A Modern Medical Acupuncture Approach
Steven K.H. Aung, MD
Medical acupuncture is a powerful tool and useful complementary therapy to
treat sexual dysfunction. This article reviews the scope of traditional Chinese
sexology as well as effective acupoints to treat sexual dysfunction. Three case
examples are presented, and the author's Conjoint Sexual Alignment Therapy is
Traditional Chinese Medical Sexology, Sexual Medicine, Sexual Dysfunction,
Medical Acupuncture, Electroacupuncture, Auriculotherapy
In Western dialogue, the concept of sexology is an umbrella term that
incorporates various academic disciplines.1-3 The psychological theories of
Freud and Kraft-Ebing established the foundation for European sexology in the
late 19th and early 20th centuries. In America, it was given impetus in the mid
20th century in the Kinsey statistical reports on the sexual behavior of men
and women.4,5 Medical sexology is a more delimited approach that considers the
health aspects of human sexuality. However, it is inappropriate to distinguish
too sharply between these endeavors since major developments such as oral
contraceptives, HIV/AIDS epidemic, sildenafil, and the abortion pill RU-486
(mifepristone), are the objects of both medical and social concern. One author2
suggests that the optimism generated by the sexual revolution of the 1960s and 1970s
is being superceded by a more negative view of sexuality as 'the source
and scene of oppression, inequality, violence, abuse, and deadly
The fundamental idea behind medical sexology is that sexuality is a vital
component of total health and well-being. Therefore, it is a vital component of
medicine, especially family practice, in which physicians frequently must
handle various sexual concerns including decline/ loss of libido,
ejaculation/orgasm problems, and intercourse difficulties. Maurice3 notes that
medical schools around the world offer little clinical training in this
important area; his text provides a relevant and comprehensive clinical
resource for family physicians.
This article will review the scope of traditional Chinese sexology, the
author's clinically-based medical acupuncture approach, and useful and
effective acupoints for the treatment of sexual dysfunction. Traditional
Perhaps the most famous traditional treatise on sexology is the Kama Sutra.6
Based on a number of ancient Hindu sources dating back several centuries BCE,
this compendium may be viewed as a positive, interesting, and stimulating
approach to the practical and esoteric art of sexual love between a man and a
woman. Less well-known than the Kama Sutra, but equally comprehensive in scope,
are the ancient Chinese sexology texts. Most of these texts were discovered in
1973 at the Ma Wang Tui Han tomb in Changsa, Hunan Province, China. They date
from 168 BCE and comprise the bulk of the more than 20 ancient Chinese sex
handbooks from the beginning of the Han Dynasty (206 BCE) to the end of the
Tang Dynasty (AD 907).
According to the ancient texts, traditional Chinese medical sexology pertains
to a female giving Yin and receiving Yang, and a male giving Yang and receiving
Yin. In principle, it is an equal and harmonious libido exchange since Yin is
female Qi and Yang is male Qi. Both the Yin and Yang modalities of Qi are
present and active in every male and female.7,8 A healthy sexual relationship
between a woman and a man involves mutual exchange of Yin (i.e., yin dao,
vagina) and Yang (i.e., yang ju, penis) for the equal benefit of both partners.
This exchange, which is physically, mentally, and spiritually embodied in
sexual intercourse, constitutes a healthy and balanced sexual relationship. In
Taoist terms, it mirrors the harmony of nature and contributes to one's
longevity. Moderation is recommended; excessive sexual activity depletes Yin in
males and Yang in females.
Traditional Chinese medical sexology, termed the 'art of the
bedchamber' in the traditional medical and erotic literature, generally
takes a positive approach toward human sexuality. Emphasized are the various
techniques whereby men and women can learn to satisfy one another in intensive,
sensitive involvement and intimacy.8-11 In this perspective, strong libido
depends on the state of one's total health. Emotional factors are important;
notably, anger, fear, and anxiety for males, and worry, fear, and depression
Male sexual dysfunction and decline/loss of libido largely pertain to KI Yang
Deficiency. The female counterpart basically refers to KI Yin and Yang
Deficiency. The key meridians for males that require tonification are the KI,
LR, and TH; for females, the KI, SP, and PC. For both sexes, stimulation of the
CV and GV extraordinary meridians is indicated to boost systemic Qi flow.
