SEXUAL SYMPTOMS

Published on 22/06/2015 by admin

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Chapter 45

imageSEXUAL SYMPTOMS

WHY WE ASK

Questions about sexual symptoms are asked primarily to ascertain the state of the Kidneys. In fact a Kidney deficiency is at the basis of many sexual symptoms such as impotence, premature ejaculation or frigidity.

In men, apart from asking about any sexual problems such as impotence, it is important to establish whether any of their symptoms is aggravated by sexual activity or if they feel excessively tired after sexual activity. An aggravation of a symptom after sexual activity always indicates a Qi deficiency, often of the Kidneys. A Kidney deficiency is indicated also if a man feels especially tired after sexual activity and particularly if the tiredness is accompanied by dizziness, backache, weak knees, etc.

However, it should not be forgotten that other organs play a role in the origin of sexual symptoms and particularly the Liver and the Heart. The Heart, in particular, plays an important role in sexual desire and in the achievement of a normal erection in men.

HOW WE ASK

For obvious reasons, the practitioner needs to be particularly tactful when asking about sexual symptoms, especially when the practitioner and patient are of the opposite sex. In some cases, when I feel instinctively that the patient would not appreciate such questions, I do not ask them.

An enquiry about sexual activity in men is important not only for diagnostic reasons but also to be able to advise them about appropriate levels of sexual activities according to Chinese medicine.1 There are significant differences between the sexual physiology of men and of women that are not often taken into account when advising patients about the desirable frequency of sexual activity: the Chinese caution about ‘excessive sexual activity’ is more relevant to men than to women. In fact, the Tian Gui, a direct manifestation of Essence (Jing), is sperm in men and menstrual blood in women: quite simply, because men lose sperm but women do not obviously lose menstrual blood during intercourse, sexual activity may potentially be weakening for men (when it is too frequent) but not so much for women.

MEN

The sexual symptoms discussed are:

(The symptoms and signs related to men’s sexual system are in Chapter 75 of Part 5.)

Impotence

Symptoms and Signs, Chapter 75

Impotence is by far the most common sexual complaint in men and the first cause that would come to mind would be a Kidney deficiency and especially a Kidney-Yang deficiency. This is a common cause of impotence, especially in older men, in which case it is accompanied by a feeling of cold, backache, weak knees, dizziness, tinnitus and poor memory, and abundant and clear urine.

In young men, however, it is my experience that impotence is more often related to a Heart pattern, such as Heart-Blood deficiency or Heart-Fire, and anxiety. In a few cases, impotence may also be caused by Damp-Heat in the Liver channel.

Impotence in young men is caused more frequently by a Heart pattern than by a Kidney deficiency.

Box 45.1 summarizes patterns underlying male impotence.

BOX 45.1   IMPOTENCE

Nocturnal emissions

Symptoms and Signs, Chapter 75

‘Nocturnal emissions’ indicates ejaculation during sleep; this symptom always has ‘pride of place’ among Kidney-deficiency symptoms in Chinese books. In the West, this symptom is relatively rare and it is not even considered a ‘symptom’ unless it occurs very frequently (e.g. once a week or more).

There are cultural reasons why this symptom always has a prominent place among Kidney-deficiency symptoms in Chinese books. In ancient times ejaculation during sleep, especially if with sexual dreams, was considered to be due to the man having intercourse with female ghosts at night; such ghosts were considered very dangerous because they robbed men of their vital Essence.

In general, nocturnal emissions without sexual dreams are due purely to a deficiency (usually of the Kidneys), while nocturnal emissions with sexual dreams are usually due to Heat (which may be Full or Empty). Thus, Empty-Heat arising from a Kidney deficiency may cause nocturnal emissions with dreams; Full-Heat, particularly of the Liver or Heart, or both, may also cause this symptom.

Nocturnal emissions without dreams are due to a Kidney-Yin deficiency whereas nocturnal emissions with dreams are due to Heat (Full or Empty).

WOMEN

The sexual symptoms discussed are as follows:

Lack of libido

Symptoms and Signs, Chapter 89

Lack of libido or an inability to reach an orgasm in women is usually related to a Kidney or Heart deficiency.

Generally, sexual desire depends on the state of Kidney-Yang and the Minister Fire: a deficient Minister Fire may cause a lack of sexual desire (and conversely, Fire of the Liver or Heart, or both, and Empty-Heat deriving from Kidney-Yin deficiency may cause an excessive sexual desire).

The Heart plays an important role in sexual arousal and orgasm in women. During sexual arousal, there is an arousal of the (physiological) Minister Fire of the Kidneys, which goes up towards the Heart and Pericardium; it is this upward flow of the Minister Fire towards the Heart that causes a flushed face and an increased heart rate. Thus, a lack of sexual desire is often due to a deficient Minister Fire and therefore Kidney-Yang.

During orgasm, the Minister Fire that was rising during sexual arousal is suddenly discharged downwards; this downward movement of the Minister Fire is controlled by the Heart (whose Qi naturally descends). Hence an inability to reach an orgasm may be due to a Heart deficiency.

Of course, a woman’s inability to reach an orgasm depends also on the man’s performance during the sexual act. According to Daoist sexual alchemy, men pertain to Fire and Fire flares up easily and is easily extinguished; women pertain to Water and Water is ‘slow to boil and slow to cool down’. It is for this reason that the ancient Daoist sex manuals were aimed primarily at men so that they would be skilled in the art of sexual foreplay. Therefore, when considering a woman’s inability to reach an orgasm we should keep in mind the possibility that this is due to her partner’s lack of skill rather than her own deficiency pattern.

Box 45.4 summarizes patterns underlying lack of libido in women.

BOX 45.4   LACK OF LIBIDO IN WOMEN

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