TCM Dietary Therapy for Impotence

Impotence refers to a condition in men where, despite having sexual desire, the penis is unable to achieve an erection for sexual intercourse, or although an erection can be achieved, it cannot be maintained with sufficient rigidity and duration to complete sexual intercourse. The former is clinically referred to as complete impotence, while the latter is termed incomplete impotence. If sexual performance has been normal but impotence signs of imbalance occasionally occur, it may be caused by temporary fatigue or anxiety following a serious wellness. Once the underlying cause is resolved, impotence will no longer occur. In such cases, there is no need to seek medical supports for impotence. However, some individuals may develop a psychological burden as a result, ultimately leading to genuine impotence.

I. Causes of Impotence

1. Psychological factors

Psychological factors are the most common and primary cause of impotence, accounting for approximately 85% to 90% of all cases. For example, discord in the marital relationship, harboring hostility towards the female partner; or a lack of harmony and mutual cooperation in sexual activities between the couple, failing to achieve ideal sexual satisfaction, leading to aversion towards sexual behavior and resulting in impotence. Similarly, an unsuitable sexual environment, such as living with multiple people in one room, being cautious or having concerns during sexual intercourse, can also lead to impotence. However, there are also many cases of impotence occurring due to a lack of sexual knowledge, with individuals experiencing fear and anxiety about failing in sexual intercourse and dissatisfying their wives, thus developing impotence; or mistakenly believing they have impotence after an unsatisfactory sexual encounter. Due to doubts or fears in these individuals, although they have sexual desires, when preparing for sexual intercourse, they experience thoughts of tension, fear, and worry, which ultimately result in the flaccidity of the erect penis, helps maintain sexual intercourse.

In addition, excessive masturbation and overindulgence in sexual activities are also common causes of impotence. Excessive sexual intercourse, especially repeated sexual intercourse, that is, having continuous sexual intercourse after one round, requires stronger stimulation to induce penile erection and ejaculation. Over time, this can lead to an inhibitory state of the erectile nerve center, resulting in functional impotence.

2. Organic causes

Organic causes refer to those resulting from anatomical defects in the sexual organs. Regardless of the cause, incomplete development or atrophy of various parts of the sexual organs can lead to organic impotence. Examples include penile curvature, hypospadias, testicular atrophy caused by mumps complicated by orchitis, post-testicular tumor resection, post-traumatic testicular removal, severe urethral trauma, and damage to the erectile nerves. Clinical supports of this type of impotence is often challenging, and in some cases, a supports may not be possible.

3. TCM Understanding of the Causes of Impotence

In traditional Chinese medicine, the pathogenesis of impotence is primarily related to the Liver, Kidney, and Yangming meridians. The Liver governs the sinews; Liver wellness can lead to the relaxation and laxity of the genital sinews. The Kidney governs the storage of essence and also controls the anterior and posterior orifices; insufficient Kidney essence means yang lacks yin essence for nourishment, resulting in impotence. Furthermore, when the true yang in the Kidney declines and fails to provide vitality, or when fear injures the Kidney, impotence can also occur. The Yangming meridian governs the genital sinews; if the Spleen and stomach are weakened, the genital sinews become relaxed, and sexual function fails to rise, which is also one of the causes of impotence. In addition, downward flow of damp-heat and overthinking injuring the Spleen can also lead to impotence.

II.Syndrome Differentiation and Subtyping with Dietary Therapy

1.Deficiency of Kidney yang

In traditional Chinese medicine, the Kidneys are believed to store essence and govern the vital fire. Kidney essence is the primordial yin and serves as the fundamental substance for reproduction, growth, and development; the vital fire is the primordial yang and represents the original driving force of the life force. Due to a preexisting yang deficiency with advancing age leading to a decline in the fire of the gate of life, or prolonged wellness damaging the Kidneys, or excessive sexual activity, or unrestrained masturbation, over time, this results in a deficiency of Kidney yang and insufficient primordial yang, which fails to promote sexual function, hence

It leads to a decline in sexual function, resulting in impotence, just as stated in “Treatise on the Causes and Manifestations of All wellness”: “Kidney deficiency fails to nourish the genitalia, hence the flaccidity and weakness.” Yang deficiency fails to warm the body and invigorate the spirit, so patients mostly have a pale complexion, fatigue, and aversion to cold with cold limbs. The waist is the residence of the Kidneys, so those with Kidney deficiency suffer from soreness and weakness in the waist and knees. Due to insufficient Kidney essence, patients often experience an empty feeling in the brain, impaired memory, dizziness, and tinnitus. The tongue is enlarged and moist, or may have tooth marks, and the pulse is mostly deep, thin, and weak at the chi position. supports should focus on warming the Kidneys and strengthening yang. Sulfur chicken can be consumed as a supports.

