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Introduction

ED causes and treatment options

Every day we see nervous men walking through our doors to ask us about sexual health and ED treatment. Relax. This is so common and we can usually help.

About 50% of men experience ED. Yet, many men don’t seek treatment due to inappropriate feelings of embarrassment. There is absolutely NO SHAME in seeking help in sexual health and the fact is that most of the causes of ED or Premature Ejaculation are everyday conditions like stress or anxiety.

If you are looking for a natural ED treatment then visit our Men’s Health Clinic.

In this article we will explain the most common versions of ED and ‘Impotence’. We will outline ED causes and natural cures, as provided by Western and Chinese medicine.

We will also discuss the causes of premature ejaculation and natural treatments.

If your question is not answered in this article then get in touch with us. We provide free online health advice. Or pop into our Clinic for a brief chat in confidence. No obligation.

If you would like a broader introduction to our treatment approach to sexual health then download our free guide to Supercharged Sex.

+What is ED

‘Erectile Dysfunction is an umbrella term. It refers to various common sexual performance issues.

ED means an inability to have an erection or maintain an erection until ejaculation.

Often, a man may lose erection as soon as he enters his partner.

Another common condition is premature ejaculation – an inability to control ejaculation (‘coming’ and orgasm). The man loses semen shortly after commencing foreplay with his partner. Or shortly after penetration.

It’s common for a man to experience ED during intimacy with his partner. Even if he is still able to masturbate and orgasm alone.

At AcuMedic Clinic we see various examples of ED and other male sexual ‘dysfunctions’. The most common are:

  • ‘I can’t get it up’ (no erection, or no erection for as long as the man and/or his partner desire)
  • ‘I come too fast’ (premature ejaculation)
  • ‘I can’t come’ (no ejaculation or orgasm)

What kind of man has ED?

ED has become a common affliction. About 50% of men between the ages of 40-70 (and about 7 in 10 men aged 70 and above) experience ED.

But it’s no longer associated with older men. Today, even the so-called ‘healthy’ men experience ED. As the Metro newspaper reported on 29th March 2016:

“Because there’s still such a stigma attached to ED, young men are often hesitant to admit it”

ED is treatable in all age groups, and awareness of this fact has been growing. More men now seek help. As a result, more are returning to normal sexual activity. All because of improved, successful treatments for ED and ‘impotence’.

What is erectile dysfunction (ED) and ‘impotence’

Etymology

Erectile dysfunction is specifically related to a man’s ability to maintain an erection. There are other problems that interfere with sexual intercourse. The ‘other’ problems include lack of sexual desire and problems with ejaculation and orgasm. 

The term ‘Erectile dysfunction’ is rather new. It’s now often used instead of ‘impotence’.

The two terms can refer to same set of conditions and symptoms. Albeit, one is current and the other, outdated.

‘Impotence’ comes from the Latin word impotentia – meaning lack of self-control, weakness.

Western medicine based the ‘impotence’ diagnosis on the Latin term impotentia coeundi.  In English this means an inability to insert the penis into the vagina.

But Western andrology has discovered more examples of male sexual health issues since. Hence ‘Erectile dysfunction’ is now used. It’s a way to cover a greater variety of related conditions and symptoms.

Also, ‘impotence’ has a negative, severe ring of finality to it. It implies a permanent lack of virility. A lack of ‘manliness’.

The psychological effect of the ‘impotence’ diagnosis can be devastating. It can cause suffering to both the patient and his partner. It can ruin a relationship.

Much like the often inaccurate and distressing Western diagnosis of ‘infertility’ (rather than sub-fertility). It can sink many couples into hopelessness.

Hence, ‘erectile dysfunction’ is now used by the medical profession. As a diagnosis, ED sounds more neutral and ‘technical’.

‘ED’ implies a ‘glitch’ somewhere down the line – further away from the man’s self. Its mechanical tone indicates that it’s fixable and reversible.

This is a well-meaning attempt to remove the stigma carried by ‘impotence’. But in divorcing this issue from the male self, the Western approach ends up obscuring the root cause.

To reify ED into ‘physical (medical)’ and ‘psychological’ categories can oversimplify this complex condition.

For the patient, this creates an artificial divide between ‘mind’ and ‘body’. As we’ll see from the Chinese medical perspective, this can be problematic. Especially, when it comes to finalising the diagnosis and tailoring the treatment. 

The mind-body barrier isn’t that simple. 

The ‘physical’ and ‘psychological’ are not so mutually exclusive, after all.

