Non-ejaculation, also known as inability to ejaculate, is the absence of semen ejaculation during sexual intercourse. According to the survey of Masters and Johnson, 450 male sexual dysfunction patients, 17 of them do not ejaculate, less than 4%; Shanghai study reported 2087 cases of male infertility patients, non-ejaculation accounted for 32.39%; more than 70% of these people are caused by the lack of sexual knowledge and incorrect methods of intercourse, indicating that the degree of poverty of domestic mass sexual knowledge is quite alarming. It deserves attention.
According to the nature of the disease, there are two kinds of organic and functional. Functional ejaculation is more common, characterized by the fact that sexual stimulation in the waking state does not reach the level required for the excitation threshold of the ejaculatory center and no ejaculation occurs, but during sleep, the activity of the subcortical center is strengthened and ejaculation can be caused by sexual dreams. Chinese medicine and acupuncture treatment mainly target functional ejaculation.
1. Etiology and pathology
The causes of functional ejaculation are mainly the following.
(1) Mental and emotional factors, also known as psychogenic ejaculation disorders, are the most numerous clinically. It is mainly the result of sexual dysfunction, the strengthening of the inhibition of the ejaculatory center and the inability to get excited. Sometimes ejaculatory premonition may occur, but it is extinguished instantly. The causes are from the psychological aspect, such as frequent masturbation before marriage, so that after marriage, sexual intercourse does not reach sufficient strength and does not ejaculate; the education received from childhood distorts sex into a dirty, dirty, obscene thing; or dissatisfied with the spouse, loss of interest in the opposite sex, decreased libido, avoiding sexual intercourse; some are afraid of wife pregnancy after marriage, long-term restraint of sexual life, forming the conditioned reflex of non-ejaculation.
(2) Medication factors: mainly because of taking drugs that affect sympathetic nerve tone, such as guanethidine and reserpine for hypertension; Librium, methiodiazide, phenothiazines, monoamine oxidase inhibitors for neurasthenia or insomnia, etc. Excessive use of bitter-cold Chinese medicine and alcohol abuse can also cause non-ejaculation.
(3) Lack of sexual knowledge: incorrect sexual position, or improper method, stagnation after penile insertion into the vagina, no friction or insufficient friction intensity, failure to excite or achieve the required intensity of excitation of the ejaculatory center often leads to non-ejaculation.
(4) Female factors: the female is afraid of painful intercourse, fear of pregnancy or sexual desire, limiting the male’s pumping; the female has poor physical fitness and is bored with sexual activity, frustrating the male’s sexual impulse.
(5) objective factors: such as narrow housing, noisy environment, the formation of sexual inhibition; the two sides work different, different commuting time, sexual activities are not coordinated; the male party work too hard, etc.
(6) anatomical factors: long foreskin, friction in the vagina, the head of the penis itchy; foreskin embedded, painful, forced to interrupt sexual intercourse; severe seminitis so that atrophic changes occur, can not effectively participate in the ejaculation process.
TCM etiological understanding.
Chinese medicine believes that the causes of non-ejaculation are mostly due to internal injuries from labor and fatigue, poor diet, internal blockage of blood and silt, and depression of emotions causing the failure to open the sperm pass and the failure of sperm organs. The causes are as follows.
(1) Labour and weariness: excessive intercourse, or frequent masturbation when young, or lustful indulgence, resulting in damage to kidney qi; or after a long illness, damaging the yin and yang of the kidneys; or a weak body and a deficiency of innate kidney qi, resulting in the inability to ejaculate due to inability to discharge or weakness of sperm discharge.
(2) Dietary indiscretion: vegetarians eat spicy food and are addicted to wine and thick flavors, which easily form internal knots of damp heat and block the seminal tract, resulting in the inability to ejaculate.
(3) Blood siltation and internal obstruction: the sperm is not ejaculated during intercourse, and the sperm is obstructed internally; or the blood siltation is caused by poor emotions and liver qi obstruction; or the blood siltation is caused by other internal organs and tissues lesions that are not treated, so that the sperm path is obstructed and the sperm is not ejaculated.
(4) Emotional and moral factors: (1) excessive thoughts and delusions, and exuberant desire, resulting in hyperactive phase fire and inability to ejaculate. (2) disharmony between husband and wife, or fear of female pregnancy, or emotional factors such as the desire not to be profound, resulting in depression of liver qi, abnormal drainage, loss of sperm shutdown, and inability to ejaculate. (③) sudden fright during intercourse, kidney qi reversal, sperm pass meeting abnormal, resulting in ejaculation disorder.
