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Treating impotence with acupuncture

Townsend Letter for Doctors and Patients, Dec, 2004 by Honora Lee Wolfe

Keywords: Chinese medicine, acupuncture-moxibustion, sexual dysfunction, impotence

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In issue #9, 2003 of Gan Su Zhong Yi (Gansu Chinese Medicine), Qiu Lian-li of the Gansu Provincial Chinese Medical School in Lanzhou published an article titled, "A Small [i.e., Short] Discussion of the Treatement of 54 Cases of Impotence with Acupuncture & the Application of Medicinals to the Navel." This article appeared on pages 26-27 of that journal. As a response to the growing use of drugs like Viagra and Cialis, and because this treatment is relatively simple and uses commonly available food ingredients, a summary is presented below.

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Cohort description

Among the 54 patients enrolled in this study, the oldest was 58, the youngest was 20, and the average age was 39 years old which seems to me young for patients suffering from impotence. The shortest duration of impotence was three months and the longest was two years. All patients met the diagnostic criteria for impotence, although that criteria was not stated in the article.

Treatment method

Black pepper was ground into powder and mixed with ginger juice in order to make a paste. This paste was spread on cotton gauze and affixed with adhesive directly over the navel. This application was changed once per day. Acupuncture was also performed at: Shen Shu (BI 23), Ming Men (GV 4), Guan Yuan (CV 4), Zhong Ji (CV 3), San Yin Jiao (Sp 6), and Tai Xi (Ki 3). The first two points were needled without retention. The other points were needled with 30 minute retention. One treatment was administered per day, five times per week. Ten treatments equaled one course of treatment. During this treatment, sexual activity was forbidden. After one course of treatment, if patients were able to get an erection, they were allowed to have sex. The longest duration of treatment was five courses and the shortest was one course.

Treatment outcomes

Treatment outcomes were based on the 1994 edition of Zhong Yi Bing Zheng Zhen Duan Liao Xiao Biao Sun (Criteria for the Chinese Medical Diagnosis, Treatment, & Outcomes of Diseases & Patterns). As such, cure was defined as disappearance of symptoms with return of normal sexual function. Improvement was defined as ability to have an erection and to have sex at least some of the time. No cure was defined as no change in the symptoms. Based on these criteria, 37 out of 54 patients were judged cured, 11 improved, and three got no effect. Therefore, the total effectiveness rate was published as 94%. The authors did not discuss any age range for the 37 patients judged as cured.

Discussion

According to Dr. Qiu, early marriage, early fathering of children, one husband with many wives, and sex outside of marriage all easily result in kidney qi vacuity and debility. (I was unaware that men in China could legally have more than one wife, so I found that part of this discussion interesting to say the least!) In any case, Dr. Qiu believes that, in order to treat this condition, one should mainly supplement the kidneys. However, this should be combined with regulating the spleen and stomach as well as the whole body's yin and yang. Shen Shu, Ming Men, Guan Yuan, Zhong Ji, and Tai Xi bank and supplement the kidney qi in order to free the flow of yang, while San Yin Jiao regulates and supplements the liver and kidneys. Black pepper mixed with ginger juice applied to the navel is able to regulate and rectify the spleen and stomach as well as strengthen and invigorate the whole body. When this acupuncture is combined with these medicinals, they promote the return of the kidney's yang and the filling of their yin. Essence is thus engendered and this leads to cure.

It is my opinion that Dr. Qiu's discussion of the causes of kidney qi debility leading to impotence should be read as a moral critique of current Chinese society and not as medical fact. Without more details about the patients' lives, it is difficult to say if Dr. Qiu's assessment of their situation is accurate or not. Given the relatively young average age of these patients, I would want to know about the incidence of obesity, psychological factors, and any involvement of either drugs of abuse or Western pharmaceuticals. Further, I would like to know how many of these cases were primary and how many were secondary impotence. Primary impotence is almost always due to psychological factors, such as guilt, fear, depression, or anxiety, while secondary impotence is almost always organic and mostly vascular. According to the Merck Manual, in North America, drugs cause approximately 25% of cases of erectile dysfunction. In addition, transient impotence due to an organic or drug-induced cause may lead to secondary psychological difficulties. None of these factors have been discussed in any way in the above study which I feel is inadequate for at least that reason alone.

Furthermore, in terms of clinical reality in the West, practitioners treating younger patients suffering from impotence must always consider the equally possible factors of damp heat, phlegm, and blood stasis which are often participating disease mechanisms, regardless of and often in addition to, any possible involvement of insufficient kidney qi, yang, or essence. These important disease mechanisms were not discussed in Dr. Qiu's article. In my clinical practice, patients with damp heat or any damp encumbrance would receive moxibustion or needles with moxa on the handles at'Zu San Li (St 36), and possibly San Yin Jiao (Sp 6) or Yin Ling Quan (Sp 9). For patients with blood stasis, I may use network vessel pricking which I have discussed in other articles in this column. In this case, it might be on the low back or sacral area, or on the medial aspect of the ankles or knees, adding moxibustion or needles with moxa at the Xi or accumulation point of the foot jue yin liver channel.

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Treating impotence with acupuncture

Townsend Letter for Doctors and Patients, Dec, 2004 by Honora Lee Wolfe

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