Premature ejaculation

Ejaculation shortly after insertion, followed by subsiding of the erection that prevents further coitus. Premature ejaculation is attributed to hyperactivity of the ministerial fire, to insecurity of kidney qì, to heart-spleen depletion, to liver channel damp-heat, or to depressed liver qì.

Patterns

Hyperactivity of the ministerial fire (相火亢盛 xiàng huǒ kàng shèng): Premature ejaculation can arise when sexual intemperance, excessive masturbation, or enduring sickness affect the kidney causing depletion of kidney yīn and exuberance of the ministerial fire. Alternatively, it may arise when wild desire stirs the sovereign fire above and causes the ministerial fire to become hyperactive below. In the former case, kidney yīn signs such as limp aching lumbus and vexing heat in the five hearts are pronounced, whereas in the latter there are marked signs of upward flaming fire such as dizziness, headache, red eyes, tinnitus, and baking heat in the face. In either case, premature ejaculation is associated with excessive libido.

Medicinal therapy: Use Major Yīn Supplementation Pill (大补阴丸 dà bǔ yīn wán) for kidney yīn depletion, and Left-Running Metal Pill (左金丸 zuǒ jīn wán) for signs of fire flaming upward.

Acumoxatherapy: Base treatment on back transport points and KI. Needle with supplementation at BL-23 (Kidney Transport, 肾俞 shèn shù), KI-3 (Great Ravine, 太溪 tài xī), BL-52 (Will Chamber, 志室 zhì shì), and KI-7 (Recover Flow, 复溜 fù liū), and with drainage at BL-15 (Heart Transport, 心俞 xīn shù), HT-7 (Spirit Gate, 神门 shén mén), KI-6 (Shining Sea, 照海 zhào hǎi), and KI-2 (Blazing Valley, 然谷 rán gǔ).

Insecurity of kidney qì (肾气不固 shèn qì bù gù): Premature ejaculation due to insecurity of kidney qì is a kidney qì vacuity pattern. It differs from the exuberant ministerial fire pattern in that it is associated with reduced rather than with increased libido. Other signs include limp aching lumbus and knees, dull dark complexion, frequent urination and, in severe cases, urinary incontinence.

Medicinal therapy: Boost the kidney and secure essence with Golden Cabinet Kidney Qì Pill (金匮肾气丸 jīn guì shèn qì wán) plus tribulus (Tribuli Fructus, 刺蒺藜 cì jí lí), dragon bone (Mastodi Ossis Fossilia, 龙骨 lóng gǔ), and oyster shell (Ostreae Concha, 牡蛎 mǔ lì). Preparatory medicines include Five-Seed Progeny Pill (五子衍宗丸 wǔ zǐ yǎn zōng wán) or Golden Lock Essence-Securing Pill (金锁固精丸 jīn suǒ gù jīng wán).

Acumoxatherapy: Base treatment on CV, back transport points, GV and KI. Select BL-23 (Kidney Transport, 肾俞 shèn shù), GV-4 (Life Gate, 命门 mìng mén), CV-4 (Pass Head, 关元 guān yuán), CV-6 (Sea of Qì, 气海 qì hǎi), KI-10 (Yīn Valley, 阴谷 yīn gǔ), and GB-25 (Capital Gate, 京门 jīng mén); needle with supplementation and add moxa.

Heart-spleen depletion (心脾亏损 xīn pí kuī sǔn): Premature ejaculation due to dual vacuity of the heart and spleen arises from excessive thought or anxiety, major or enduring sickness, or dietary irregularities causing insufficiency of qì and blood and qì vacuity fall that weakens the power to contain essence. It is accompanied by shortness of breath and lack of strength, and a lusterless complexion. Accompanying signs may include heart palpitation or fearful throbbing, reduced sleep and profuse dreaming, dizziness, forgetfulness, abdominal distension, sloppy stool, reduced food intake, and torpid intake.

Medicinal therapy: Supplement the spleen and heart with Spleen-Returning Decoction (归脾汤 guī pí tāng). Alternatively use Ginseng Provisioning-Nourishing Decoction (人参养荣汤 rén shēn yǎng róng tāng).

Acumoxatherapy: Base treatment on back transport points, CV, ST, and SP. Select BL-15 (Heart Transport, 心俞 xīn shù), BL-20 (Spleen Transport, 脾俞 pí shù), BL-17 (Diaphragm Transport, 膈俞 gé shù), CV-4 (Pass Head, 关元 guān yuán), CV-6 (Sea of Qì, 气海 qì hǎi), ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo); needle with supplementation and add moxa.

Liver channel damp-heat (肝经湿热 gān jīng shī rè): Liver channel damp-heat may arise either when predilection for sweet, fatty, fried, and spicy foods causes damp-heat to arise within or after repeated contraction of damp-heat evil. When it causes stagnation of qì dynamic, it can stir the ministerial fire, which harasses the essence chamber, causing premature ejaculation. In such cases, premature ejaculation is associated with frequent erections. Accompanying signs include bitter taste in the mouth, torpid intake, oppression in the chest and rib-side pain, hot itchy scrotum, and yellow or reddish urine. The tongue fur is yellow and slimy and the pulse is stringlike, slippery and rapid.

Medicinal therapy: Clear heat and drain dampness with Gentian Liver-Draining Decoction (龙胆泻肝汤 lóng dǎn xiè gān tāng).

Acumoxatherapy: Base treatment on back transport points, LR, GB, and SP. Select BL-18 (Liver Transport, 肝俞 gān shù), LR-2 (Moving Between, 行间 xíng jiān), GB-34 (Yáng Mound Spring, 阳陵泉 yáng líng quán), LI-11 (Pool at the Bend, 曲池 qū chí), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), and SP-9 (Yīn Mound Spring, 阴陵泉 yīn líng quán); needle with drainage and add moxa.

Depressed liver qì (肝气郁 gān qì yù): Premature ejaculation due to depressed liver qì arises when affect-mind dissatisfaction causes depression and binding of qì dynamic; this impairs liver free coursing and affects the kidney’s ability to secure essence. The principal accompanying sign is mental depression; other signs include rib-side distension and distending pain in the lesser abdomen, oppression in the chest, sighing, and in some cases dry mouth with bitter taste, reduced sleep and profuse dreaming, thin white tongue fur, and a stringlike pulse.

Medicinal therapy: Course the liver and rectify qì using Bupleurum Liver-Coursing Powder (柴胡疏肝散 chái hú shū gān sǎn).

Acumoxatherapy: Base treatment on back transport points, PC, LR, and SP. Select BL-18 (Liver Transport, 肝俞 gān shù), BL-23 (Kidney Transport, 肾俞 shèn shù), PC-6 (Inner Pass, 内关 nèi guān), LR-14 (Cycle Gate, 期门 qī mén), LR-3 (Supreme Surge, 太冲 tài chōng), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), and ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ); needle with even supplementation and drainage.