The first time I treated a man for erectile dysfunction was in student clinic. The intake was fairly routine for the first 90% of it. I asked about things like stress and sleep and bowel movements and food cravings. The patient was fidgety though and I knew that something was going on besides the fairly innocuous given reason for his appointment that day. When I asked the magic question (“Is there anything else you want to tell me that I haven’t asked you about?”), the direction shifted and what really mattered was put on the table. Indeed, my patient actually was there to see if anything could be done about his erectile dysfunction. When he said this, I froze for just a second.
I was alone in my treatment room with this patient (for the most part, I rarely had a treatment partner in student clinic per my own request; I wanted to treat as much as possible and not split my shift responsibility with another) and he was, yes–you guessed it–a man. Surprising, huh? I’m a woman. It’s true. I am indeed female. It was embarrassing and surprising to suddenly be talking about sexual health with any patient, much less a man patient, and since I hadn’t at all expected this conversational turn, it was that much more startling.
My inner Professor Bruno immediately kicked in, though. When I was in the classroom, I was there for my students, not for me. When I’m in the treatment room, I’m there for my patients, not for me. If I was embarrassed, well–I could see from the look on my patient’s face that he was just as uncomfortable if not more so than I was at this moment. And so, I got a grip on myself and started asking the patient all the relevant questions. Could he achieve an erection at all? Was it partial or a complete erection? And so forth. Questions about context were next. When did he start having this issue? Was there a specific time and cause that he could pinpoint as to when and why he started having this concern? We then re-reviewed his current prescription list and talked about his original reason for coming within the context of the more pressing, and real, reason that had brought him to clinic that day.
This was my first erectile dysfunction patient and he wasn’t my last. By the time I treated my second case, I was no longer at all uncomfortable or embarrassed to discuss any and all topics related to men and their sexual health. By the time I was done with student clinic I became somewhat of an expert on the subject and I continue to work within this realm as a tui na practitioner. When the board exams and licensing process is over (it’s looking like that will be mid June if all goes as planned) I will treat male concerns with acupuncture and herbs once again. Until then, there are ways that tui na, cupping, and other non-invasive modalities can help a male patient and, in fact, I do use them at present in my office. Watch for more blog posts on this subject in future–it’s a great topic and worth further discussion. For this essay, though, I will introduce the subject and give some suggestions for potential patients (mine or otherwise).
A couple things really stand out for me when it comes to men’s health in general. For one thing, guys do not like to discuss their more vulnerable health issues. When I was in my first graduate program, in literature, I worked in the gym as a weight room attendant and a strength training consultant just to give myself a break from studying all the time. I lost count of the times that guys would approach me at the consultant station and, when my male shift partner was out of earshot, confess that they hated their skinny legs or abdominal fat. Men in clinic are the same, but if it has to do with erectile dysfunction they are even less happy to speak up.
My advice? Think about it like any other body part. Divested of the cultural baggage, it is just another body part and no need to be ashamed of its vagaries. When you are discussing erectile dysfunction with a practitioner, we care about if things work, how things work, and what may be causing the issue. A Chinese medicine practitioner will not treat the penis directly and we do not perform a physical examination. You keep your clothes on during your treatment. We aren’t psychotherapists and you do not need to discuss your feelings about the situation, either. It is part of your whole-body wellness and dysfunction in the system is expressing itself via the penis, that’s all. Our goal will be to return the system to health with the end result of a better function in the genital organ. There is no reason to feel ashamed or embarrassed.
Chinese medicine is similar to Western in that we ascribe erectile dysfunction to age-related, emotional, pharmaceutical, or functional-physical causes. If you are older, we’d say that the Kidney is diminishing and treat accordingly. If it’s due to an emotional issue, like anxiety, or to fatigue or general systemic weaknesses, then that’s a different story and we can look into treatment from that perspective. Maybe there are issues related to pharmaceuticals for blood pressure or it’s a matter of diabetes causing the problem. Maybe there was a physical trauma of some sort. Popular cultural imaginary tends to see Chinese medicine for erectile dysfunction as nothing more than Chinese herbs for a better erection but that is not the case. Herbs can help, but there is much more to traditional Chinese medicine than dodgy pills that can be purchased online.
Keep in mind that there is no magic bullet that will cure erectile dysfunction. Popular pharmaceutical drugs like Viagra really and truly do not offer an instant resolution to this issue. Did you know that there can be unpleasant side effects from these drugs, including blindness (here) and/or hearing loss (here)? Each person has to make their own choices about how they are going to deal with their health concerns, but if at all possible, it really is smart to explore all the options before immediately and unthinkingly reaching for a pill. (That said, it is really important that a patient know why they are experiencing ED. It could be a harbinger of serious health conditions, such as heart trouble; consequently, whether or not the patient wants to follow a Western protocol, it is necessary to at least consult with an MD to see if any specific testing is warranted).
