TCM Guide to Spermatorrhea: Causes, Diet, and Folk Remedies

Spontaneous ejaculation without sexual intercourse or masturbation is called spermatorrhea. Clinically, spermatorrhea is divided into two categories: nocturnal emission and involuntary seminal emission. The former occurs during sleep while dreaming, and the latter occurs while awake. Although there are differences in severity of signs of imbalance and the time of onset between the two, the underlying pathogenic causes are essentially the same. As Zhang Jingyue said, “Nocturnal emission and involuntary seminal emission are both wellness of semen loss. Although their manifestations differ, their fundamental causes are the same.”

For unmarried young and middle-aged adults, experiencing spermatorrhea once every 1 to 2 weeks can be regarded as a normal physiological phenomenon, known as “sperm overflows when full”. However, most individuals suffering from spermatorrhea develop the condition due to emotional tension and anxiety caused by a lack of correct understanding. They believe that “one drop of semen is equivalent to ten drops of blood” and that spermatorrhea severely depletes vital energy and harms physical health. Over time, this can ultimately lead to neurasthenia. In fact, apart from containing a small amount of sperm, semen only has a minimal amount of protein, fat, and carbohydrates, which are insignificant to the overall body.

Some patients claim to have spermatorrhea, but in fact, it is not spermatorrhea, but just urethral secretions that occur during sexual excitement, or prostatic secretions without sexual excitement. If spermatorrhea occurs excessively frequently, several times a week or even several times a night, accompanied by signs of imbalance such as dizziness, fatigue, soreness in the waist, palpitations, lack of energy, insomnia, and dream-disturbed sleep, it should be regarded as a pathological condition and requires active supports.

I. Causes of Spermatorrhea

1. Psychological factors

Most patients with spermatorrhea are caused by psychological factors. Due to their lack of correct sexual knowledge and excessive sexual desire that they cannot restrain, especially engaging in prolonged reading of pornographic books, viewing pornographic pictures, having a wandering mind before sleep, and indulging in random thoughts, which lead to sexual excitement. Over time, the sexual activity center is stimulated, resulting in spermatorrhea. Some cases are due to long-term masturbation or frequent sexual intercourse, which disrupt the function of the spinal cord sexual center and lead to spermatorrhea. Others experience spermatorrhea due to sleeping on their back with their hands pressing on the lower abdomen, or wearing overly tight underwear that stimulates the genitals and causes sexual excitement.

2.Weak constitution

For individuals with a weak constitution, the functions of their zang-fu organs are feeble. When combined with excessive fatigue, the cerebral cortex loses control over the lower sexual centers, while the excitability of the erection center and ejaculation center increases, leading to frequent occurrences of spermatorrhea.

3. Local lesions

In addition, local inflammatory lesions in the genital organs or lower urinary tract, such as phimosis, redundant prepuce, urethritis, prostatitis, and other wellness, can also stimulate the genital organs and induce spermatorrhea.

4. TCM Understanding of the Etiology of Spermatorrhea

In traditional Chinese medicine, it is believed that the semen in the human body is stored in the Kidneys and should be sealed and retained rather than leaked externally. Excessive mental strain, anger damaging the Liver, indulgence in sexual activities, and excessive consumption of rich food and alcohol can all affect the Kidney’s ability to retain semen, leading to spermatorrhea. Excessive mental strain can deplete Heart yin, resulting in excessive Heart fire and gradual depletion of Kidney water. The excessive pathogenic fire disturbs the deficient yin essence, helps maintain the Kidney essence from being firmly retained and causing semen to leak externally. Alternatively, excessive worry can injure the Spleen qi, leading to a sinking of the middle qi and an inability of qi to retain essence, resulting in spermatorrhea. Or, harboring improper thoughts can cause excessive Heart fire, scorch the true yin, disrupt sleep at night, and lead to spermatorrhea in dreams. Or, emotional frustration and anger can injure the Liver, causing Liver Qi Stagnation and abnormal dispersion and regulation, disturbing the seminal chamber. Or, excessive indulgence in sexual activities and frequent masturbation can lead to frequent loss of semen, resulting in uncontrolled dispersion and regulation, depletion of yin essence, and excessive yang without restraint, disturbing the seminal chamber and causing spermatorrhea. Or, congenital deficiencies and inherent weaknesses can lead to a weak lower energizer and an inability of the seminal gate to remain closed, resulting in spermatorrhea. Or, exposure to damp pathogens, accumulation and transformation into heat, excessive consumption of rich food and alcohol, damage to the Spleen and stomach, and internal generation of damp-heat can cause damp-heat to flow downward, disturb the seminal chamber, and make the seminal gate unable to remain closed, leading to spermatorrhea.

