Penis, phallus, dick, willy, schlong...


Whatever term you choose to use, I feel it's important to chat with my patients about what's happening down there, but many of them don't share the same enthusiasm. Talking about sexual and reproductive health can be confronting and embarrassing, resulting in many people turning to Dr. Google, which is fraught with false treatments and sometimes downright dangerous misinformation.

Discussions around male sexual health and function in Chinese Medicine have been a point of discussion in texts dating as far back as 2200 years ago. When it comes to issues affecting your penis, Chinese medicine zooms out to a more holistic view of the body, understanding that physical, mental, and emotional factors can all play a significant role in how well your penis can perform. This is crucial for allowing a TCM practitioner to come to an accurate diagnosis. Rather than just diagnosing 'erectile dysfunction', a Chinese Medicine practitioner views this as one symptom of many different syndromes which could be occurring.

In Chinese Medicine, the Kidney and Liver organs play a very important role in sexual function. Imbalances within these organs or their meridians often manifest in sexual dysfunction. It is always important to note that the organ systems in Chinese Medicine refer to dynamic functional physiology and interrelationships rather than fixed anatomical structures as understood by Western Medicine.

Kidney Yang energy is responsible for arousal and sexual desire. When Kidney Yang is deficient, there may be a loss of libido, while an excess of Kidney Yang could mean getting a bit overexcited and finishing a bit sooner than anticipated. Kidney Yin, on the other hand, refers to the heavier nutritive substances involved in sex like blood and body fluids (including semen). Where yin is deficient, it may result in a soft erection, loss of erection, or inability to orgasm.

The Liver meridian encircles the genitals, so acupuncturists will often choose points along the Liver meridian on the lower legs and feet to treat disorders affecting the genitals and reproductive system. The Liver meridian is particularly prone to stagnation of qi and blood, which can impair healthy erections and ejaculation. It can also be invaded by damp-heat conditions which often manifest with STI-type symptoms such as redness, swelling, itching, burning sensations, or abnormal discharge.

It's a shame that we aren't better equipped to have more open and frank conversations around sexual health, as the incidence of sexual issues is a fairly common occurrence for most men. For example, premature ejaculation is estimated to affect between 21-31% of Australian adult men, while erectile dysfunction affects around one third of adult men with a growing incidence as they age.

Premature ejaculation is kind of like the game finishing at half-time. Mental health plays a crucial role in PE, with high stress, performance/sexual anxiety, and low self-esteem all considered to be contributing factors. Maintaining good physical health is also important which includes regular exercise and changes in diet. Those experiencing PE should avoid foods high in saturated fats, sugars, or spice (chili), while increasing food which in TCM are considered to nourish the Kidney such as shellfish, walnuts, and shiitake mushrooms. The 'stop-start' technique (also colloquially known as edging) can be a good way to try and improve stamina and get a better understanding of your body's cues of when you might be approaching the point of no return. Using condoms during intercourse (or when engaging in some self-love) can be helpful to reduce sensitivity and therefore delay ejaculation.

While less common, delayed ejaculation can also cause its own issues. Think the big bad wolf here, a lot of huffing and puffing without any satisfactory conclusion. Certain medications like the SSRI class of antidepressants can result in delayed ejaculation (which conversely can be of benefit for men suffering from PE).

Erectile dysfunction (aka impotence) is when you can't quite get it up or keep it that way. It is a fairly common problem as you age. While the little blue pill might provide some temporary respite, it's important to look at the ways your underlying health might be involved. From a western medicine perspective, they separate the cause into organic (diabetes, impaired circulation, hormones, side effects of drugs) versus psychogenic (stress, anxiety, depression, etc.). A key way of differentiating the two is whether or not nocturnal penile tumescence is present (essentially erections during sleep and 'morning wood'). Looking after your general health is a great way to help manage ED. This includes things like quitting smoking, minimizing alcohol intake, staying active, and maintaining a healthy body weight. Seeing a therapist can help with improving your overall mental health and manage stress or anxiety associated with sexual performance. Use of vacuum constriction devices ('penis pump') or penile constriction rings ('cock ring') may also help with achieving and maintaining an erection.

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