What Traditional Chinese Medicine Formulas Can Help with Sexual Dysfunction Caused by Prostatitis?

"I've had urinary urgency and frequent urination for over six months, and my sex life has been unsatisfactory. Every time it ends too quickly…”

Mr. Li, 42, explained his difficulties to the doctor. Test results confirmed chronic prostatitis, and his weak erections and premature ejaculation were typical accompanying symptoms of the condition. In fact, cases like Mr. Li's are very common. Chronic prostatitis is a common male condition, with a prevalence in China ranging from 6% to 32.9%. Notably, more than 60% of chronic prostatitis patients also experience sexual dysfunction, with the most common issues being erectile insufficiency (about 29%) and premature ejaculation (about 40%).

Although modern medicine offers Western medications, their effectiveness is sometimes unsatisfactory and may come with uncomfortable side effects. The holistic perspective and syndrome-differentiation approach of Traditional Chinese Medicine (TCM) provide another option for these patients. TCM believes that sexual dysfunction related to chronic prostatitis often originates from "kidney qi deficiency," along with possible "damp-heat accumulation" or "qi and blood stagnation," which impair the reproductive system's normal function and often involve the liver, spleen, and heart as well.

Clinically, these causes often overlap. Based on the experience of many TCM physicians, sexual dysfunction accompanying chronic prostatitis can be divided into several common patterns, each treated with different approaches:

Damp-Heat Accumulation Type

Core issue:

A persistent damp-hot sensation in the lower abdomen, as if wrapped in a wet towel, accompanied by swelling and discomfort in the genital area. Over time, control weakens, leading to finishing “too quickly.”

Common Formulas:

1. Qingre Lishi Gushen Decoction

Made from Bi Xie, Cuscuta, Poria, etc.

Its main functions are tonifying the kidneys, clearing damp-heat in the lower burner, and stabilizing essence. It is suitable for those with mild kidney deficiency but pronounced damp-heat causing premature ejaculation.

2. Simiao Combined with Five-Seed Decoction

Composed of Atractylodes, Phellodendron, Achyranthes, Coix, plus Cuscuta, Goji berries, etc.

It clears heat and dampness while replenishing kidney qi and essence. When combined with certain Western medications, it may reduce side effects and help better control ejaculation.

TCM Clinical Insights:

• Adding blood-activating medicinals such as earthworm (Dilong) or leech (Shuizhi) to damp-heat-clearing formulas can improve local prostate blood circulation.
• Using formulas based on Asparagus root, Rehmannia, and ginseng, combined with Bupleurum or Gentian root to clear liver fire, can help redirect “false fire” back to the kidneys.

Emotional Stagnation + Kidney Deficiency Type

Core issue:

Depressed mood, low energy, soreness of the lower back and knees, and kidney qi deficiency. The lower abdomen feels cold, the reproductive organs lack nourishment, resulting in erectile difficulty and poor sexual endurance.

Common Formulas:

1. Shugan Gushen Decoction

Contains Bupleurum, Angelica, White Peony, Cornus, Schisandra, etc.

It soothes the liver qi, improves mood, tonifies both liver and kidney, stabilizes essence, and prevents premature ejaculation or involuntary leakage.

2. Modified Shaoyao Gancao Formula

Based on large amounts of White Peony and Honey-fried Licorice for relieving tension and pain.

For pronounced kidney-yin deficiency, add Rehmannia and Cornus;

For dual yin-yang deficiency, add Epimedium or Morinda to warm and tonify.

TCM Clinical Insights:

• Start with liver-soothing herbs like Bupleurum and Curcuma, then add kidney-tonifying herbs such as Morinda or Acanthopanax.
• Many young men's erectile issues are psychological in origin, requiring gentle emotional regulation and nourishment of liver blood.
• Agarwood can help regulate qi and relieve emotional distress; its volatile oils ease lower-body pain and improve stress responses.

Disturbed Heart-Mind, Heart–Kidney Disharmony Type

Core issue:

Long-term anxiety, depression, insomnia, overwork, and persistent mental fatigue reduce sexual interest or cause loss of control with minimal stimulation.

Common Formula:

1. Heart-Nourishing Formula (modified Tianwang Buxin Dan)

Contains Salvia, Angelica, Rehmannia, Ziziphus seed, Biota seed, Polygala, Schisandra, etc.

Its main actions are nourishing yin and blood, calming the mind, and restoring control over ejaculation.

TCM Explanation:

TCM believes the heart plays a regulatory role in sexual function. If heart-blood is deficient and the mind is unsettled, libido and erection quality may decline. Therefore, treatment focuses on calming the spirit and regulating the mind.

Kidney Deficiency with Blood Stasis Type

Core issue:

Lower-back and knee weakness, fear of cold, prolonged fatigue after ejaculation, along with perineal stabbing pain and urinary splitting, signs of prostate blockage, leading to severe erectile problems.

Common Formulas:

1. Warm Kidney and Open Channels Decoction

Includes deer antler or deer horn glue, Eucommia, Cuscuta, plus Astragalus and ginseng for qi-tonifying, combined with leech or centipede for strong blood-activating effects.

Used for severe erectile dysfunction.

2. Blood-Activating Kidney-Tonifying Formula

Based on peach kernel and safflower for breaking stasis, and Angelica, Rehmannia, White Peony for nourishing blood.

For mild cases, add Salvia and Vaccaria;

For severe cases, add leech or Eupolyphaga.

TCM Clinical Insights:

• Kidney-tonifying focuses on nourishing kidney-yin using Rehmannia and Goji berries, combined with gentle yang-warming herbs like Epimedium or Morinda, while avoiding excessively hot tonics.
• Animal-derived tonics such as silkworm moth or gecko powder are recommended for strongly replenishing essence and blood.
• Insect-derived herbs such as leech and centipede can reduce prostate fibrosis and improve local circulation but should be used cautiously for those with stomach ulcers.

Spleen–Kidney Dual Deficiency Type

Core issue:

Weak digestion, heavy dampness, fatigue, poor appetite, and a cold constitution. The waist and abdomen often feel chilly, overall vitality is low, and the body lacks “power,” leading to weakened sexual function.

Common Formulas:

1. Tonify Spleen and Stabilize Kidney Formula

Including Astragalus, Codonopsis, Atractylodes, Cimicifuga, Bupleurum, etc.

It tonifies middle qi and raises clear yang.

For erectile issues, add centipede and Epimedium to enhance yang and open channels;

For damp-heat, add Bi Xie and Phellodendron to clear and drain.

2. Modified Wumei Pill

Based on Mume fruit, Asarum, Cinnamon twig, Aconite, Coptis, Phellodendron—a combination of cold and warm herbs.

For pronounced spleen deficiency, add Atractylodes and Poria.

TCM believes that sexual dysfunction caused by chronic prostatitis often involves multiple underlying factors. Through careful syndrome differentiation, TCM physicians use internal herbal formulas to regulate organ function, clear damp-heat, promote qi flow, activate blood, open channels, and replenish kidney essence, providing whole-body support to relieve symptoms and improve quality of life. Naturally, consulting a professional TCM practitioner for diagnosis and individualized treatment is essential.

The Diuretic and Anti-inflammatory Pill is formulated by adjusting herbs according to each person’s condition, targeting sexual dysfunction caused by chronic prostatitis. Based on syndrome differentiation, it offers personalized support to revitalize prostate tissue and help patients reduce anxiety caused by their symptoms.