Treating Chronic Pelvic Pain Syndrome in Men: Cold-Dampness or Damp-Heat

Chronic Pelvic Pain Syndrome (CPPS) is a common urogenital disorder characterised by persistent pain in the pelvic region (such as the perineum, testicles, and lower abdomen), often accompanied by urinary abnormalities and sexual dysfunction. 

Due to its complex aetiology, Traditional Chinese Medicine (TCM) typically approaches treatment by differentiating between two primary patterns: Cold-Dampness and Damp-Heat. So, does your CPPS belong to Cold-Dampness or Damp-Heat? How should it be properly managed? Today, we will analyse the distinguishing features of these two TCM syndromes and provide targeted solutions.

What is Chronic Pelvic Pain Syndrome (CPPS)  

Modern medicine defines CPPS as pelvic pain lasting for more than three months (affecting the lower abdomen, perineum, or testicles), possibly accompanied by urinary dysfunction or sexual issues, yet without clear evidence of bacterial infection or other organic causes.  

Generally, it’s a condition where no specific cause can be identified, but discomfort persists. This is particularly common among men who sit for long periods, such as office workers, drivers, and programmers.  

In TCM, this condition falls under Jing Zhuo (Turbid Essence) or Lin Syndrome (Strangury Disorder). The core cause of pain is stagnation of Qi and Blood, which manifests in two main patterns: cold-dampness type and Damp-Heat type.  

Cold-dampness is a type of dampness primarily caused by Kidney Yang deficiency. It leads to stagnation of cold and dampness, obstructing Qi and blood circulation. The damp-heat type is mainly due to the liver channel damp-heat descending, causing internal congestion. Let's delve deeper into the specifics of each type!

Characteristics of Cold-Dampness Type CPPS  

1. Pain Characteristics  

Dull, cold pain in the lower abdomen or perineum, which improves with heat application.  

2. Urinary Symptoms  

- Frequent urination (especially nocturia)  

- Thin urine stream  

- Clear, copious urine  

3. Sexual Dysfunction  

- Decreased libido  

- Erectile dysfunction  

4. Systemic Symptoms  

- Cold intolerance  

- Cold hands and feet  

- Fatigue  

5. Tongue & Pulse Diagnosis  

- Tongue Pale, swollen with a white, slippery coating  

- Pulse Deep and slow  

High-Risk Groups  

- Drivers and programmers (prolonged sitting)  

- Those who frequently consume cold beer and raw or cold foods  

- People exposed to excessive air conditioning (worsens symptoms)

Dietary Recommendations  

1. Avoid irritants: spicy foods (chilli, Sichuan pepper), alcohol, coffee.  

2. No cold foods: ice cream, cold drinks, raw seafood (exacerbates pain).  

3. Reduce greasy foods: fried foods and fatty meats (increase digestive burden).  

4. Eat more fruits and vegetables: cucumber, bitter melon, winter melon, apples, bananas (rich in vitamins and fibre).  

5. Increase lean protein: fish, chicken, eggs (boosts immunity).  

6. Limit sugar: Avoid high-sugar foods to prevent inflammation.  

Note: Dietary adjustments help but cannot replace professional treatment. Patients should follow medical advice. Next, let’s examine damp-heat type CPPS.

Characteristics of Damp-Heat Type CPPS  

1. Pain Characteristics  

- Burning, distending pain in the perineum, worse when sitting on hard surfaces.  

2. Urinary Symptoms  

- Dark yellow urine  

- Burning sensation during urination  

- Post-urination dribbling  

3. Sexual Dysfunction  

- Premature ejaculation  

- Frequent nocturnal emissions  

4. Systemic Symptoms  

- Bitter taste in the mouth  

- Damp, sweaty scrotum  

- Sticky stools  

5. Tongue & Pulse Diagnosis  

- Tongue Red with a yellow, greasy coating  

- Pulse Slippery and rapid  

High-Risk Groups  

- Frequent alcohol drinkers (business banquets, social drinkers)  

- Spicy food lovers (hot pot, barbecue)  

- Overworked white-collar workers (stress, late nights)  

- Those in humid environments (symptoms worsen in summer) 

Dietary Recommendations  

1. Eat light: avoid hot-natured foods (lamb, shrimp, crab, eel, salted fish).  

2. No irritants: chilli, pepper, raw garlic, onions, liquor.  

3. Avoid blood-activating & hormonal foods: longan, red dates, donkey-hide gelatin, royal jelly.  

4. Recommended foods: lean meat, chicken, eggs, crucian carp, turtle, cabbage, asparagus, spinach, cucumber, winter melon, mushrooms, tofu, seaweed, and fruits.  

5. Avoid fatty meats, crab, snails, and pickled foods.  

6. No greasy-sweet foods: candy, cream cakes, glutinous rice, lard, fatty pork, egg yolks.  

7. No cold drinks or raw fruits.  

Following these dietary guidelines can help alleviate symptoms and promote recovery.  

Conclusion & TCM Treatment Recommendations  

The above sections outline dietary considerations for both CPPS types. But how can TCM effectively treat this condition? Herbal medicine Diuretic and Anti-inflammatory Pill, from Wuhan Dr. Lee's TCM Clinic, is a better option. 

This treatment is tailored to the patient's specific symptoms. 

- Cold-Dampness patients: herbs that warm and transform dampness, strengthen the spleen, and boost Qi.  

- Damp-Heat patients: herbs that clear heat, drain dampness, soothe the Liver, and relieve stagnation.  

Additionally, the formula includes heat-clearing, blood-activating, and diuretic herbs to alleviate pelvic pain, reduce congestion and swelling, improve urinary dysfunction, and restore health. 

In conclusion, accurate diagnosis of CPPS requires professional TCM evaluation (symptoms, tongue, pulse). Do not self-medicate—consult a qualified TCM practitioner. Most patients can achieve significant relief with proper syndrome differentiation, herbal treatment, and lifestyle adjustments.