Chinese Herbs for Sex: A Traditional Approach to Desire, Performance and Those Awkward Moments

Sex is one of the few activities that may require energy, relaxation, good circulation, emotional cooperation and reasonably good timing—all at once. No wonder things occasionally fail to proceed according to plan.

Chinese medicine has addressed sexual health for centuries. But it does not place every problem into one convenient category called “not enough yang.” Erectile difficulties, low libido, premature ejaculation and performance anxiety can arise from entirely different patterns. Taking the strongest, hottest tonic you can find may produce more heartburn than romance.

Chinese herbs should therefore be selected according to the whole person, not merely according to what did—or did not—happen last night.

Erectile Dysfunction: First Find the Cause

In Chinese medicine, an erection depends upon adequate Kidney energy, healthy circulation of Qi and Blood, and a reasonably peaceful mind. Erectile dysfunction may involve Kidney Yang deficiency, Kidney Yin deficiency, depleted Essence, emotional tension, poor circulation or general exhaustion.

Western medicine also recognizes many possible causes, including blood-vessel disease, diabetes, neurological conditions, hormonal problems, medication side effects and psychological stress. Persistent erectile dysfunction deserves a medical evaluation because treating the underlying cause is more important than merely coaxing the equipment into temporary cooperation.

Kidney Yang Deficiency

This is the pattern most people associate with sexual weakness. Typical signs may include:

• Low libido

• Difficulty obtaining or maintaining an erection

• Feeling cold

• Fatigue

• Weak or aching lower back and knees

• Frequent urination

• A pale tongue

Traditional formulas may include Jin Gui Shen Qi Wan or, in colder and more depleted cases, You Gui Wan.

Common Kidney Yang herbs include:

• Yin Yang Huo — Epimedium

• Ba Ji Tian — Morinda root

• Rou Cong Rong — Cistanche

• Tu Si Zi — Dodder seed

• Du Zhong — Eucommia bark

• Bu Gu Zhi — Psoralea fruit

Yin Yang Huo is sometimes translated as “horny goat weed,” proving that Chinese herb translators are occasionally allowed to have fun. According to legend, a herdsman noticed that goats became unusually amorous after eating it. Whether the goats provided written testimonials is not recorded.

These herbs are warming and stimulating. They are not automatically appropriate for someone with night sweats, dry mouth, irritability, high blood pressure, insomnia or other signs of heat.

Kidney Yin or Essence Deficiency

Not every sexual deficiency is cold. Some people are depleted but also feel hot and dry. Possible signs include:

• Reduced libido or unreliable erections

• Night sweats

• Dry mouth

• Ringing in the ears

• Hot palms and soles

• Restlessness

• Lower-back weakness

Formulas such as Liu Wei Di Huang Wan or Zuo Gui Wan may be considered when the problem involves Kidney Yin or Essence rather than Yang deficiency.

Wu Zi Yan Zong Wan, the Five-Seed Formula, has traditionally been used for reproductive weakness, depleted Essence, poor sexual function and certain fertility problems. It is a nourishing formula rather than a herbal battering ram. Its effects, when appropriate, are generally expected to develop gradually.

Low Libido: Desire Cannot Always Be Ordered to Report for Duty

In Chinese medicine, libido is closely connected with the Kidneys and Essence, but it can also decline because of fatigue, Blood deficiency, worry, depression, resentment, chronic illness, medication effects or relationship difficulties. No herb can reliably overcome exhaustion, emotional unhappiness or a partner who is still angry about something said in 1997.

When low libido accompanies coldness and fatigue, warming Kidney tonics may be considered. When it accompanies dryness, night sweats and restlessness, nourishing Yin may be more appropriate.

Useful tonic herbs, depending upon the pattern, may include:

• Gou Qi Zi — Goji berry

• Tu Si Zi — Dodder seed

• Rou Cong Rong — Cistanche

• Shu Di Huang — Prepared rehmannia

• Shan Zhu Yu — Cornus fruit

• Ren Shen — Asian ginseng

• Dang Shen — Codonopsis

Asian ginseng has received some research attention for sexual function, but the evidence remains limited and it can interact with medicines or aggravate insomnia and other conditions. It is not simply an all-purpose energy pill.

Performance Anxiety: When the Mind Interrupts the Body

Performance anxiety creates an especially annoying situation: the more desperately a person tries to perform, the less cooperative the body may become.

In TCM terms, anxiety may constrain Liver Qi, disturb the Heart or weaken the Spleen and Heart through excessive worry. The appropriate treatment may involve calming the Spirit and regulating Qi rather than aggressively tonifying the Kidneys.