II. Syndrome Differentiation and Dietary Therapy

1.Disharmony between the Heart and Kidney

The Heart’s yang should descend to the Kidneys to warm the Kidney water, while the Kidney yin should ascend to nourish the Heart fire. This is known as the harmonious interaction between the Heart and Kidneys or the coordination of water and fire. If a person has excessive desires or the Heart is stimulated by external factors, it can cause the Heart fire to become hyperactive in the upper part of the body, helps maintain it from descending to the Kidneys. Additionally, frequent sexual activity can deplete the Kidney yin in the lower part of the body, helps maintain it from ascending to nourish the Heart. Without restraint from the Heart fire, this can lead to a disharmony between the Heart and Kidneys, where the overactive Heart fire disturbs the depleted yin essence, causing the Kidney essence to be unable to be stored properly and resulting in frequent spermatorrhea. As stated in “She Gong Man Lu” (Records of a Broken Arm), “Spermatorrhea during sleep does not necessarily result solely from excessive sexual desire; it often arises from a disharmony between the Heart and Kidneys. When a person overexerts their mind, the fire becomes hyperactive, helps maintain the water from ascending and leading to a disharmony between the Heart and Kidneys. Scholars who overexert themselves in studying often suffer from this condition.” You Zai Jing also said, “When the mind is agitated, the spirit is disturbed above, leading to the loss of essence below.” Clinically, this condition manifests as restlessness of the mind, difficulty in falling asleep with vexation, palpitations and forgetfulness, dizziness and tinnitus, frequent dreaming and spermatorrhea, tidal fever and night sweats, a red tongue with a thin yellow coating, and a thin and rapid pulse. The supports should focus on nourishing yin, reducing fire, and harmonizing the Heart and Kidneys. One can consume Lian Shi Xue Er Tang (Lotus Seed and Tremella Decoction).

Formula and Preparation Method: Lotus Seed (with seed embryo) 15-25 g, Euryale Seed 12-15 g, Tremella 6-9 g, Chinese Yam 15 g, 1 egg, appropriate amount of granulated sugar. First, decoct Lotus Seed, Euryale Seed, and Chinese Yam in water, then add Tremella. After the Lotus Seed and Euryale Seed are cooked, finally add the egg (after cracking the shell, stir the egg with chopsticks before adding), and add sugar for consumption.

In the formula, lotus seed clears Heart fire and reduces heat, egg and tremella nourish yin and blood, Chinese yam strengthens the Spleen and tonifies the Kidney, and gorgon fruit astringes and stops semininal emission. It is most appropriate for supports semininal emission caused by disharmony between the Heart and Kidney.

One can also consume Lotus Seed and Pork Tripe Soup. Formula and preparation method: Take 1 pork tripe, fill it with 60 grams of lotus seeds with their Hearts and coats intact, cook until thoroughly tender, add a small amount of salt, consume the meat and soup in portions, or have it as a side dish with meals.

In the formula, lotus seed clears the Heart, facilitates communication between the Heart and Kidney, and consolidates essence qi; salt leads fire downward; pig Liver nourishes deficiency to consolidate essence. When used together, they collectively exert the functions of nourishing yin, clearing fire, calming the mind, and consolidating essence.