It is useful to distinguish between these complex physiological and
psychological sexual disorders and those ordinarily encountered in male and
female urology and gynecology.12,13 Females not only have various special
problems surrounding menstruation, pregnancy, and menopause, but also more
complex problems such as inhibited sexual response and dyspareunia
('frigidity'). Special male problems include erectile dysfunction and
premature ejaculation ('impotence'). Regarding menopause in both
sexes, libido does not necessarily decline with hormonal deficiency due to
Virtually all the author's patients are received as referrals from other
physicians, and are considered to be difficult cases unresponsive to biomedical
treatment (mainly drug therapy). The complete biomedical data for each referred
patient is then reviewed. A Four Diagnosis evaluation (inquiry, observation,
palpation, and auscultation/olfactory) is conducted. Assessment is made of a
patient's Shen (spirit) and other techniques to select the optimal acupuncture
points for stimulation.
Basic electroacupuncture14 is utilized in about 90% of clinical treatments;
most patients have chronic conditions and electroacupuncture is a more powerful
tool for these conditions. Electroacupuncture generally produces a stronger
stimulation than the standard insertion of acupuncture needles. Moreover,
electroacupuncture allows the electrical stimulation to be precisely adjusted
according to what is required for specific conditions. Electroacupuncture is
beneficial not only for controlling pain, but also for harmonizing Qi. It may
be applied by various devices such as the 4-channel outlet model (ITO IC 4107)
that is commonly used in clinical practice. A low frequency and intensity pulse
of 2 Hz/second with square wave forms are indicated for normal pain control
(endorphin release), and Qi balancing. A higher frequency and intensity pulse
(100-300 Hz/second with square wave forms) are indicated for more severe
disorders involving the major internal organs and the central nervous system
The treatment goals are the same as for traditional acupuncture, namely, to
alleviate pain and harmonize Qi. Patients generally feel relaxed during their
30-60 minute experience of being connected to the electroacupuncture device.
Initially, the procedure is the same as for traditional acupuncture. The
relevant acupoints are selected and the needles are inserted with the requisite
tonifying or sedating manipulation. Then, once the De Qi needling sensation has
been achieved at each site, the wires of the device are clipped to the needles
and the current is applied.
Assessing treatment efficacy is largely based on patient self-reports. Results
are generally good, with most patients reporting symptom control and enhanced
well-being. A trial course of 3-4 treatments is given to see how patients
respond to acupuncture. If they wish to continue, patients are treated 2 times
weekly for 2 weeks, 1 time weekly for 1 month, and 1 time monthly until they
report feeling healed. Ongoing maintenance 2 times yearly is offered (or,
according to the patient's needs). Ancillary techniques are also used, including
acupressure, moxibustion, cupping, and auriculotherapy. Auricular acupuncture
is sometimes useful in supplementing the traditional approach. According to TCM
theory, several points and areas on the ear are effective in human sexuality:
External Genitalia, Kidney, Liver, Shen Men, and the 2 Sympathetic Lines. Ear
press pins may be inserted for 1-2 weeks; the patient is instructed in pressing
them for self-care.
For the 3 cases presented, follow the protocol delineated above. Specific
acupuncture points are indicated in each case, with the locations as described
by Xinnong.15 Some of these points are on the list of 'pearls' of
medical acupuncture in sexology that the author has developed through clinical
experience (Table 1). Informed
consent was obtained from each patient described.
A 35-year-old woman was referred with loss of libido, fatigue, and sleep
disturbances (frightening nightmares). During her childhood and early
adulthood, she experienced sexual abuse by an uncle, including sexual
intercourse. Married for 10 years with 3 children, the patient considered her
marriage a priority. She received various biomedical therapies such as
antidepressants and psychotherapy for what was perceived to be her sexual
problem. She appeared depressed and overweight, with a lack of interest in sex
and, indeed, her life. The patient had a history of asthma and colitis as well
as hormonal problems which, apparently, led to moodiness, anger, and irregular
menstruation (mainly, amenorrhea). Since she had experienced severe trauma that
remained clinically unresolved, she was assessed as having a severe case of
Kidney Yin and Yang Deficiency with weak Shen.
To open the Qi gates and release her 'emotional pollution,' PC 6
(Inner Gate) and TH 5 (Outer Gate) were bilaterally stimulated , as well as SP
10, LR 3, ST 44, and GB 43 (Lower Limb Gates). To help release her past
psychological trauma, CV 3 and CV 5 were stimulated.