Hence the natural ED treatment should tackle both – the mind and body – at the same time.

Nonetheless, we hope that phrasing the matter as ‘ED’ will make it easier for men to talk about this. After all, this is a notoriously sensitive topic.

+Western Medical View

Western medicine as ED treatment – summary

The recognised causes of, and treatments for ED vary in Western medicine but usually they are separated into psychological and physical causes.

ED causes – physical

ED as a result of a medical condition

Any disorder that impairs blood flow in the penis has the potential to cause Erectile Dysfunction. These include:

  • Diabetes (up to 50% of diabetics suffer from ED).
  • Kidney disease.
  • Multiple Sclerosis (MS).
  • Direct problems with the penis function.

ED as a result of poor lifestyle

Clearly many of the medical issues mentioned above are related to lifestyle choices such as:

  • Excessive smoking.
  • Excessive alcohol consumption.
  • Poor diet choices and overeating.

ED as a side effect of surgery

Surgery (for example, prostate surgery) can injure nerves and arteries near the penis. This can cause ED. Injury to the penis, spinal cord, prostate, bladder, and pelvis can lead to ED. 

The smooth muscles and fibrous tissues of the corpora cavernosa (the erectile tissue that makes up the bulk of the penis) are also vulnerable. Damage there from surgery can cause ED.

ED as a side effect of medications

Many common medicines can cause ED and ‘impotence’ as a side effect.

Medications include:

  • High blood pressure drugs.
  • Antihistamines.
  • Antidepressants.
  • Tranquilizers.
  • Appetite suppressants.
  • Cimetidine (an ulcer drug).

ED causes – psychological

Many men suffer from psychological impotence. This is primarily due to stress, performance anxiety or insecurities in the relationship, etc.

The psychological causes of ED include:

  • Stress
  • Anxiety
  • Guilt
  • Depression
  • Low self-esteem or Small Penis Syndrome
  • Fear of sexual failure – also known as ‘performance anxiety’

Many psychological factors come as secondary reactions to physical causes of ED.

ED treatment – Western medicine

It’s recommended that ED and ‘impotence’ treatment moves from least invasive to most invasive.

This means cutting back on any harmful drugs as the first step in ED treatment.

Psychotherapy and behaviour modifications is the next step.

Next, vacuum devices, oral drugs, locally injected drugs, and surgically implanted devices. In rare cases, surgery involving veins or arteries.

ED treatment – drugs

A variety of drug treatments for ED and ‘impotence’ is available on prescription.

In March 1998, the Food and Drug Administration (in the U.S) approved sildenafil citrate. The drug arrived on the market as Viagra. It was the first oral pill designed to treat ‘impotence’.

It had to be taken 1 hour before sexual activity. Sildenafil works to enhance the effects of nitric oxide. It’s the chemical that relaxes smooth muscles in the penis during sexual stimulation. This can allow increased blood flow into the penis.

Sildenafil can improve the response to sexual stimulation. But it can’t trigger an automatic erection as injection drugs do.

Sildenafil lists a number of potential unwanted effects ranging from headaches and dizziness to visual disturbances, rashes and other more serious issues.

Oral testosterone can reduce impotence in some men with low levels of natural testosterone.

Patients also have claimed effectiveness of other oral drugs. These include yohimbine hydrochloride, dopamine and serotonin agonists, and trazodone. But no scientific studies have proved the effectiveness of these drugs in relieving impotence.

ED treatment – injections

Many men gain potency by injecting drugs into the penis, causing it to become engorged with blood.

Drugs such as papaverine hydrochloride, phentolamine, and alprostadil (marked as Caverject) widen blood vessels.

These ED and ‘impotence’ treatments may create unwanted side effects. Side effects include persistent erection (known as priapism) and scarring.

Nitroglycerin, a muscle relaxant, sometimes can enhance also erection. It’s used by rubbing it on the surface of the penis.

A system for inserting a pellet of alprostadil into the urethra is marketed as MUSE. It uses a pre-filled applicator to deliver the pellet about an inch deep into the urethra at the tip of the penis. An erection will begin within 8 to 10 minutes and may last 30 to 60 minutes.

The most common side effects of the preparation are:

  • Aching in the penis, testicles, and area between the penis and rectum.
  • Warmth or burning sensation in the urethra.
  • Redness of the penis due to increased blood flow.
  • And, minor urethral bleeding or spotting.