In addition, patients can choose to take diet therapy prescriptions that have the effects of astringing essence and helps maintain nocturnal emission.

2.Damp-heat pouring downward

Exposure to damp pathogens leads to their accumulation and transformation into heat, or excessive consumption of rich alcohol and heavy flavors generates internal damp-heat, which descends to the Kidneys, disturbs the essence chamber, and results in frequent spermatorrhea. As stated in Ming Yi Za Zhuo (Miscellaneous Writings of a Famous Physician): “For dream-induced spermatorrhea and involuntary seminal emission, most people supports it as Kidney deficiency and use Kidney-tonifying and essence-astringing medications without success. Little do they know that this condition is mostly related to the Spleen and stomach. Individuals who consume alcohol and heavy flavors frequently suffer from phlegm-fire and damp-heat.” Clinically, it is manifested by nocturnal emission during dreams, difficult and reddish urination, or turbid urine, dry mouth with bitter taste, yellow and greasy tongue coating, and soggy and rapid pulse. The supports principle is to clear heat and resolve dampness. Modified Lian Zi Liu Yi Tang can be administered.

Preparation Method: 60 grams of lotus seeds (with the seed embryo), 30 grams of adzuki beans, 10 grams of raw licorice root. Add an appropriate amount of water and simmer over low heat until the lotus seeds and adzuki beans are soft and cooked. Then, add a small amount of rock sugar. Consume the lotus seeds and adzuki beans, and drink the soup.

In the formula, the combination of lotus seed and raw licorice can clear Heart heat to promote dampness elimination, calm the mind and stop involuntary seminal emission; red adzuki bean strengthens the Spleen, promotes dampness elimination and detoxifies, and when combined with the above, the effect is more remarkable.

One can also take Pig Kidney and Plantago Decoction. Formula and preparation method: 1 pig Kidney, 15 grams of semen plantaginis, 15 grams of eucommia bark. Wash the pig Kidney and remove the tendons, then put all the ingredients together in a sand pot to make soup. Season it and consume.

Take it every other day for several consecutive days.

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

3.Hyperactivity of ministerial fire

Ministerial fire in humans originates from the Liver and Kidneys. Excessive sexual activity can deplete Kidney yin, while prolonged Liver Qi Stagnation can transform into fire. Both conditions can lead to hyperactivity of ministerial fire, disturbing the essence chamber and causing the essence gate to become unstable, resulting in involuntary seminal emission. As stated in Yiguan (Medical Compendium): “When Kidney yin is deficient, essence cannot be retained; when Liver yang is excessive, fire cannot be contained. When uncontained fire acts upon unretained essence, involuntary emission during dreams is inevitable.” signs of imbalance include heightened sexual desire, involuntary seminal emission during dreams, irritability, chest and hypochondrial pain, dizziness, bitter taste in the mouth, dry throat, red tongue with a yellow coating, and a wiry and rapid pulse. The supports principle is to clear and drain ministerial fire, and the patient can consume Ginkgo Egg.

Formula and Preparation Method: 1 egg, 2 crushed raw ginkgo kernels (Ginkgo biloba kernels). Crush the ginkgo kernels, make a small hole in the egg, insert the crushed ginkgo kernels into it, seal the hole with paper, and then steam it in a steamer until heated. Consume 1 egg each morning and evening, and continue until the wellness is supports.

In the formula, chicken eggs nourish yin and replenish deficiency, while ginkgo seeds have astringent properties to helps maintain involuntary discharge. Adding two crushed lotus seeds (with the bitter embryo) to clear the Heart and calm the mind will yield even better results.

One can also take Huanglian Ejiao Jizihuang Decoction.

