Erectile dysfunction (ED) is the inability to get or keep a firm enough erection to have sex on an ongoing basis. Let's be very clear: ED is a secondary symptom of a serious health condition! Some examples:
Poor blood flow to the penis It's blood flow that creates and sustains an erection. Without sufficient blood flow, there is no erection or no lasting erection. Patients with arterial blockages, peripheral artery disease, and atherosclerosis are all candidates for ED. Cardiologists will tell you that if there is blockage in one vessel there are blockages in others.
Comorbidity There could be another condition, syndrome, or disease causing this problem. See the writeup on Benign Prostatic Hyperplasia for one example.
Emotional concerns Stress triggers sympathetic nervous system, which reduces all systems not needed for immediate survival. Digestion is one of these systems and so is the reproductive system. Trauma, financial stress, relationship stress, work stress, and PTSD responses all count toward these types of stress. Depression and anxiety are also complicit in ED. Sleep disruption causing a patient to be too tired for too long is another psycho-emotional cause for ED.
Pollutants and toxins Environmental pollutants and internal pollutants such as food preservatives, overconsumption of xenoestrogens and soy (which can act like an estrogen overload), and certain pharmaceuticals can trigger ED.
Diet and exercise Long term high sugar and simple carbohydrate intake can lead to type 2 diabetes which can cause blood flow problems and nerve transmission disruption. High fat diets can lead to high cholesterol and arterial blockage which also causes blood flow problems. Lack of exercise can also lead to blood flow problems and thus to ED.
What I'm getting at is: treat the underlying problem in addition to the ED! ED will almost always be the chief complaint, but it's probably not the chief issue. Address the patient's concerns about not being able to get an erection, but also address the underlying causes and educate your patient about what you find.
Suggested Acupuncture Protocol for ED
This protocol targets the reproductive system and helps with ED. This should help alleviate the symptoms while you treat the underlying causes. As usual, the sides listed below are somewhat arbitrary. Liver generally expresses on the right, which is why the Liver points Huo Ying and Huo Zhu are on the right. You can switch them up if you need to.
Left Side PC 9, Xia San Huang, Lv 1
Du 25, the tip of the nose, is considered to be an image for the penis. Needling here hurts like a mother, but you can teach the patient to pinch or acupressure the tip of the nose as 'homework.' Liver 1 and PC 9 are wood points. In ancient Chinese medicine writings ED is considered to be wood related. Insert junior high joke here.
Treating the Liver/wood element is crucial in treating ED. Treating this meridian treats the sinews and tendons and also treats the emotional aspect of ED.
Herbal Medicine Suggestions
While acupuncture diagnosis and treatment focuses on the Liver channel, herbal medicine focuses on the Kidney organ and channel. This is a great example of how differently you diagnose and treat in herbal medicine compared to acupuncture medicine.
You have many to choose from. Pick and customize the formula and herbs that work best for your patient's differential diagnosis.
Huan Shao Dan Also called the Return to Spring formula. Commonly prescribed in China
Zuo Gui Wan Kidney strengthening
Jin Gui Shen Qi Wan Warms Kidney Yang
Bu Zhong Yi Qi Tang Tonifies Spleen Qi, lifts prolapses. You could consider erectile dysfunction a type of organ prolapse with the right supporting pulse, tongue, s/sx.
Fu Zi Li Zhong Wan Warms Stomach yang, which has a relationship with the Jueyin channel. Jueyin goes directly to the genitals and grown.
Ge Jie Da Bu Tang Kidney tonic with gecko in it - very powerful for Kidneys
San Piao Xiao Wan Strengthens Kidney yang and jing, treats premature ejaculation and nocturnal emissions.
Jin Suo Gu Jing Wan Astringes Kidney qi.
Advise your patients to (and how to) lower their stress, work out, eat well, rest, do Qigong/Tai Chi, maintain a healthy BMI, start to meditate, etc.