Erectile dysfunction (ED) is the inability to get or maintain an erection long enough to engage in sexual intercourse. There are many different causes, including conditions that affect blood vessels, neurological disorders, mental health conditions, and physical injuries.

The most common form is vascular erectile dysfunction, which involves blood flow issues that impair the ability of the penile tissues to fill and stay engorged. Other types include neurogenic ED, caused by nerve problems that prevent signals from traveling from the brain to the penis; hormonal erectile dysfunction, often related to testosterone deficiency or thyroid disorders; and psychogenic erectile dysfunction, which stems from psychological issues such as anxiety, depression, or stress.

Erectile dysfunction can also be a result of chronic conditions such as diabetes, diabetic neuropathy, high blood pressure (hypertension), high cholesterol (hyperlipidemia), and vascular disease. Physical trauma, including surgical procedures or radiation therapy, may also contribute to ED. Additionally, ED may occur as a side effect of prescription drugs, including antidepressants and anti-anxiety medications.

Western Medical Treatment

Common Western medical treatments for erectile dysfunction include oral medications designed to increase blood flow to the penis, such as sildenafil (Viagra®), vardenafil (Levitra®), tadalafil (Cialis®), or avanafil (Stendra®). Other options include penile low-intensity focused shockwave therapy (LiSWT); injectable medications such as alprostadil (Caverject®), papaverine (Papacon®), and phentolamine (Regitine®); vacuum constriction devices (penis pumps); and testosterone replacement therapy.

A Chinese Medical Approach

In Traditional Chinese Medicine (TCM), treatment begins with a thorough diagnosis, which may include pulse and tongue diagnosis, palpation of the lower abdomen, low back, and acupuncture meridians. Patients are also asked about various aspects of their health and body systems.

After assessment, a differential diagnosis is made. Common patterns of disharmony include Kidney Yang deficiency, Kidney Yin deficiency, Spleen Yang deficiency, Qi deficiency, Qi and Blood stagnation, Kidney Qi not firm, Liver Qi stagnation, and Jing deficiency (premature aging).

Treatment

Once a diagnosis is established, treatment typically involves weekly or biweekly acupuncture sessions. Initial treatments focus on clearing energetic blocks that may be preventing healing. As progress continues, acupuncture targets the primary meridians involved, and possibly the Eight Extraordinary Vessels, particularly the Du Mai (Governing Vessel) and Chong Mai (Penetrating Vessel). If blood stasis is present, the Luo vessels may also be activated. Moxibustion is often used to warm Yang, nourish blood, and promote circulation.

Chinese herbal medicine can significantly accelerate recovery. Classical formulas such as Shen Qi Wan, You Gui Wan, Zuo Gui Wan, Liu Wei Di Huang Wan, Gui Zhi Fu Ling Wan, Xue Fu Zhu Yu Tang, and Qi Bao Mei Ran Dan may be prescribed, often in modified forms tailored to the patient's unique condition.

Other Recommendations

In addition to acupuncture and herbal therapy, lifestyle changes play an important role in addressing erectile dysfunction. Regular cardiovascular exercise—such as brisk walking, jogging, swimming, bicycling, or jumping rope—for at least 45 minutes three times per week is strongly encouraged. Quitting smoking is also crucial. In cases where psychological factors contribute to ED, working with a sex therapist may provide added benefit.

How Long Will It Take?

Based on clinical experience, most patients begin to notice symptom improvement within 4 to 6 visits. After about 2 months of weekly treatment, patients often experience significant improvement, leading to a more satisfying and fulfilling sex life. To maintain progress, maintenance treatments every 2 to 3 weeks are recommended for 3 to 6 months, followed by monthly sessions to support ongoing health and wellness.