Reproductive health - Male

Question 1

What is Shen Jing?

Answer 1

• Shen Jing is translated as kidney essence, it is the prenatal vital substance which is stored in the Kidney and responsible for growth, development and reproduction.

Question 2

What organs are responsible for male fertility?

Answer 2

• Kidney, Liver and Spleen – responsible for one’s fertility

Question 3

What is the role of Kidney, Spleen and Liver in fertility?

Answer 3

• The Kidney stores reproductive (prenatal) essence, the Spleen transforms nutritive essence into energy and blood, the Live regulates the movement of energy in the body.
• The vital energy of life circulates in the primary channels network, organ systems and the eight extra vessels. Chong Mai, Ren mai, Du mai and Dai mai.

Question 4

What are male reproductive system diseases related to in TCM?

Answer 4

• TCM diagnosed male reproductive system disease are mainly related to the pathologies of the Liver, Kidney, Spleen, eight extra vessels and the vital substances of essence and blood.

Question 5

What are outcome measures in male fertility?

Answer 5

• Blood tests, semen analysis, hormonal assessments, imaging studies and patient-reported outcome measures (PROMS).

Question 6

What is the male reproductive system made up of according to biomedicine?

Answer 6

• Consists of the external genitals: penis, testes and the scrotum and internal parts such as the prostate gland, vas deferens and urethra
• A man’s fertility and sexual traits depend on the normal functioning of the male reproductive system, as well as hormones released from the brain

Question 7

What are common male reproductive health issues?

Answer 7

• Common male reproductive health issues include sexual dysfunction, infertility, prostate disease, testicular cancer

Question 8

What is erectile dysfunction?

Answer 8

• ED also known as Yang Wei.
• Yang refers to Kidney Yang and Yang hydraulics
• The term Wei means flaccidity and atrophy
• Yang Wei means the inability to achieve erection and ultimately reflects the state of the Kidney and distribution of Qi and Blood.

Question 9

What is the ethology of erectile dysfunction?

Answer 9

• Aetiology includes emotions / stress, improper diet inducing dampness, constitution weakness (kidney xu), overexertion, aging etc.

Question 10

What is the pathogenesis of erectile dysfunction?

Answer 10

• Pathogenesis: Kidney xu (Yin, Yang and essence), Spleen and Heart Qi and Blood Xu, Liver Qi stagnation and its variations (blood stasis, or damp-heat accumulation, Liver yin xu), but the Kidney and Liver are the two primary organs related to ED in TCM.

Question 11

What is the biomedicine view of erectile dysfunction?

Answer 11

• Erectile dysfunction is also known as ED or impotence, refers to inability to obtain and keep an erection that is sufficient for sexual intercourse.
• It effects up to 2-3 males over age 45 years.

Question 12

What is the biomedicine view of the causes of erectile dysfunction?

Answer 12

• Causes: physical and psychological: stress and mental health concerns can worsen erectile dysfunction, physical causes like diabetes, heart disease, sleep disorders, alcoholism, obesity, or other metabolic disorders may be linked to ED, and a combination of physical and psychological issues is most common cause of erectile dysfunction.
• Treatment: psychological treatment, medicine and medical devices.

Question 13

What are the treatment principles for ED?

Answer 13

• Acupuncture, herbal medicine, tuina, dietetics, exercise
• Aims to restore the Yin-Yang balance and Qi-Xue harmony by tonifying deficiencies, regulating qi and blood to restore qi dynamic and resolving dampness-phlegm
• Bian Bing and Bian Zheng principle is applicable.
• San Yin Zhi Yi, Tong Bing Yi Zhi and Yi Bing Tong Zhui

Question 14

What is male infertility?

Answer 14

• Sperm is closely related to essence (Jing) stored in the Kidney. The Kidney essence and tian gui controls men’s growth, development and reproduction with emphasising the significance of the eight-year-cycle based on the yellow Emperors inner canon su wen.
• Kidney, Liver and Spleen are responsible for fertility

Question 15

What are the patterns involved in male infertility?

Answer 15

• Deficiency of Kidney Yin / Yang (prenatal essence) – leads to low semen quality as the Kidney stores reproductive essence which is required for reproduction
• Weak Spleen: leads to depletion in the formation of Qi (energy) and blood (postnatal insufficiency)
• Stagnant Qi (energy circulation not freely flow) or blood stasis – leads to abnormal morphology of the sperm or varicoele (enlarged veins and testes), sperm delivery options.

Question 16

What is the biomedicine view of male infertility?

