TCM Acupuncture Therapy for Chronic Prostatitis Combined with Erectile Dysfunction and Premature Ejaculation

Chronic prostatitis is a common male reproductive disorder characterized by pelvic discomfort, urinary abnormalities, and sexual dysfunction. When chronic prostatitis coexists with erectile dysfunction (ED) and premature ejaculation (PE), it can form a vicious cycle. For such complex conditions, Traditional Chinese Medicine (TCM) acupuncture demonstrates unique therapeutic advantages. 

Modern studies have confirmed that acupuncture can regulate neuroendocrine function, improve local microcirculation, and relieve psychological tension through multiple pathways. It provides a holistic, safe, and long-term approach with minimal side effects for treating chronic prostatitis with sexual dysfunction. Compared with medication alone, acupuncture shows significant effects in symptom relief and quality-of-life improvement, making it an important part of modern integrative management for male diseases.

I. TCM Pathogenesis and Mechanisms

(1) TCM Understanding of Chronic Prostatitis

In TCM, chronic prostatitis falls under categories such as jing zhuo (seminal turbidity), bai yin (leukorrhea-like disorder), or lin zheng (urinary strangury). Its pathogenesis mainly involves damp-heat in the lower burner, qi and blood stasis, and kidney deficiency.

(2) TCM Pathogenesis of Erectile Dysfunction and Premature Ejaculation

Erectile dysfunction (ED) is referred to as yin wei in TCM, while premature ejaculation corresponds to ji jing. The main pathological mechanisms include:

Kidney essence deficiency:

The kidneys store essence and govern reproduction. When kidney essence is insufficient, the zong jin (reproductive muscles) are not nourished, leading to weak erections or poor ejaculation control. Patients often experience lower back soreness, tinnitus, hair loss, and fatigue.

Liver qi stagnation:

The liver meridian encircles the genitals and governs the smooth flow of qi. Emotional stress or depression causes liver qi stagnation, impeding qi and blood flow to the reproductive system, leading to erection difficulty or rapid ejaculation—often associated with psychological factors.

Heart and spleen deficiency:

Overthinking damages the heart and spleen, resulting in insufficient qi and blood to nourish the zong jin. Symptoms include weak erections, early ejaculation, palpitations, insomnia, and poor appetite.

(3) Pathological Correlation Between the Two

Chronic inflammation damages the smooth muscle function of the corpus cavernosum, causing erectile issues. Persistent pelvic discomfort may lead to pelvic floor tension, accelerating the ejaculation reflex. Conversely, anxiety and endocrine disorders caused by sexual dysfunction can worsen prostate congestion and inflammation, creating a difficult-to-break pathological cycle.

II. Theoretical Basis of Acupuncture Treatment

According to meridian theory, acupuncture's efficacy is based on regulating the interconnected meridian system. The Liver Meridian (Foot Jueyin) encircles the genitals; the Kidney Meridian (Foot Shaoyin) connects to the spine and bladder; the Ren Vessel originates from the uterus and emerges at the perineum; and the Du Vessel starts from Changqiang and runs along the spine. These meridians link the prostate and genital organs, forming a functional network of "kidney–essence chamber–reproductive system." Stimulating acupoints on these meridians can regulate qi and blood circulation within the prostate and reproductive organs.

III. Acupuncture Protocol for Chronic Prostatitis

(1) Core Acupoint Selection

Main groups involving Ren, Du, Heart, and Kidney meridians:

Mind-calming group: Baihui (GV20), Yintang (EX-HN3), Neiguan (PC6) — to calm the mind and relieve stress.

Kidney-tonifying group: Shenshu (BL23), Taixi (KI3), Guanyuan (CV4), Dahe (KI12), Zhongji (CV3) — to strengthen kidney yang, nourish essence, and regulate urination.

Heart–Kidney coordination group: Xinshu (BL15) — to harmonize the heart and kidney and restore vitality.

(2) Syndrome-based Acupoint Combination

Different syndromes require flexible point combinations:

Damp-heat in the seminal chamber: Yinlingquan (SP9), Ligou (LR5) — to clear damp-heat and regulate water metabolism.

Liver depression and kidney deficiency: Taichong (LR3), Zhishi (BL52) — to soothe the liver and tonify the kidney.

Disharmony of heart and brain: Sishencong (EX-HN1), Shenting (GV24) — to calm the mind and regulate brain–heart function.

Kidney deficiency with blood stasis: Sanyinjiao (SP6), Xuehai (SP10) — to invigorate blood and nourish yin.

Spleen–Kidney deficiency: Zusanli (ST36), Pishu (BL20) — to strengthen the spleen and replenish postnatal qi.

(3) Special Acupoint Combinations

For Erectile Dysfunction: Shangxing (GV23) – Shenmen (HT7) – Mingmen (GV4) – Zhongji (CV3).

This combination awakens the mind, calms restlessness, tonifies kidney yang, and invigorates the reproductive system, producing the effect of “revitalizing yang through spirit regulation.”

For Premature Ejaculation: Yintang (EX-HN3) – Xinshu (BL15) – Shenshu (BL23) – Jinggong (EX-CA1).

This set calms the mind, clears heart fire, tonifies the kidney, and consolidates essence, effectively prolonging ejaculation latency.

IV. Precautions and Care During Acupuncture Treatment

(1) Contraindications

Although acupuncture is safe and effective, contraindications must be observed: patients with severe coagulation disorders, local infections or ulcers, extreme fatigue, hunger, or unstable vital signs should avoid treatment.

(2) Prevention of Adverse Reactions

Possible side effects include fainting or minor hematoma. Practitioners must use sterile, disposable needles and ensure proper skin disinfection before treatment.

(3) Lifestyle and Self-care Recommendations

Diet:

For damp-heat types — avoid spicy, alcoholic, and greasy foods; favor mung beans and winter melon.

For kidney deficiency — consume walnuts, black sesame, and yam to nourish essence.

For blood stasis — eat hawthorn and rose to promote circulation.

Exercise:

Engage in 30 minutes of aerobic exercise daily (walking, swimming).

Strengthen pelvic floor muscles through Kegel exercises (3 sets of 15–20 reps/day).

Avoid prolonged cycling or horseback riding that may compress the prostate.

Mental adjustment:

Practice mindfulness meditation to ease anxiety; cognitive-behavioral therapy if needed.

Behavioral adjustments:

Avoid sitting for long periods (stand every 45 minutes), do not hold urine, maintain regular sexual activity (1–2 times weekly), and avoid coitus interruptus or semen retention.

Conclusion

TCM acupuncture demonstrates unique advantages in treating chronic prostatitis combined with erectile dysfunction and premature ejaculation. Based on holistic theory and syndrome differentiation, multi-acupoint stimulation can simultaneously address prostatic inflammation and sexual dysfunction for synergistic results. However, acupuncture still has limitations: individual responses vary, and standardized efficacy indicators are lacking. Therefore, it should be combined with herbal medicine for optimal outcomes.

The Diuretic and Anti-inflammatory Pill is an excellent herbal formula for chronic prostatitis with ED and PE. Rooted in TCM principles of clearing heat and detoxifying, invigorating blood circulation, strengthening the spleen, and draining dampness, it eliminates pathogenic bacteria, reduces inflammation, and relieves symptoms to promote complete recovery.