Diagnostic points.
1. Normal sexual desire and normal penile erection.
2, no random ejaculation action during intercourse, no semen ejaculation
3. No orgasm and pleasure during sexual intercourse.
4.More history of seminal emission or masturbation ejaculation.
5. Exclude organic disorders, such as congenital anomalies, obstruction or ligation of vas deferens, high paraplegia, etc.
Differential diagnosis.
(1) Retrograde ejaculation: normal duration of intercourse, but still no normal ejaculation after orgasm, sperm and fructose in urine after intercourse.
(2) Azoospermia: normal intercourse, ejaculation and orgasm, with semen discharge and no sperm on laboratory tests.
(3) Abnormal penile erection: the penis is continuously erect for more than 6 hours or even up to several days, and does not become soft even after ejaculation, accompanied by penile pain.
Dialectical typing.
In Chinese medicine, the treatment of non-ejaculation is based on the identification of systemic symptoms and the differentiation of deficiency and reality.
The author’s doctoral supervisor, Professor Xu Fusong, divided the treatment into six types.
1, Yin deficiency fire: Mostly seen in young and middle-aged patients, with a short duration of illness, inability to ejaculate, vigorous sexual desire, Yang strength, yellow urine and dryness, red tongue with little coating and fine pulse.
2, the fate of the fire failure: mostly seen in middle-aged patients, longer duration of the disease, ejaculation can not, accompanied by low libido, erectile insecurity, cold and awe, mental discomfort, five night diarrhea, light tongue with white fur, sunken pulse.
3.Yin and Yang deficiency: Mostly seen in patients with secondary non-ejaculation and impotence, longer duration of the disease, decreased libido, insistent penis, pale face, thirsty and drinkable, red tongue with thin white coating and thin pulse.
4, damp-heat injection: mostly seen in drinkers and fatty and sweet eaters, ejaculation can not, urination yellow and muddy, dry mouth sticky and do not want to drink, yellow and thick tongue coating, pulse moistened with a number.
5, spleen deficiency and kidney: Mostly seen in people with spleen deficiency, no ejaculation during intercourse, seminal emission after intercourse, with loose stools, small urine often yellow, light mouth and discord, thin white tongue coating, soft pulse.
6, heart and liver depression and fire: Mostly seen in patients with marital discord, commonly with unrestrained emotions, nervousness, strong yang and easy ejaculation, inability to ejaculate, swelling of the penis, dreams and seminal emission, irritability, or anxiety, red tongue and string with a number of pulse.
The author’s master’s supervisor, Professor Li Biao, divided the treatment into seven types.
1. Fire failure of the vital gate: inability to ejaculate, low libido, or impotence, pale or obscure face, soreness and weakness of the waist and knees, tiredness and weakness, dizziness and heaviness of the head and eyes, clear and long urine, pale and fat tongue, white moist and greasy moss, sunken or weak pulse.
2, yin deficiency fire evidence: ejaculation can not, sexual desire, Yang strong, or see ejaculation, dizziness and tinnitus, five heart bothered, hot flashes and night sweats, red tongue with little moss, sunken and thin pulse and number.
3, Yin and Yang two deficiency evidence: mostly seen in patients with secondary non-ejaculation or impotence, longer duration of the disease, decreased libido, penis lifting but not firm, pale face, thirsty and drinkable, red tongue with thin white coating and thin pulse.
4. Heart and spleen deficiency: Yang can be lifted, but can’t be patient for a long time, not ejaculating, accompanied by palpitations, insomnia and dreaminess, dizziness and weakness, lack of color, little food and dullness, light tongue with thin white fur and weak pulse.
5. Damp-heat infusion: easy to raise Yang, or even Yang is strong and does not fall, intercourse without ejaculation, less abdominal distension and fullness, puffiness and swelling of the pubic area, bitter and irritable mouth, insomnia and dreaminess, frequent dreaming, short and red or yellow urine, yellow and greasy tongue coating, and stringiness of the pulse.
6.Liver qi stagnation: easy to raise Yang, no ejaculation, swelling and pain in both sides, sighing, irritability, or emotional depression, dizziness, abdominal constriction, testicular swelling, red tongue, thin white fur, string pulse.