My approach to the treatment of men’s health issues in this realm (either erectile dysfunction or male infertility) is to address anxiety, diet, sleep, and over-all constitutional health. Especially if the problem resides in the Kidneys or is stress-related, I can address concerns even now as a tui na practitioner. (Note: While I
am was in the process of finishing boards and getting licensed to practice acupuncture I am was able to offer all that traditional Chinese medicine does minus the needling and the herbal aspects.) At present, my strategy is to have the initial consultation with the patient and decide what I can and cannot do at that time. Generally, there will be tui na or cupping, maybe moxa, and acupressure with a focus on certain acupuncture points specific to men’s health. I then send the patient to my mentor, a licensed acupuncturist and faculty member at my program, for herbs. This is a strategy that has thus far seen very good results in my bodywork clients who come to me for this issue. (Update: I am now a licensed acupuncturist and my treatment plan has shifted accordingly.)
As ever, I also feel very strongly that education is a great tool for healing, particularly if pharmaceutical drugs like blood pressure medication or other like are affecting the patient. One book that I highly recommend is The Viagra Alternative: The Complete Guide to Overcoming Erectile Dysfunction Naturally, pictured here:
This book is not TCM-focused but it has a terrific explanation of the panorama surrounding male sexual dysfunction and it outlines varying natural ways to address concerns. Its author is French and a noted expert in men’s health. In my estimation, knowledge is power. If a guy wants to become healthier and more in control of his situation, it’s useful to know what’s going on and to make a plan. Reading this book is a good start. Taking stock of your life and your over-all health and focusing on the broad picture rather than just the one body part is a smart tactic.
Chinese medicine can do a lot for men’s health but the man also needs to be ready to work with the practitioner. The problem might just be emotional baggage that diminishes the libido. Is the patient ready to do some psychological decluttering, maybe even with a therapist? Or it could be that the patient needs to lose some weight. Will he opt to change his diet and make time for exercise? A patient may need to follow a consistent herbal regimen. Is this going to happen? It may be that the patient’s pharmaceutical medications need to be altered and, if so, is the patient willing to keep both the Western MD and the TCM practitioner in equal estimation? (Myself, I do not advocate for just stopping medications without the MD’s approval; I’m not a big fan of Western medicine but I want what’s best for the patient and that can mean integrative or allopathic-centered protocols. For more on that, see my blog post, here).
So what can Chinese medicine do, then? Well, anything listed in the preceding paragraph (hormone levels, stress relief, drug side effect amelioration) can be enhanced with TCM treatment. Chinese medicine is slower than the seemingly-instant results associated with taking a pill but we don’t have the side effects and our benefits and results tend to last. A Chinese medicine practitioner also will take the time to really speak with you, listen to you, and work with you to achieve a whole-body health improvement. Even if you ultimately decide to go another route, it is always smart to at least consult with a TCM practitioner and see what can be done in your individualized case. You might be pleasantly surprised at what is possible for you.
Don’t be embarrassed to speak with your practitioner, though. We’re on your side, and we want you to achieve your version of optimal health. Your sexual health is part of that picture, and nothing for which you should feel a sense of shame.
Erectile dysfunction can be a wake-up call that leads to better overall health and quality of life. When you go for your appointment, your practitioner may be able to help you with a series of bodywork treatments. You may need herbs and acupuncture. Your issue might be resolved with just your office visits and your compliance with your herbal regimen. Chinese medicine is that good. But really? If you’re willing to make changes outside of the treatment room too, your chances for a satisfactory outcome are that much greater. If you are healthier in general it should, in fact, and can spill over to your health and wellbeing in the bedroom.
Are you ready to experience traditional Chinese medicine and an over-all healthier life?
Paula Bruno, Ph.D., L.Ac., is a licensed acupuncturist and herbalist, an AOBTA-CP traditional Chinese bodywork therapist, and a wellness educator. She maintains an active and growing practice at her Austin, TX office. Dr. Bruno is also available for distance appointments for wellness consultation or coaching.
In her first career, she was a Spanish professor.
Dr. Bruno’s specialties as a traditional Chinese medicine practitioner include: • Musculoskeletal health (acute or chronic pain relief; Ehlers Danlos syndrome & hypermobility support) • Digestive support, gut health, and weight loss • Aesthetic treatment, including scar revision • Men’s health • General preventative care and immune support for all persons.
Note: Material on this web site is not intended to replace your treatment or care provided by an MD. It is for educational/entertainment purposes only. A TCM practitioner in Texas identifies syndrome patterns but does not diagnose illness. Always consult your primary care doctor for health concerns.