscles that control the blood vessels leading into the penis. This increase in blood causes an erection. If this process is interrupted at any point, ED can result.

The specific causes of ED, according to modern biomedicine, include:

  • Heart and vascular disease

  • High blood pressure

  • High cholesterol

  • Obesity and metabolic syndrome

  • Diseases, including diabetes, Parkinson’s disease, and multiple sclerosis

  • Altered hormone levels (especially low testosterone)

  • Medications, alcohol, tobacco, and other recreational drugs

  • Depression, stress, and anxiety

How is erectile dysfunction diagnosed by a doctor?

A diagnosis of erectile dysfunction can be made by a health care professional. Usually, a physical exam and an interview about sexual and medical history are enough to diagnose erectile dysfunction. However, the following tests may also be performed when diagnosing ED:

  • Blood and/or urine sampling for laboratory testing

  • Ultrasound imaging

  • Nocturnal erection test, also known as a nocturnal penile tumescence or NPT

  • Psychological exam

  • Neurological tests

These tests for ED will identify the type of ED as either:

  • Physiological: a breakdown somewhere in the arousal pathway between the brain and the penis

  • Functional: the inability of the penis to become erect, even if the pathway is working properly

  • Psychological/mental: caused by stress, anxiety, and/or depression

In 2007, Kasper et al. created three classifications your doctor may use to describe your specific kind of erectile dysfunction. They are:

  • Failure to initiate erection

  • Failure of the penis to fill with blood

  • Failure to the penis to store blood

How is this different from Acupuncture and Chinese medicine diagnosis of ED?

Chinese medicine was created in a time before blood tests, x-rays and other medical diagnostic procedures, so we rely mainly on asking question and some observational techniques. I’m not going to look at your genitals or ask to see your erection. I am going to look at your tongue, take your pulse, and palpate your abdomen.

By finding out when you experience ED, what else is happening at that time, your stress level, how the quality of your erection differs from what your ideal erection is and the presence of other symptoms, I can diagnose the ED as one of the patterns of disharmony we expect to see with these symptoms. There are both modern and pre-modern Chinese medicine diagnoses for ED.

How is erectile dysfunction treated by Western medicine?

Western medical (allopathic) erectile dysfunction treatments include:

  • Oral medications: Viagra, Cialis, Levitra are drugs that increase blood flow to the penis (from a chinese medicine perspective, these drugs "spin the yang qi" as a result of imbalanced or unopposed tonification of yang energy. I chinese medicine yang is only tonified simultaneous with nourishing blood and yin in order to prevent the yang burning itself out. because one root cause of ED is deficient yang, a drug that often leads to further damage to the yang is not the best treatment. in my experience, patients often report that the drugs lose there efficacy over time and their symptoms are worse than before engaging in this type of drug therapy)

  • Injected medications: the drug alprostadil is available as an injection or suppository (Muse)

  • Devices: penis pumps

  • Surgery: penile implants, blood vessel surgery

How does acupuncture and herbal medicine treat the symptoms associated with ED?

Not surprisingly, acupuncture and herbal medicine are the key modalities I use. In the case of erectile dysfunction, we’re also going to talk about diet and exercise. Typically, I also teach my patients some short Qigong exercises and self-massage techniques for you to do at home (you can also do this kind of massage with an intimate partner)

check out the other posts (with more arriving weekly) on these and other conditions

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