7.Stagnant blood stasis evidence: Yang strong, no ejaculation, numbness and swelling in the pubic area, or even tingling, intensified every time after sleep and rest, dark red tongue, petechiae or petechiae on the edge of the tongue, thin and astringent pulse.
The author thinks that it is more appropriate to clinically identify and treat the five types: vital fire failure, yin deficiency and fire, liver qi stagnation, damp-heat infusion, and stasis of the seminal tract.
Treatment.
General treatment.
① Coordinate the relationship between husband and wife, encourage the female partner to take the initiative to cooperate and assist the male partner in treatment.
② strengthen physical exercise, using traditional fitness therapy, such as qigong, taijiquan, etc.
③ increase nutrition, strengthen the body and improve the quality of the whole body.
④ Quit smoking and drinking; keep your body and mind happy.
⑤ improve the living room environment.
(6) Circumcision if the foreskin is too long.
Drug treatment: (omitted)
Acupuncture treatment.
I. Classification and typing treatment
Acupuncture points for the evidence of vital fire failure: Guan Yuan, Zhi Mou, Shu San Li, Zhao Hai, Tai Xi.
Acupuncture points for evidence of yin deficiency and fire: Guan Yuan, Kidney Yu, Foot San Li, San Yin Jiao, Tai Xi.
acupuncture points for the evidence of liver qi stagnation: menstruation, shenmen, yanglingquan, nei guan, tai chong.
acupuncture points for damp-heat infusion evidence: Zhongji, Sanyinjiao, Yinlingquan, Yanglingquan, Taichong.
Acupuncture points for evidence of stasis in the sperm duct: Zhongji, Zhimou, Diji, Sanyinjiao, and Blood Sea.
The actual evidence is treated with diarrhea, while the deficiency evidence is treated with tonic method or acupuncture and moxibustion, once a day for 7 days.
Second, identification of disease treatment
Option 1: Take acupuncture points: Qu bone, Yin Lian, Dadun, and identify and match points. The acupuncture point Qu Bone is suitable for acupuncture sensation radiating to the penis, and the acupuncture point Yin Lian is suitable for localized soreness and swelling, and the acupuncture point Dadun is used for “bird pecking moxibustion” for 5 minutes, 3 times a day; 10 times is a course of treatment.
Option 2: lower abdomen: Daher, Qu bone, Zhongji; sacral: secondary s, middle s; foot: Xing interval, Taichong. Take two to three bilateral acupuncture points, retain the needles for 10-20 minutes, perform acupuncture once in between, five times for a course of treatment.
Third, head acupuncture with acupuncture treatment
Head acupuncture with three lines beside the frontal area is the main, with Dachu, Sanyinjiao, and for those who are real, add Tai Chong and Zhongji through Qu bone; for those who are deficient, add Tai Xi and Guan Yuan through Zhongji. Acupuncture technique: head acupuncture with pumping method, body acupuncture points require acupuncture to feel the penis or perineum, Sanyinjiao, Tai Chong with stronger stimulation, daily or every other day once, 10 times for a course of treatment.
Four, plum blossom needle treatment
Points: Liver Yu, Sanjiao Yu, Large Intestine Yu, Kidney Yu, Qu bone.
Method: Knock on Liver Yu, Sanjiao Yu, Large Intestine Yu and Kidney Yu with plum blossom needle until local bleeding is slight, then dial the right Liver Yu, left Sanjiao Yu, right Kidney Yu and left Large Intestine Yu with fire pot, and then dial their opposite sides, alternately; finally, stab the Qu bone point with milli-needle, with strong stimulation, without leaving the needle, twice a week.
V. Ear acupuncture treatment
Acupuncture points: Jing Gong, Endocrine, Kidney, Liver, Shen Men, Subcortex, 2 to 4 points each time, stay for 30 minutes.
Acupoint injection
2mg of nitrostigmine plus 10ml of water for injection, inject 2ml at each acupuncture point, or 4mg of nitrostigmine injection, inject after acupuncture at Qu bone point, once every 2 days.
Seven, the umbilical cord therapy
Musk 0.5 grams, white pepper 6 grams, research fine mix, each take 1 gram, with 75% alcohol dressing navel, fixed with adhesive tape, 2 days a change, 10 days for a course of treatment.
Eight, electric massager treatment.
Under the guidance of a doctor, the use of electric massager to induce ejaculation can often get better results.