Erectile dysfunction (ED) can affect a man at any age. In younger men, the cause tends to be emotional, whereas, in older men the cause is usually physical. There are 4 components when considering the pathomechanism of ED, they are: 1. vascular, 2. neurogenic, 3. anatomical and 4. hormonal.
Emotional factors (stress, anxiety, depression, fear, anger, and frustration)
Iatrogenic (medical) - surgery in the pelvic region, surgery or treatment of prostate,
Iatrogenic (medications) - Some peptic ulcer medication like Tagamet, blood pressure medications, especially beta-blockers, heart medications like Digoxin, anti-depressants, especially MAO inhibitors, sleeping pills. The more medications a patient is taking puts them in a higher risk category for ED.
Difficulty achieving an erection
Inability maintaining an erection
In Chinese medicine, ED is related primarily to the Kidneys, caused by a decrease in Kidney Yang and the "ministerial fire", which is located between the Kidneys. This is the most common cause seen, but there are other pathologies which can involve the heart, Liver, and Spleen organs. Also, there can be meridian pathologies that involve the Du, Ren, Chong, Kidney, and Liver meridians. The Du, Kidney and Liver meridians actually run through the genitalia, and the Du, Ren and Chong run through the prostate.
There are three crucial factors for arousal, erection, orgasm and ejaculation:
Communication between the Heart and Kidneys.
The proper descending of Heart fire and ascending of Kidney water.
The unobstructed flow of Qi & blood in the meridians (Du, Kidney, Liver).
In a balanced system the Heart and Kidneys are always communicating with one another. Heart Qi (fire) descends to meet the ascending Kidney Qi (water) to maintain balance. During sexual arousal there is a build - up of "ministerial fire", this rises up to the Heart and causes a flushed face during sexual excitation. The heart rate then begins to increase, and the Heart Qi then descends to release the "ministerial fire" downwards as an orgasm / ejaculation. This can only occur if there is proper communication between the Heart and Kidneys.
The Du and Ren meridians are connected and form a circuit that runs down the front and back of the body. In order for there to be normal sexual functioning these meridians need to be able to communicate freely with one another, and be free of any obstructions.
Emotions are a big factor in ED. Over-thinking and worrying too much can have an effect on the Heart and Spleen, which can cause a deficiency in Qi & blood, and therefore a lack of nourishment to the genitalia. Anger, frustration and stress can bind up Qi in the Liver causing blood stasis; again there is a lack of Qi & blood reaching the penis. Fear injures the Kidneys and causes a deficiency in Kidney Qi and Kidney essence.
Also, abuse of alcohol and a poor diet of fried or greasy foods, can affect the Spleen & Stomach. This can cause an accumulation of dampness, which can combine with heat or cold and flow downward to block the meridians in the genitalia region; and therefore causing flaccidity.
The primary treatment for ED is with an Herbal formula which can tonify deficient organs, move Qi and blood, dispel stasis, improving hormone balance, and nourishing blood. Secondary to herbal therapy is acupuncture, which works at unblocking the channels, improving circulation, balancing the body's energy, and improving communication between the channels and organs to promote normal functioning. Lifestyle changes are always a big part of any treatment, which promote healthy living.