Oral pharmaceutical medications have become the standard treatment for erectile dysfunction. In a guideline published by the American Urological Association in 2005, PDE5 inhibitors – including Viagra, Cialis, and Levitra – were recommended as a first-line therapy. But even though these medications are generally very effective, they often have side effects and may stop working after a few years. In addition, some men have medical conditions which prevent them from using the drugs (for example, men who take nitrate medications for heart disease). Still other men are opposed to medications in general and prefer to seek natural alternatives.
One non-drug treatment for erectile dysfunction that is attracting some attention is acupuncture. Acupuncture is an ancient Chinese practice in which a practitioner inserts very fine needles into specific sites along the body’s pathways or “meridians.” These meridians connect the head, torso, arms, legs, and all internal organs. According to traditional beliefs, the body has a life force called Qi (pronounced “chee”) which flows along these meridians. When the flow of Qi becomes blocked or unbalanced, pain and illness result. Acupuncture, by stimulating specific acupoints, will restore the ideal flow of energy.
The goal of acupuncture is to modify the sensation of pain and to alter bodily functions in order to treat or prevent various ailments. However, it should be noted that acupuncture does not treat a specific illness or condition, but rather, treats an overall pattern or cause.
Although acupuncture tends to be most beneficial when erectile dysfunction is caused by a “state of mind”, many practitioners believe that erectile dysfunction can be improved regardless of whether the cause is physical, mental, or environmental. However, it is important to realize that acupuncture is not regulated in the same way as pharmaceuticals, so finding an acupuncturist who is properly licensed and certified is critical.
The thought of needles being inserted into the penis will probably make most men cringe. But contrary to common perceptions, no acupuncture needles are ever placed in the groin area. Because the energy pathways run along the entire body, acupuncture points on the extremities, abdomen, and back are typically used. According to some acupuncturists, the most effective points are often those furthest from the local area. It should also be noted that needles used for acupuncture are as flexible and thin as human hair.
Since Chinese medicine originated long before blood tests and other sophisticated diagnostic procedures, an acupuncturist makes a diagnosis based on asking questions and simple observational techniques such as looking at the tongue, taking the pulse on each wrist, and palpitating the abdomen. Treatment often involves a combination of acupuncture and Chinese herbal medicine. Diet and exercise are also discussed. Foods such as scallions, lamb, sea cucumber, shrimp, bitter melon seeds, and ginseng are often recommended.
According to Chinese medical theory, there are three primary causes for erectile dysfunction, each with a very different treatment plan involving different needle placements and Chinese herbal formulas. The first cause is “declining fire of the gate of vitality”. The Chinese believe that the gate of vitality (Ming Men) is located in the kidneys and controls our ability to be warm. The fire also affects digestion, urination, metabolism, and sexual energy in both sexes. We receive the original energy for the fire at birth and resupply it with energy from the food and drink we consume. When the fire burns well, it promotes good digestion, since there is sufficient heat to “cook” the contents of the stomach. But when the fire is low, the body can’t digest food properly or turn waste fluids into urine. There may also be a cooling off of sexual energy. An acupuncturist will diagnose this condition by looking for symptoms such as cold arms and legs, listlessness, and frequent urination. Treatment involves focusing on an acupuncture point called GV4 (also known as Ming Men), which is located in the center of the spine, just below the 2nd lumbar vertebrae, as well as other points on the stomach, spleen, and kidneys.
Another cause for erectile dysfunction is excessive sweating in the groin area. According to Chinese medical theory, this condition is caused by either a kidney or liver disharmony. It typically occurs in younger men and is often a result of poor diet, especially an excess of rich food and/or alcohol. An acupuncturist will diagnose this condition by looking for symptoms such as excessive sweating around the scrotum and groin, a bitter taste in the mouth, itching or pain in the genitals, excessive thirst, and a greasy yellow coating on the tongue. Treatment usually involves acupuncture (including acupuncture point CV6 on the lower abdomen), dietary changes, and herbal treatments.
The third cause for erectile dysfunction is liver qi stagnation or blood stagnation, which can be a result of chronic stress or poor circulation. Less commonly, the condition can also be caused by varicose veins or trauma or surgery to the testicles. Symptoms include irritability, aches and pains, insomnia, and digestive complaints. Acupuncture has been less successful for this condition; herbal remedies are more commonly used. It should be noted that blood stagnation is basically equivalent to poor blood flow, which is the condition treated by Viagra, Cialis, and Levitra.
Acupuncture treatment plans generally range from 10-20 weekly sessions. Sessions are typically 30-50 minutes in duration and involve 6-10 needles. The patient remains fully clothed and listens to relaxing music while the treatment is administered. Many patients fall into a deep sleep and wake feeling rejuvenated.
Although some Western physicians believe in acupuncture, most do not accept the traditional Chinese explanations of how it works. Some Western physicians speculate that the needles stimulate the release of endorphins, the body’s natural painkillers. Other theories claim the needles release neurotransmitters, chemicals that carry messages between nerve endings.
Does acupuncture really work for erectile dysfunction? The only way to prove scientifically whether acupuncture really works is to study it the way medications are now studied: with placebo-controlled trials. With placebo-controlled trials, an experimental treatment is tested against a dummy treatment (placebo) which has no active ingredient. Neither the patients nor the researchers know who is getting the real treatment until the trial is over. With medications, it is relatively easy to make a dummy pill look and taste like an active medication. However, with a treatment like acupuncture, placebo-controlled trials are much more challenging, since it is hard to perform fake acupuncture. Most of the trials that are considered valid have compared acupuncture to sham treatments that use needles inserted in the wrong places instead of in the correct acupoints.
One of the few scientific studies comparing acupuncture to placebo was conducted in 2003 by Dr. Paul Engelhardt in Vienna, Austria. A total of 21 patients with erectile dysfunction were randomized into two groups. In the treatment group, acupuncture was done at the standardized acupoints used in the treatment of erectile dysfunction. In the placebo group, acupuncture was done at acupoints used in the treatment of headache. Within the placebo group, it soon became apparent that the majority of patients (10/11) did not show any improvement in their erection status, so were crossed over into the treatment group. Overall, a satisfactory response was achieved in 68.4% of the treatment group and in only 9% of the placebo group. However, Dr. Engelhardt noted that some of the improvements may have been due to the strong interactive communication that the patients received.
In another study conducted in 1997, Aydin et al compared acupuncture versus hypnosis. The study included 15 men who received acupuncture treatment, 16 men who underwent hypnosis, and 29 men who served as controls. Acupuncture and hypnosis were successful in 60 and 70%, respectively, while patients in the control group reported significantly better erections in 43–47%.
Unfortunately, there just hasn’t been enough good research to determine if acupuncture is an effective treatment for erectile dysfunction. Because it is generally safe, men who are interested in non-medicinal treatments are certainly free to give it a whirl. Keep in mind, however, that acupuncture can be time consuming and expensive. Also keep in mind that erectile dysfunction may be a sign of an underlying medical condition, so a complete physical examination by your doctor or healthcare provider is essential.