Answer 16

• Defined as a couple that have not been able to successfully conceive a child even though they’ve had frequent, unprotected sexual intercourse for a year or longer.
• Male infertility is one of the largest health problems facing men, 4 in 10 cases of infertility are attributable to a problem in the main.
• Can be caused by low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm.
• Injuries, chronic health problems, lifestyle choices, environmental factors like radiation or x-ray and other factors may contribute to male infertility.
• Treatment: sperm retrieval.

Question 17

What are the treatment principles for male infertility?

Answer 17

• Acupuncture, herbal medicine, tuina, dietetics, exercise
• Aims to restore the Yin-Yang balance and Qi-Xue harmony by tonifying deficiencies, regulating qi and blood to restore qi dynamic and resolving dampness-phlegm
• Bian Bing and Bian Zheng principle is applicable.
• San Yin Zhi Yi, Tong Bing Yi Zhi and Yi Bing Tong Zhui

Question 18

What is prostatitis?

Answer 18

• Prostate is not specifically discussed.
• Modern practitioners consider it functionally and anatomically analogous with the uterus.
• Kidney organ system and related to the middle channels that originate at the Kidney: ren mai and du mai.
• The Liver channel passes through the lower burner and connects with Ren Mai, the lower burner is where the prostate bland is located therefore Liver pathology esp Liver qi stagnation or blood stasis could be associated with certain stages of prostatitis.

Question 19

What is a potential cause of prostatitis in terms of TCM?

Answer 19

• Prostate is located in the LB, therefore is influenced by pathology that sinks into the lower burner. Sinking of Spleen Qi, dampness / dampness-heat from the spleen dysfunction or improper diet

Question 20

What are the patterns involved in prostatitis?

Answer 20

• Common aetiological factors include: external damp-heat, internal emotions, improper diet, exhaustion / overwork.

Question 21

What is the prostate in biomedicine?

Answer 21

• The prostate makes fluid that contains sperm (semen). This fluid protects the sperm when they travel toward a woman’s egg

Question 22

What is prostatitis in biomedicine?

Answer 22

• Problems with the prostate usually include prostate enlargement, prostatitis, and prostate cancer.
• Prostatitis is a disorder associated with inflammation or infection of the prostate gland.
• It can be acute or chronic onset presenting main complaint of painful or difficult urination as well as pain in the groin, pelvic area or genital.

Question 23

What is the cause of prostatitis in biomedicine?

Answer 23

• Cause: bacterial infection, autoimmune disorders or pelvic floor muscle dysfunction.
• Diagnosis is based on a thorough medical history, physical examination and laboratory tests such as urine culture and prostate-specific antigen (PSA).
• Treatment: antibiotics, alpha-blockers, anti-inflammatory medications and lifestyle changes.

Question 24

What are the treatment principles of prostatitis in TCM?

Answer 24

• Acupuncture, herbal medicine, tuina, dietetics, exercise
• Aims to restore the Yin-Yang balance and Qi-Xue harmony by tonifying deficiencies, regulating qi and blood to restore qi dynamic and resolving dampness-phlegm
• Bian Bing and Bian Zheng principle is applicable.
• San Yin Zhi Yi, Tong Bing Yi Zhi and Yi Bing Tong Zhui

Question 25

What etiological factors are common for ED, male infertility and erectile dysfunction?

Answer 25

1. External pathogens (invasion) - damp heat
2. Emotional factors
3. Improper diet
4. Exhaustion and overwork, age

Question 26

What are women dominant in?

Answer 26

Yin dominant
Blood focus

Question 27

What are men dominant in?

Answer 27

Yang dominant
Qi focus

Question 28

What patterns are common in ED, prostatitis and male infertility?

Answer 28

Liver Qi constraint
Damp heat
Kidney (Yin / Yang essence) xu
Qi and Blood Xu
Blood stasis

Question 29

What are the master and couple pairs?

Answer 29

SP4 + PC6
LU7 + KI6
GB41 + TE5
BL62 + SI3

Question 30

What factors effect erection?

Answer 30

Heart-blood, penetrating vessel, Kidney yang (ming men) and Liver-blood

Question 31

What is the treatment of damp heat in ED, prostatitis and erectile dysfunction?

Answer 31

Clear heat and drain the damp from the lower jiao
Herbs: Long Dan Xie Gan Tang

Question 32

What is the treatment of Liver Qi constraint in ED, male infertility and prostatitis?

Answer 32

Dredge the Liver, relieve constraint and regulate Qi