Research on drugs for ‘impotence’ and ED treatment is expanding. Patients should ask their doctors about the latest advances.

ED treatment – psychological

Experts often treat psychologically-based ED and ‘impotence’ using techniques that decrease anxiety. This will usually involve some counselling therapy which aims to reduce ‘performance anxiety’.

The patient’s partner can help apply the techniques. These include gradual development of intimacy and stimulation.

+Chinese Medical View

Chinese medicine for ‘impotence’ and as ED treatment – Overview

Acupuncture and Chinese herbs can treat many of the causes of ED and ‘impotence’. These can be prescribed according to Chinese medical theory and full diagnosis.

Acupuncture has been proved to have therapeutic effect on male sexual dysfunction (non-organic). That is, erectile dysfunction, and defective ejaculation, according to the World Health Organisation*.

Chinese medicine understands that there are physical, lifestyle and psychological factors which cause ED but tends to relate them with each other more than the separatist approach of Western medicine.

Physical damage to the penis and erectile system can be harder to reverse with Chinese medicine but the medical conditions, lifestyle habits and psychological causes can be treated together in Chinese medicine.

Chinese medicine recognises mind and body as distinct elements, but unlike Western medicine, it seeks to treat both the mind, body and lifestyle at the same time. Because, any activity requires a simultaneous use of both. Issues with the mind can affect the body, and vice-versa.

Chinese medical treatment for ED uses various herbs and acupuncture points. All tailored to a single patient. The combined treatment have a synergistic effect. Together they reinforce the mental and the physical.

Therefore Chinese herbs and acupuncture may be used as ED treatment of physical and psychological causes.

Causes of ED

Before discussing the causes of ED according to Chinese medicine it is important to note some of the issues with the language of Chinese medicine.

  1. When discussing organs in Chinese medicine we do not mean the anatomical organ but a collection of functions associated with that organ in Chinese medical theory.

Hence, during diagnosis a Chinese medical practitioner may attribute ED to “kidney deficiency”. But they are not referring to the pair of elimination organs in the back of your body. Rather, they mean a set of functions which Chinese medical theory groups under the rubric of ‘Kidney’.

This is one of the biggest obstacles in communication between East and West and requires clarifying. On this website we capitalise the organ names when describing their energetic functions. For example, Liver, as opposed to liver.

  1. The language of Chinese medicine sounds very esoteric because it is an ancient medicine but this does not mean that it is unscientific. For thousands of years Chinese medicine has been going through empirical ‘clinical trials’ and has created a language to try to describe its observations. The descriptions may sound funny but the observations are accurate.

In Chinese medicine ED and ‘impotence’ is usually due to disorders of the Kidney. Why?

Because one of the main functions of the Kidney is to store energy essential to proper sexual function.

In most cases, the cause of ED is Kidney Energy Deficiency. This can also be aggravated by obesity, stress, smoking and alcohol.

In Chinese medical terms ED is often caused by two types of imbalance occurring at the same time:

  1. The decline of Fire in the Kidney
  2. The exhaustion of Essence, blood and Qi (low energy and poor circulation)

There are various causes of Fire depletion:

  • Overindulgence in sexual activity
  • Frequent masturbation
  • Damage to the Kidney by fright
  • Excessive worry such as performance anxiety or small penis syndrome
  • Dampness-Heat- accumulating and flowing downward in the body.

There are various causes of exhaustion of Essence, blood and Qi:

  • Stress and overworking
  • Poor sleep
  • Poor lifestyle
  • Ageing
  • Tiring relationships

There are many other potential causes of ED, for example dysfunction of the Spleen, Heart or flow of blood and Qi. Our doctors can discuss these with you if applicable.

Chinese Medical diagnosis for ED treatment

Our doctors will discuss your issues and ask questions. They will give you a pulse and tongue diagnosis.

This will give them a good idea about the state of your important organs (Kidney, Heart, Liver, Spleen) and Qi (function or essential energy) circulation. This can enable the Chinese Medicine doctor to assess the causes of ED.

The Chinese medical doctor will pay attention to small signs as well. These are often missed during Western diagnosis. For example, the Chinese medical practitioner will ask about the patient’s bowel movements or sleeping patterns.

To pinpoint the cause of ED and to tailor the treatment the Chinese practitioner would look out for signs such as:

  • Dizziness,
  • Blurred vision
  • Tinnitus
  • Insomnia
  • Lassitude
  • Soreness and weakness in the loin and knees.

