Disease and Condition Overview
Erectile Dysfunction is characterized by men whose inability to obtain an adequate erection affects their normal life. In Chinese medicine, it is caused by excess overindulgence in sex, masturbation, or fear damaging the kidney. These factors damage kidney qi or cause weakness of mingmen fire or as a result of over induIgence in fatty foods and alcohol lead to lowering of damp heat. Erectile dysfunction is closely associated with irregular function of kidney, liver, heart, and spleen.

Erectile dysfunction is often related to psychological problems and it may also be associated with some chronic illnesses. It is important to differentiate between various causes.

Pair-point Treatment Combinations

(1) Guanyuan (RN4), Shenshu (BL23) (Fig 30)
Guanyuan (RN4), Shenshu (BL23) strengthen and tonify kidney. These points, used in combination, fortify yuan or congenital qi, strengthen kidney and tonify yin and yang. This treatment is appropriate for all types of Erectile Dysfunction.

Needling techniques:
1. Guanyuan (RN4) perpendicular insertion to a depth of 0.5 cun, after needling, apply moxa for 10 minutes.
2. Shenshu (BL23) needle, use tonify method, after needling, apply moxa for 10 minutes.

(2) Mingmen (DU4), Taixi (KI3) (Fig 123)
Mingmen (DU4): on the lower back, on the posterior midline, in depression below the spinous process of the second lumbar vertebra.
Taixi (KI3): on the medial side of the foot, posterior to the medial malleolus, in the depression between the prominence of the medial malleolus and the Achilles tendon.
Mingmen (DU4) tonifies kidney. Taixi (KI3) tonifies yin and strengthen kidney. This pair point combination tonifies kidney, fortifies yuan or congenital qi, tonifies yin and strengthens yang. This treatment is appropriate for erectile dysfunction caused by weakness of the mingmen fire.

Needling techniques:
1. Mingmen (DU4) perpendicular insertion to a depth of 1 cun, using moxa sticks 10-20 minutes.
2. Taixi (KI3) perpendicular insertion to a depth of 0.5 cun.

(3) Mingrnen (DU4), Shenshu (BL23) (Fig 124)
Mingmen (DU4): on the lower back, on the posterior midline, in a depression below the spinous process of the second lumbar vertebra.
Shenshu (BL23) : on the lower back, below the spinous process of the second lumbar vertebra (L2), 5 cun lateral to the posterior midline.
Mingmen (DU4) primarily strengthen kidney yang while Sbenshu (BL23) tonifies kidney yin. This pair point combination works on both yin and yang by tonifying yin and strengthening yang. This treatment is appropriate for erectile dysfunction caused by kidney yang deficiency.

Needling techniques:
1. Mingmen (DU4) perpendicular insertion to a depth of 1 cun, using moxa sticks 10-20 minutes.
2. Shenshu (BL23) perpendicular insertion to a depth of 1 cun, using moxa sticks 10-20 minutes.

(4) Qihai (RN6), Sanyinjia0 (SP6) (Fig 125)
Qihai (RN6): on the lower abdomen, on the anterior midline, 1.5 cun inferior to the umbilicus.
Sanyinjiao (SP6): on the medial side of the lower leg, 3 cun superior to the prominence of the medial malleolus, in the depression near the posterior border of the tibia.
Qihai (RN6) regulates and tonifies lower jiao qi. Sanyinjiao (SP6) regulates qi from the liver, spleen, and kidney. This pair point combination fortifies yuan or congenital qi to control yin and yang. This treatment is appropriate for erectile dysfunction caused by qi deficiency.

Needling techniques:
1. Qihai (RN6) perpendicular insertion to a depth of 1 cun, using moxa sticks 10 minutes.
2. Sanyinjiao (SP6) perpendicular insertion to a depth of 1 cun, using moxa sticks 10 minutes.

(5) Qihai (RN6), Rangu (KI2) (Fig 118)
Qihai (RN6) regulates qi warm lower jiao. Rangu (KI2) tonifies kidney yin and reduces deficiency heat. This pair point combination both clears and tonifies. This treatment is appropriate for erectile dysfunction caused by lower yuan deficiency and/or weakness in fire of the life force.

Needling techniques:
1. Qihai (RN6) perpendicular insertion to a depth of 1 cun, using moxa sticks 10 minutes.
2. Rangu (KI2) perpendicular insertion to a depth of 1 cun.

Commentaries
Acupuncture is more effective in the treatment of erectile dysfunction caused by psychological reasons than other root causes, such as vascular lesions.

Generally, it is most common to see patients with yang deficiency. It is therefore important to emphasize the use of moxibustion. Select Mingmen (DU4), Taixi (KI3) or Mingmen (DU4), Shenshu (BL23), to stoke the fire of mingmen. In serious cases, select Qihai (RN6), Sanyinjiao (SP6) or Qihai (RN6), Rangu (KI2) to warm and solidify the yang of the lower jiao. For cases with difficulty in differentiating between excess and deficiency or heat and cold, select Guanyuan (RN4), Shenshu (BL23).