The patient's sexual dysfunction was then treated. For females, this involves
the SP and KI. Bilaterally needled were SP 6, SP 9, and SP 10, as well as KI 3,
KI 6, KI 7, and KI 10. In order to boost the patient's Qi, CV 4, CV 6, CV 17,
and GV 4 were also stimulated (during the trial course, 2 times weekly for 2
weeks). While this patient responded well during the course of treatment, the
recommendation was made that she consider other complementary therapies such as
hypnosis to treat her deeply rooted trauma, with follow-up and meditation
therapy to strengthen her will to live.
A 45-year-old man, a truck driver married for 5 years with 4 children, was
referred with decline of libido and premature ejaculation. He had experienced a
work-related back injury and undergone vertebral fusion surgery for this
problem. He continued to experience back and neck pain. A urologist concluded
that all test results were normal. Clinically, the patient's reflexes were
normal and his Shen appeared vibrant. Noted was some limitation of movement of
his back, including lower back muscle tightness and tenderness. The Qi gates
were opened by bilaterally needling PC 6 and TH 5; pain management was
attempted with GB 30, BL 22, BL 23, BL 40, and BL 60.
Stimulated bilaterally were LU 9, SP 6, SP 9, SP 10, LR 3, LR 8, and KI 10,
with moxibustion for tonification and to increase blood flow to the penis. Also
stimulated to balance the patient's overall sexual Qi energy were GV 4, CV 4,
CV 6, and CV 17. The patient reported relief from pain and enhanced libido.
A 35-year-old man, married with 4 children, was referred with generalized pain
and fibromyalgia,16 a difficult condition from both an Eastern and Western
medical perspective. He was unable to perform sexually, with a lack of interest
in sexual intercourse and accompanying erectile dysfunction. The patient
reported marital problems due to his sexual inadequacy. The clinical approach
for this patient was successful over a 6-month period. Treatment entailed
bilateral stimulation of LR 8, LR 13, SP 6, SP 9, SP 10, KI 10, BL 17, BL 23,
and LI 11, as well as GV 4, GV 17, GV 20, CV 4, CV 6, and CV 17.
Table 1. Selected
'Pearls' of Medical Acupuncture for Human Sexology
Decline/loss of libido
EX-HN 1, GV 4, CV 4
SP 6, KI 10, ST 44
Decline/loss of libido
SI 3, LU 7, LR 8
PC 6, ST 41
CV 3, CV 4, CV 5, CV 6
Releasing childhood trauma
TH 3, TH 5, TH 10
Releasing emotional pollution
Harmonizing the spirit
GV 4, GV 20
Harmonizing the mind
Harmonizing the body
Connecting the inner and outer spirit
Connecting the body, mind, and spirit
Sexual Alignment Therapy'
Sexual dysfunction is not easily treatable. Composed of physical, mental, and
spiritual factors, it is a delicate and complex clinical endeavor. Moreover, it
also depends on the behavioral actions and attitudes of each partner in their
relationship. The author has found the following technique to be one of the
most successful components of the 'conjoint sexual alignment method'
(developed over 20 years of integrative family and geriatric medical practice).
It is an effective sexual approach in the ongoing relationship between 2
people, in most cases a husband and wife, who experience mutual loss of sexual
interest and libido. This approach calls for treating them together with
The couple sit or lie down in a mutually pleasurable position, touching their
hands or other parts of their body so that the electrical stimulation flows
through both of them in a complete circuit; both of them interconnected via PC
8 is optimal.
The man's CV 6 is wired to the woman's GV 4, and the woman's CV 6 is wired to
the man's GV 4. Furthermore, bilaterally, the male LR 8 is wired to the woman's
SP 6, and both the female and male KI 10 are interconnected (Figure 1). The
normal low-intensity electroacu- puncture therapeutic and the normal but
flexible treatment schedule are again used. protocol
This is a simple but powerful method for enhancing the couple's interest in and
concern for one another, as well as mutually balancing their Qi. It enhances
their understanding of the need to harmonize their energy for their mutual
clinically successful in treating some sexual problems. It is effective for
rapid symptom control and deeper energy alignment. Other Chinese therapies are
useful in this regard, including herbal medicine and dietetics, Qi Gong, and
massage/manipulation.17-20 These therapies complement acupuncture just as
acupuncture itself complements biomedicine.
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Dr Steven K.H. Aung practices integrative Traditional Chinese Medi-
cine and biomedicine at his clinic in Edmonton, Alberta, Canada. Founder and
instructor of the Certificate Program in Medical Acupuncture, Faculty of
Extension, University of Alberta, Edmonton, Dr Aung is also Associate
Clinical Professor in the Medicine and Family Medicine departments, University
of Alberta, as well as a World Health Organization advisor on Medical