4.Overstrain injuring the Heart and Spleen

Individuals with Heart-Spleen qi deficiency often experience exacerbated qi injury after overexertion, leading to insufficient central qi and the inability of qi to hold essence, resulting in involuntary seminal emission. Alternatively, excessive worry and mental strain can also injure the Heart and Spleen, leading to the inability of qi to hold essence and causing seminal leakage. Such patients often experience sudden involuntary seminal emission when fatigued or emotionally stressed, accompanied by palpitations, insomnia, forgetfulness, a sallow complexion, fatigue in the limbs, reduced appetite, loose stools, a pale tongue with a thin white coating, and a weak pulse. The supports should focus on nourishing the Heart and Spleen. It is advisable to consume Chinese Yam and Poria Steamed Buns.

Formula and Preparation Method: 100 grams each of Rhizoma Dioscoreae powder and Poria powder, 200 grams of wheat flour, 300 grams of white sugar, a small amount of lard, green and red shredded candied fruits. First, place the Rhizoma Dioscoreae and Poria powders in a bowl, add water to soak into a paste, steam for half an hour, then mix in wheat flour, white sugar, lard, and green and red shredded candied fruits to form the filling. Take soft dough that has been fermented and adjusted with alkali, wrap the filling to make steamed buns, steam until cooked, and serve as desired.

In the formula, Poria (Fuling) has a sweet and neutral taste. In Renzhai Zhizhi Fang, Poria alone is ground into powder and taken with rice soup to supports dream leakage or leukorrhea due to Heart deficiency. In Heji Jufang, Weixi Pills, made by grinding Poria into powder, are used to supports male patients with deficiency of primordial yang, insecure essence and qi, white turbid urine, and frequent dream leakage. If combined with Chinese Yam (Shanyao), which strengthens the Spleen and stops diarrhea, the effect of invigorating the Spleen and resolving dampness will be even better.

One can also take Xinpi Shuangbu Decoction. Formula and preparation method: 15 grams each of longan pulp, lotus seed, gordon euryale seed, Chinese yam, and jujube. Decoct them into a soup, and consume the soup along with longan pulp, lotus seed, gordon euryale seed, Chinese yam, and jujube.

In the formula, longan flesh (Arillus Longan) nourishes the Heart and Spleen, jujube (Ziziphi Jujubae Fructus) replenishes blood and benefits qi, Chinese yam (Dioscoreae Rhizoma) strengthens the Spleen and replenishes qi, lotus seed (Nelumbinis Semen) nourishes the Heart and calms the mind, and gorgon fruit (Euryales Semen) astringes and helps maintain involuntary discharge. Therefore, it is suitable for individuals with Heart-Spleen deficiency, involuntary seminal emission and spermatorrhea, qi deficiency with fatigue, and palpitations with forgetfulness.

In addition, one can choose food therapy recipes that nourish qi and blood for consumption.

5. Insecure Kidney Qi

If a person has congenital insufficiency, inherent deficiency, weakness of the lower energizer, and insecure essence gate; or engages in excessive indulgence in sensual pleasures after birth, gets married early, has excessive sexual activity, or frequently masturbates, leading to frequent leakage of semen, over time, this can result in Kidney deficiency and an insecure essence gate. As stated in Zheng Zhi Yao Jue (Essentials of assessment and supports), “Excessive sensual desires lead to weakness of the lower energizer and uncontrolled leakage and slipperiness.” signs of imbalance include frequent nocturnal emission, or even spermatorrhea, listlessness, pale complexion, soreness and weakness of the waist and knees, cold limbs, loose stools, frequent urination, or incomplete emptying of the bladder after urination, pale tongue with a white coating and tooth marks, and a deep and weak pulse. The supports principle is to warm and tonify Kidney yang, astringe essence, and stop diarrhea. Pan Tao Guo can be taken.

Formula and Preparation Method: 100 grams each of gordon euryale seed (Qian Shi), lotus seed (without core) (Lian Zi), jujube (Da Zao), walnut kernel (without skin) (Hu Tao Ren), prepared rehmannia root (Shu Di), 6 pig Kidneys, 15 grams of fennel powder (Xiao Hui Xiang Mo). Add an appropriate amount of water, boil until well-cooked and mushy, then mash. Mix with 1000 grams of glutinous rice flour and an appropriate amount of white sugar using the juice. Knead into a dough, and bake into several small cakes. Consume in portions.