Depending upon the overall pattern, formulas might include:

• Xiao Yao San for tension, frustration and constrained Liver Qi

• Jia Wei Xiao Yao San when tension is accompanied by heat or irritability

• Gui Pi Tang when anxiety occurs with fatigue, poor sleep, palpitations and Blood deficiency

• Suan Zao Ren Tang when insomnia and nervous restlessness are prominent

• Chai Hu Shu Gan San for pronounced emotional constraint and tension

Herbs may help some people feel calmer, but performance anxiety is not always an herbal deficiency. Honest communication, less pressure, adequate time, counseling and a sense of humor may be far more effective. The bedroom should not feel like the final round of a television game show.

Premature Ejaculation and Lack of Control

Chinese medicine often associates premature ejaculation with the Kidneys failing to secure the Essence. This may occur with fatigue, weak lower back and knees, frequent urination or a general sense of depletion.

Traditional formulas that may be considered include Jin Suo Gu Jing Wan or Suo Quan Wan, depending upon the complete pattern. A practitioner may also use a modified Kidney-tonic formula containing herbs such as Tu Si Zi, Shan Zhu Yu, Sha Yuan Zi or Qian Shi.

Premature ejaculation can also be related to anxiety, heightened excitement, prostatitis, medication effects or relationship factors. A strongly astringent formula should not be prescribed merely because someone wishes the evening had lasted longer.

Herbs for “Performance Enhancement”

Chinese herbal tonics are generally better at rebuilding energy over time than producing a dramatic result at precisely 8:30 on Saturday night.

When fatigue and weakness are the main problems, a practitioner might use Qi and Blood tonics such as:

• Ren Shen or Dang Shen

• Huang Qi

• Bai Zhu

• Dang Gui

• Gou Qi Zi

• Shu Di Huang

Formulas such as Ba Zhen Tang or Shi Quan Da Bu Tang may be considered for people who are genuinely Qi-and-Blood deficient. They are not appropriate simply because someone wants to become the romantic equivalent of an Olympic athlete.

Better sleep, regular exercise, good cardiovascular health, moderate alcohol use and treatment of diabetes or high blood pressure may improve sexual function more reliably than continually searching for a stronger tonic. A healthy diet that supports cardiovascular and metabolic health may also help reduce or improve erectile difficulties.

Blood Stasis and Poor Circulation

When erectile problems involve poor circulation, fixed pain, a dark or purplish tongue, a history of vascular disease or other signs of Blood stasis, simply adding more warming tonics may not solve the problem.

Formulas such as Xue Fu Zhu Yu Tang are sometimes used by practitioners when Blood stasis is clearly present. This formula should not be casually self-prescribed, particularly by anyone taking aspirin, Plavix, warfarin, Eliquis or other medications that affect bleeding and clotting.

New erectile dysfunction can occasionally be an early sign of cardiovascular or metabolic illness. Do not assume the Kidneys merely need cheering up.

Be Suspicious of “All-Natural” Instant Sex Pills

Products promising immediate, spectacular results deserve special caution. The FDA regularly finds undeclared sildenafil, tadalafil and similar prescription ingredients in products sold as “natural” sexual enhancers. These hidden drugs can interact dangerously with nitrate medicines such as nitroglycerin and cause a severe drop in blood pressure.

Avoid mysterious gas-station pills, internet products promising “instant male power,” and anything claiming to work just like a prescription drug without containing one. It may work just like a prescription drug because somebody secretly put one in it.

When to Seek Medical Advice

Consult a physician when erectile dysfunction is persistent, sudden, worsening or accompanied by pain, penile curvature, urinary symptoms, chest discomfort or other significant changes.

Also obtain professional advice before taking sexual tonics when you have:

• Heart disease or uncontrolled blood pressure

• Kidney or liver disease

• Diabetes

• A history of stroke

• Prostate disease

• Significant anxiety or depression

• Prescription medications, especially nitrates, blood thinners or blood-pressure drugs

A prolonged or painful erection is an emergency and requires immediate medical treatment—not another dose of herbs.

The Traditional Bottom Line

Chinese medicine does not treat sexual difficulties with one universal aphrodisiac. It asks whether the person is cold, hot, tired, anxious, depleted, congested or suffering from poor circulation.

The right formula may warm Kidney Yang, nourish Yin and Essence, strengthen Qi and Blood, improve circulation or calm the mind. The wrong formula may accomplish little besides making the patient warmer, thirstier and considerably more frustrated.

Sexual health is part of overall health. Good sleep, exercise, affection, communication and a little patience all belong in the formula—even though none of them comes in a bottle.