Formula and Preparation Method: Take 90 grams of sulfur, divide it into 15 packets, with 6 grams in each packet. Administer one packet per day, mixed into the feed for one rooster. After feeding all 15 packets to the rooster, slaughter the rooster, remove its feathers and internal organs, and boil it in water. When consuming, eat the chicken and drink the broth, but note that it should not be taken for an extended period.

In this formula, sulfur is the essence of fire, capable of supplementing fire and strengthening yang, supports decline of fire in the Mingmen (Gate of Life), cold and weakness in the waist and knees, and impotence. Chicken meat warms the middle-jiao and tonifies the Spleen, replenishes qi and nourishes blood, and tonifies the Kidneys and benefits essence. Although there are only two ingredients, they take into account both qi and blood, as well as the Spleen and Kidneys, and have the effect of enhancing sexual function. Generally, a few doses can produce results.

In addition, one can choose food therapy prescriptions for warming the Kidney and strengthening yang to take.

2.Deficiency of the Heart and Spleen

The Yangming meridian is the sea of water and grain and is responsible for nourishing the sinews related to sexual function. Pensiveness is associated with the Spleen, while the Heart governs the mind and spirit. Excessive pensiveness can injure both the Heart and Spleen, leading to a lack of sources for generation and transformation. Alternatively, after severe or prolonged wellness, the middle qi becomes weak, and qi and blood are not yet restored, both of which can result in inadequate nourishment of the sinews related to sexual function, causing erectile dysfunction (either inability to achieve an erection or an erection that is not firm). Due to excessive mental strain and inadequate nourishment of the spirit, patients often experience palpitations, forgetfulness, insomnia, and excessive dreaming. When the Spleen fails to transport and transform properly, patients lose their appetite, suffer from abdominal distension and loose stools, have a sallow complexion, feel fatigued and lack strength, and exhibit a pale tongue with a weak pulse. The supports principle is to tonify the Heart and Spleen. Steamed young pigeon can be consumed as a therapeutic food.

Formula and Preparation Method: 1 young pigeon, 30 grams of Astragali Radix (Huangqi), 30 grams of Lycii Fructus (Gouqizi), an appropriate amount of cooking wine, refined salt, monosodium glutamate, ginger slices, clear chicken broth, and chicken oil. Slaughter the young pigeon, remove its feathers, internal organs, and claws, wash it thoroughly, briefly blanch it in boiling water, then remove, wash again, and cut it into pieces. Place the pigeon pieces in a steaming jar. Wash the Astragali Radix and Lycii Fructus separately and place them in the steaming jar. Add cooking wine, salt, monosodium glutamate, ginger slices, and clear chicken broth to the steaming jar. Steam in a steamer until the meat is tender and cooked through. Remove from the steamer, pick out the ginger slices and Astragali Radix, and drizzle with chicken oil. Consume twice a week. Results can be seen within 2 to 3 weeks.

The young pigeon in the formula refers to a newly hatched squab, with thick and tender meat. It is highly aphrodisiac in nature and has the functions of nourishing the Kidneys and replenishing qi. Consuming it can enhance human sexual function. Astragali Radix (Huang Qi) has the functions of invigorating the Spleen, replenishing qi, raising yang, and consolidating the exterior. Modern research has proven that Astragali Radix has cardiotonic and diuretic effects. Lycii Fructus (Gou Qi Zi) can nourish the Kidneys, replenish qi, promote the production of body fluids, and assist yang. This formula is a commonly used food for recuperation after wellness among the folk. It is indeed effective for patients with sexual dysfunctions such as impotence and spermatorrhea.

In addition, one can choose to consume dietary therapy prescriptions that nourish qi and blood.

