Erectile Dysfunction (ED) is usually believed to be an ‘old man’s issue’ as its prevalence increases with age as testosterone falls. However, this condition is a common and rising issue even in younger men these days due to high levels of stress— with as many as one in two sexually active men suffering from ED.
ED is a problem that not only interfere with one’s sexual activity but also with a person’s quality of life. ED can be caused by a variety of physical or psychological factors— psychological causes such as stress account for about 20% of ED cases, especially in younger men.
An occasional inability to maintain an erection happens to most men and is normal. However, continuous erection problems are a sign of ED and should be evaluated immediately instead of delaying consultation out of embarrassment.
Symptoms
Erectile dysfunction (ED) is the inability to achieve or keep an erection that is firm enough throughout the whole course of sexual activity. Therefore, the symptoms include:
- Difficulty in getting erections
- Erections that are too soft for sexual intercourse
- Inability to maintain erections
Morning wood, or also known as nocturnal penile tumescence (NPT), is an indicator of healthy blood and nerve supply to the penis. The presence of NPT also likely indicates that you’re physically capable of getting and maintaining an erection while awake.
If you stop experiencing NPT or notice that you’re not waking up with an erect penis anymore, this may be an early sign of ED. You may have something happening within your body that’s preventing adequate blood or nerve supply for proper erectile function.
What are the causes?
ED was believed to be caused primarily by psychological issues in the past. With a better understanding of the disease, we now know that there are multiple factors which lead to ED. The possible causes of ED can be a physical problem alone or in combination with psychological issues. In some cases, erectile dysfunction is one of the first signs of an underlying medical problem. Some common factors are:
Physical
- Various health conditions, such as cardiovascular diseases, diabetes, high blood pressure, obesity, nerves damage and etc
- Poor lifestyle, including but not limited to smoking, alcoholism, lack of exercises and drug abuse
- Certain medications or prescription drugs
- Hormonal changes, such as low testosterone levels
- Surgical complications
- Injuries in the pelvic area or spinal cord
Psychological
- Performance anxiety
- Depression or other mental health conditions
- Stress
- Relationship problems
- Guilt
- Low self esteem
A thorough consultation or questionnaire is usually carried out to identify any possible lifestyle or psychological causes. The patient will be asked questions about his erections. For example, how often do you fail to achieve erections? Do you have morning erections? Can you achieve erections when alone but not with your partner? And so on.
ED from a TCM point of view
TCM views the human body as an integrated whole, where all organs and systems are interconnected and interdependent on each other. When Yin and Yang are in balance, our body is healthy.
Kidney, Liver, Qi and blood are thought to be closely related with achieving and maintaining erections.
Kidney
Kidney stores the essence of our body, and governs reproduction. Kidney Yang, in fact, acts as a boost to achieve erections. Uncontrolled sexual activity, prolonged exposure in cold environments, over-consumption of cold food and drinks can weaken our Kidney Yang, eventually leading to formation of ED.
Symptoms of Kidney Yang deficiency:
- Lower libido
- Dizziness and ringing in the ear
- Lower back ache and weaker lower limbs
- Tiredness
- Cold limbs and intolerant to cold environment
- Increased frequency of urination.
Liver
Liver governs emotions and is responsible for the smooth circulations of Qi, blood, and body fluid. Moreover, the Liver meridian passes through and surrounds our genitals. The smooth circulations in the Liver meridian therefore ensure an effective erection.
Under-expressed or overly expressed emotions, especially anger, causes Liver Qi stagnation. Imbalanced diet, consuming too much spicy, oily, sweet stuffs contribute to generation of Dampness-Heat. Both of which then affect circulations, leading to a blockage in the Liver meridian and eventually leading to ED.
Symptoms of Liver Qi stagnation:
- Able to achieve erections during sleep or other times, but not with sexual partner
- Feeling depressed or irritable
- Pain and feeling of distension in the hypochondrium (two sides of chest)
- Sigh frequently
Symptoms of Dampness-Heat in body:
- Moist, itchy, and smelly scrotum
- Darker urine (amber color)
- Burning sensation during urination
- Tiredness and heavy limbs
- Nausea
- Bitterness in mouth
Qi and blood
Qi and blood are the fundamental elements to generate erections, having smooth circulations of Qi and blood are also important.
Therefore, when a man suffers from chronic diseases or injuries, his blood vessels are usually damaged and circulations are affected,leading to Qi stagnation and blood stasis.
Overthinking and working too hard physically or mentally can also exhaust the Spleen and Heart very quickly. Both organs are important for generating Qi and blood.
Both conditions can lead to ED even though their causes are vastly different.
Symptoms of Heart, Spleen, Qi and blood deficiency:
- Palpitation
- Amnesia
- Tiredness and lack of energy
- Pale looking
- Loss of appetite
- Stomach bloating
- Watery stools
Signs of Qi and blood blockage:
- History of chronic diseases
- Dark red tongue with dark patches or dark spots
The above body conditions can exist in multiple combinations. It is recommended to consult a physician for a detailed diagnosis.
Tips for resolving ED

The first three acupoints are suitable for all body constitutions.
Press on the acupoints and rub in a circular motion for 2-3mins, twice daily. Soreness should be felt at the acupoints when rubbing.

Ingredients
菟丝子Cuscuta chinensis 10g
覆盆子Palmleaf raspberry fruit 5g
枸杞子 Goji berry 10g
五味子Magnolia berry 5g
车前子Plantain seed 5g
Instructions
- Insert the ingredients into a tea bag and place in a teapot/ cup.
- Add boiling water and let the ingredients steep for 5 minutes.
- Consume the beverage gradually throughout the day (add warm water as required).
- Drink 2-3 times a week.

Ingredients
茉莉花 Jasmine 5g
橘络Tangerine Pith 5g
玫瑰花 Rose 5g
Instructions
- Insert the ingredients into a tea bag and place in a teapot/ cup.
- Add boiling water and let the ingredients steep for 5 minutes.
- Add honey to taste.
- Drink 3-5 times a week.

Ingredients
荷叶 Dried lotus leaf 10g
中国薏米 Chinese barley 60g
Instructions
- Rinse all the ingredients with water.
- Put rinsed lotus leaves into a filter bag.
- Place the ingredients into a pot with 1.5 litre of water.
- Boil with high heat, and turn to medium-low heat after the soup boils.
- Cook for 30 minutes.
- Add honey or rock sugar to taste.
- Drink 3-5 times a week.

Ingredients
西洋参 American ginseng 3g
红枣 Red dates 10g
龙眼干 Dried longan 6g
Instructions
- Put all ingredients into a cup and pour boiling water over it.
- Let it simmer for 5-10 mins before consumption.
- Drink 2-3 times a week.

Ingredients
丹参Red sage 8g
橘络Tangerine Pith 5g
Instructions
- Put all ingredients into a cup and pour boiling water over it.
- Let it simmer for 5-10 mins before consumption.
- Drink 2-3 times a week.
TCM Treatments
If the above remedies do not work, it is advisable to visit a physician to have a more in-depth understanding and professional help. TCM treatments like acupuncture or herbal medication may be useful to help reduce stress and improve Qi, reducing the occurrence of ED. In fact, independent medical studies have shown that acupuncture may help with some cases of ED.
As there is no “one size fits all” treatment plan, a consultation with a physician is recommended to more accurately diagnose your body condition and suggest treatment options customised for you.
https://pulsetcm.sg/book-an-appointment/
Note: Information provided is not a substitute for a physician or any form of medical care. Individual symptoms differ due to different body constitutions and diagnosis. One should consult a licensed TCM practitioner for accurate diagnosis and treatment.