In the formula, apart from Dazao (Fructus Jujubae) tonifying the Spleen and Huixiang (Fructus Foeniculi) warming the Kidney, Hutaoren (Semen Juglandis) and Shudi (Radix Rehmanniae Preparata) can replenish the Kidney and enrich essence, while Lianzi (Semen Nelumbinis) and Qianshi (Semen Euryales) can astringe essence and helps maintain involuntary seminal emission. Therefore, taking the whole formula together can make the Kidney qi abundant, the essence gate firm, and involuntary seminal emission will naturally be supports.

One can also consume Yangshen Decoction. Formula and Preparation Method: 2 sheep Kidneys, 2 sheep penises (ram’s genitalia), 12 grams of Cistanche deserticola Y.C.Ma (Cistanche), 10 grams of Lycium barbarum L. (Goji berries), 12 grams of Morinda officinalis F.C.How (Indian mulberry root), 15 grams of Dioscorea opposita Thunb. (Chinese yam), 10 grams of Rehmannia glutinosa (Gaertn.) Libosch. ex Fisch. et C.A.Mey. (Prepared rehmannia root), 10 grams of Euryale ferox Salisb. ex Konig et Sims (Fox nut), 10 grams of Rosa laevigata Michx. (Cherokee rose fruit), and 5 grams of Schisandra chinensis (Turcz.) Baill. (Schisandra). First, split open the sheep Kidneys, remove the omentum and ducts, and cut them into strips. Thoroughly clean the sheep penises inside and out. Wrap the eight herbs, namely Cistanche deserticola, Lycium barbarum, Morinda officinalis, Dioscorea opposita, Rehmannia glutinosa, Euryale ferox, Rosa laevigata, and Schisandra chinensis, in gauze. Place them in a pot with water for stewing. After it boils, reduce the heat to a simmer. One can eat the meat and drink the soup, taking it once a day.

In the formula, sheep Kidney and sheep penis are products from flesh and blood with affection, which can tonify the Kidney and consolidate semen. The other herbs combined are also for tonifying the Kidney, replenishing essence, and astringing to helps maintain involuntary seminal emission. Therefore, this formula is most suitable for supports involuntary seminal emission caused by Kidney-yang deficiency and failure of the essence gate to hold.

III. External Folk and Proven Prescriptions

1. Take an appropriate amount of Galla Chinensis, grind it into powder. Before going to bed, mix it with a small amount of warm boiled water to form a paste, place it on the umbilicus, and fix it with a plaster and adhesive tape. Change it every other day.

2. 50 grams of Calcined Os Draconis, 40 grams of Galla Chinensis. Grind the above herbs into a fine powder, mix with water to form a paste, fill the navel completely with the paste every night before going to bed, then secure it with adhesive plaster, and use it continuously for one week.

3.Sanjian Ointment: Aconitum carmichaelii Debx. (Tianxiong), Aconitum carmichaelii var. praeparatum (Fuzi), Aconitum carmichaelii Debx. (Chuanwu), 6 grams each; Cinnamomum cassia Presl (Guixin), Cinnamomum cassia Presl (Guangui), Cinnamomum cassia Presl twig (Guizhi), Asarum heterotropoides var. mandshuricum (Xixin), Zingiber officinale Roscoe (Ganjiang), Zanthoxylum bungeanum Maxim. (Chuanjiao), 60 grams each. Remove impurities from the aforementioned herbs, slice them together, and soak in sesame oil. Generally, soak for 5 days in spring, 3 days in summer, 7 days in autumn, and 10 days in winter. Then, decoct the mixture and remove the dregs. Filter it thoroughly and continue to decoct. Gradually add yellow lead oxide while stirring continuously until the mixture reaches a consistency where drops do not disperse in water, thus forming an ointment. When using, add a small amount of opium to the ointment and apply it to the umbilicus and Dantian area.