3.Liver Qi Stagnation

The Liver governs the tendons, and the external genitalia are the convergence of the main tendons. Prolonged emotional disharmony, such as worry, pensiveness, resentment, or long-term marital discord or sexual disharmony, can disrupt the Liver’s dispersing and regulating function, impairing the convergence of the main tendons and leading to flaccidity. As Shen Jin’ao stated, “Depression can also injure the Liver, helps maintain the Liver wood from dispersing and regulating, thus causing flaccidity of the external genitalia and inability to achieve an erection.” Patients often present with distending pain in the costal regions, reduced appetite, loose stools, pale tongue coating, and wiry pulse. The supports principle is to soothe the Liver and resolve depression. One can consume rose-infused pork Kidney.

Formula and Preparation Method: 100 grams of pig Liver, 1 pair of pig Kidneys, and 5 grams of Rosa rugosa flowers. Wash the pig Liver and slice it. Cut the pig Kidneys in half, remove the fascia, wash them, blanch in boiling water, then remove and slice into Kidney pieces. Soak the Rosa rugosa flowers. Then, place all three ingredients together in a casserole and cook until done. Season and serve.

In the formula, pig Liver and pig Kidney nourish the Liver and blood, tonify the Kidney and strengthen yang. Rose flowers regulate qi to helps with occasional depression, soothe the Liver and invigorate the Spleen. Compendium of Materia Medica Supplement records that “dried rose flowers in the shade can be used to make tea by steeping in boiling water” and “supports Liver and stomach qi pain”. It is commonly used in folk medicine to supports hypochondriac pain caused by Liver Qi Stagnation. Therefore, the entire formula can achieve the effects of soothing the Liver, relieving depression, tonifying the Kidney, and boosting yang, thus curing impotence.

In addition, Zhugan Hehuan Soup can also be chosen for consumption.

4.Damp-heat pouring downward

Excessive consumption of rich and greasy food and unrestrained alcohol drinking will damage the Spleen and stomach, impairing their transporting and transforming functions, leading to indigestion and accumulation in the stomach, which results in the accumulation of dampness and generation of heat. Over time, downward flow of damp-heat causes relaxation of the penile tissue, resulting in impotence. Patients often concurrently suffer from spermatorrhea, accompanied by damp and itchy scrotum with a sensation of heaviness, or even swelling and pain, as well as red and astringent painful urination. The tongue coating is yellow and greasy, and the pulse is wiry and slippery. The supports principle is to clear heat and resolve dampness, and Lotus Seed Liuyi Decoction is recommended.

Formula and Preparation Method: 60 grams of lotus seeds (with the seed embryo), 10 grams of raw licorice root. Add an appropriate amount of water and simmer over low heat until the lotus seeds are soft and cooked. Then add a small amount of rock sugar. Consume the lotus seeds and drink the soup.

The combination of lotus seed and licorice in the formula can clear Heart heat to facilitate dampness elimination. It can not only be used for spermatorrhea due to downward flow of damp-heat but also calm the mind and stop spermatorrhea.

In addition, using Elephantopus scaber and pork soup is also effective. Formula and preparation method: 150 grams of fresh Elephantopus scaber, 200 grams of lean pork. Boil them together to make soup, divide it into 4 doses and finish it in one day, with 1 dose per day. It can clear heat and eliminate dampness, detoxify, nourish yin and moisten dryness.

In addition, heat-clearing and dampness-eliminating dietary prescriptions can also be selected for consumption.

5. Fear and fright injuring the Kidney

Fear can injure the Kidney, and fright can cause qi disarray. If a person suddenly experiences extreme fright, qi will leak downward, resulting in impotence or a weak erection; accompanied by signs of imbalance such as mental distress, timidity with excessive worry, palpitations, insomnia, and a thin and wiry pulse. The supports principle is to nourish the Kidney and calm the spirit, and Gou Shen Fu Shen Decoction can be taken.

Formula and Preparation Method: One pair of yellow dog’s testes, 10 grams each of Zhu Fu Shen (Poria with Pine) and Schisandrae Fructus (Schisandra chinensis), 5 grams of Juncus Effusus (Deng Xin Cao), and 3 grams of Glycyrrhizae Radix et Rhizoma (Licorice). Decoct in water and take orally. The dog’s testes can be eaten.