All these come with a failure to have or maintain an erection. They are also often seen in patients who experience premature ejaculation.

The Chinese medical doctor would also take note of the patient’s complexion. They would check the tongue and observe the nature of the pulse.

Chinese herbs and acupuncture as ED treatment

A combination of acupuncture and Chinese herbs can restore balance in the necessary organs and increase energy. This can stimulate sexual appetite and increases penile erection.

The aims of Chinese medicine treatment for ED usually include:

  • Strengthening the flow of energy and blood to the sexual organs
  • Reversing any syndromes affecting Kidneys
  • Improving cardiovascular performance
  • Balancing emotions which can reduce addictive and poor lifestyle choices
  • Reducing stress
  • Improving sleep

Acupuncture will probably be advised by your doctor. We usually recommend about 5 sessions of acupuncture over the course of about 3 weeks to assess the effects of our treatment. Your doctor will give you a more accurate assessment of when you should experience the benefits which usually begins after 1 or 2 sessions.

Chinese herbs are often used as a powerful supplement to the Acupuncture ED treatment. These herbs will work on exactly the same issues but from a nutritional point of view. This system is very complex and tailored to the individual.

While there are many herbs known to improve male sexual function it is advisable to take an individual approach rather than buying ‘herbal viagra’. Certainly, after treatment you may find some herbs to be particularly helpful but it is best to be under the supervision of our doctors.

+Hope for men looking for natural ED treatment

As a branch of Chinese medicine, andrology has a long history. The practice of using Chinese herbs and acupuncture to treat male sexual issues goes back a long time. Thousands of years. 

There are a few reasons for this. All related with Chinese medical theory’s foundations in Taoism. 

Taoists believed that before the dawn of civilisation men had perfect health. They could control their sexual impulses with their minds. They could get it up or down just by using their thoughts alone. 

But as the civilisation rolled in, unhealthy food and alcohol became abundant. Unhealthy lifestyles, with bad sleeping habits, became the norm. As a result, the male race became mentally and sexually weak.

Whether our ancestors had so much control over their bodies is no longer relevant. The main point in Chinese medical theory is this: Male sexual ‘dysfunctions’ are largely reversible. They can be reversed through a dual strengthening of the mind and body.

Lifestyle Advice for the prevention and treatment of ED and ‘impotence’

Good lifestyle, diet and medicine can help you to protect and strengthen your Kidneys. Stronger Kidneys can lead to increased libido and sexual stamina.

Here is what you can do right now to boost your Kidneys:

Eat fruit & veg

Good healthcare starts in the kitchen. 

Even if you’re taking medications, your food and drink should be a part of your healthcare. Don’t ruin your doctor’s efforts. Avoid eating things that are bad for kidneys. 

Grapes, leek and strawberries are good for Kidneys. They can support, supplement and tonify the health of Kidneys. 

Chinese medicine also recommends you include cooked kidney beans. Have 3 heaped table spoons. This can go towards your daily ‘5 A DAY’ mix of fruit and veg.

Balance work with rest

According to Chinese medicine, too much of any activity, posture or food is bad for your health.

That’s because every action – whether work or leisure – taxes a particular part of your body. When done excessively, tampers with the organ’s function of keeping you balanced and healthy. 

Remember: physical work and sexual intercourse affect the Kidneys.

Every time a man ejaculates during sex his body releases essential energy. The energy is stored by the Kidneys. It’s known in Chinese medicine as the ‘Original Qi’. ‘Original’ because you inherit this energy from your parents.

The Original Qi determines your constitution. It sustains your body and it creates life (when shared through semen). 

The ageing process is a reflection of the Original Qi’s depletion in the Kidneys.

Avoid overindulgence in sex.

Avoid excessive physical exertion. For example, walking while carrying a heavy load or standing up for long periods. Push yourself too much and pain will develop in the lower back. 

This lumbar pain is a common sign of Kidney exhaustion. Protect your Kidneys by avoiding physical strain at work and home. Have rest in regular bursts.

For more expert tips on strengthening your Kidneys, read our article 5 STEPS TO BETTER KIDNEY HEALTH.


+ *CLINICAL TRIALS

Aydin S et al. Acupuncture and hypnotic suggestions in the treatment of non-organic male sexual dysfunction. Scandinavian Journal of Urology and Nephrology, 1997, 31(3):271-274.

Shui HD. [Acupuncture treatment of defective ejaculation.] Chinese Acupuncture and Moxibustion, 1986, 6(1):19 [in Chinese].


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