In the formula, canine testis functions to replenish essence and strengthen the marrow, fortify yang and supports impotence. Zhufushen (Poria with Pine) calms the spirit, tranquilizes the mind, and helps with occasional restlessness. Schisandra fruit not only has the effects of tonifying the Kidneys, consolidating essence, and retaining Kidney qi, but also nourishes Heart qi, calms the mind, and gathers the dispersed qi of the Lungs and Kidneys. Juncus effusus clears the Heart and helps with occasional restlessness. Prepared licorice root tonifies the Spleen, replenishes qi, nourishes the Heart, and moistens the Lungs. The entire formula works together to calm the mind and benefit the Kidneys.

One can also consume the decoction of loach and prawn. Formula and preparation method: Take 100 grams of loach, remove the internal organs, and 1 pair of prawns. Add water, green onions, ginger, and salt, then boil and consume. Take it once a day for 7 consecutive days, rest for 7 days, and then repeat the above method. Results will be seen after 4 to 6 courses of supports.

This formula is a Kidney-tonifying and yang-boosting agent capable of stimulating the sexual nerves. Some scholars have used only Misgurnus anguillicaudatus (loach), 500 grams, removing internal organs, and boiling it with water, scallions, ginger, and salt. Consume it within one week, wait seven days, and then repeat the process as above for 3 to 6 courses of supports. It is effective for supports impotence, especially impotence caused by fright damaging the Kidneys.

III.External Folk and Proven Prescriptions

1. 15 grams of Cnidium monnieri (L.) Cusson powder, 15 grams of Cuscuta chinensis Lam. powder. Pound into a paste, apply to Qugu (RN2, qū gǔ) acupoint, five times a day.

2. 5 grams each of Foeniculi Fructus (common fennel) and prepared Zingiberis Rhizoma (ginger, processed). Grind them into powder, add a little salt, and mix with human milk (honey or chicken blood can also be used as a substitute). Apply the mixture to the navel and secure it with adhesive plaster. Change it every 5 – 7 days, and 10 days constitute one supports course.

3.Tieqi Ointment: Yangqishi (Actinolitum) 3 g, Shechuangzi (Fructus Cnidii) 3 g, Xiangfu (Rhizoma Cyperi) 3 g, Jiuzi (Semen Allii Tuberosi) 3 g, 7 Tufeng (Gryllotalpa) (wingless and footless, calcined), Dafengzi without shell (Semen Hydnocarpi) 1.5 g, Shexiang (Moschus) 1.5 g, Liuhuang (Sulfur) .5 g. Grind all ingredients into a fine powder, refine with honey to make pills the size of a finger. One hour before intercourse, cover and press the pill onto the navel with oiled paper, secure it externally with a silk bandage, and remove the medicine after intercourse.

4. 5 Momordicae Semen, 9 grams each of Cinnamomi Ramulus and Canis Os, 3 grams each of Zingiberis Rhizoma Siccum and Zanthoxyli Pericarpium. Grind into powder, mix with human milk or honey, apply to the navel, and secure with adhesive plaster externally. Replace every 3 days, 7 applications constitute one course of supports.

5. Medicated Cake Recipe for supports Impotence with Inability to Achieve Erection: 3 grams of white pepper, 6 grams of processed aconite root, 6 grams of realgar, 15 grams of wheat flour, and an appropriate amount of Da You wine. First, grind the first three medicinal substances into fine powder separately, then mix them evenly with the flour. Next, heat the Da You wine and pour it in, blending the ingredients to form a small medicated cake for later use.

When using, apply the medicinal cake to the patient’s umbilicus and secure it with a bandage. If the medicinal cake is cold when applied, a hot water bottle can be used to warm it. If a hot water bottle is not available, 500 grams of fried salt or fried fine sand can be wrapped in a thick towel and used for pressing and warming instead. When the abdomen feels warm, remove the hot water bottle, fried salt, or fried sand bag. The medicinal cake can be removed only when there is an itching sensation at the umbilicus.

6.Jiu Tian Ling Ying San: Radix Aconiti Lateralis Preparata (black aconite root), Fructus Cnidii (cnidium fruit), Sumbul (purple myrtle flower), Radix Polygalae (polygala root), Rhizoma Acori Tatarinowii (sweetflag rhizome), Os Sepiae (cuttlefish bone), Semen Momordicae (koita seed), Flos Caryophylli (clove) 6 grams each, Camphor 4.5 grams. Grind the above herbs into a fine powder. Administer during yang-related conditions…