case 3

Vol. 17, #2. January 2006

Sexual Dysfunction: Acupuncture For
A Woman With Loss of Libido
W. Watere, MD

ABSTRACT
A 38-year-old married woman presented with loss of libido and no interest in sexual intercourse for the previous 9 months. The patient's 10-year desire to have children was unfulfilled. At the end of 15 sessions of acupuncture treatment, she regained her libido and resumed normal sexual activity.
KEY WORDS
Libido, Sexual Activity, Acupuncture, Wind and Cold Syndrome, Kidney Yang Deficiency

INTRODUCTION
Sexual dysfunction is usually caused by disturbances of the central nervous system, organic disease, psychosomatic disorder, or some drugs.^1,2 Sexual dysfunction is more commonly seen in clinical practice due to emotional states rather than organic disturbances.¹ According to Traditional Chinese Medicine (TCM), sexual dysfunction is caused by excessive sexual activity or excessive masturbation leading to decline or deficiency of fire from the Gate of Life, or by mental injury that damages the Heart and Spleen as well as the Kidney.² Male sexual dysfunction and decline or loss of libido largely pertains to kidney Yang deficiency. The female counterpart basically refers to kidney Yin and Yang Deficiency.³CASE REPORT
A 38-year-old married woman (1.7 m, 65 kg) was referred to the TCM-Centre at Elisabeth Hospital, Recklinghausen, Germany, with loss of libido and no interest in sexual intercourse for 9 months. Her 10-year desire to have children was unfulfilled. She reported that she had cold limbs, lower back, and lower abdomen, and aversion to cold as well as irregular menstruation. She was depressed, fatigued with lassitude, and had no interest in the usual activities of daily life.

The patient's physical examination findings were normal, except that her limbs, lower back, and lower abdomen were cold. Her tongue was pale with a thick white coat. Blood pressure was 110/70 mm Hg; pulse regular at 88/min (according to TCM: deep and weak pulse⁴).

She had undergone an appendectomy 8 years before. She reported no nicotine or alcohol use.
In the last 2 years, the patient had consulted 3 gynecologists whose investigations revealed no abnormalities. Laboratory findings, including hormonal test results, were normal. She received no treatment. She consulted us and her diagnosis was loss of libido and no interest in sexual intercourse.

METHODS
Traditional Chinese Medicine: Diagnosis, Treatment, and Treatment Principles
The patient's TCM diagnosis included Wind-Cold Syndrome and Kidney Yang Deficiency.^2,5Treatment included acupuncture, and treatment principles included eliminating Wind and Cold and strengthening Yang, as well as replenishing the Kidney essence.^2,6-9Selected Acupuncture Points:1,2,6-8

BL 23 (Shenshu)
GV 4 (Mingmen)
GV 20 (Baihui)
ST 36 (Zusanli)
CV 6 (Qihai)
CV 4 (Guanyuan)
CV 3 (Zhongji)
SP 6 (Sanyinjiao)
GB 20 (Fengchi)
GB 41 (Zulinqi)
LI 4 (Hegu)
LU 9 (Taiyuan)

Treatment
The patient gave informed consent for treatment. She was treated in a room with infrared-light for warmth, especially necessary for Wind-Cold Syndrome. She relaxed and listened to Chinese instrumental (Yin-Yang) music. The patient's comfortable treatment room may have strengthened the effects of acupuncture.

Needle type used was Hwato 0.25 x 40 mm; single-use, sterile needle (Suzhou Medical Appliance Factory, Suzhou, China). Needles remained in place for 30 minutes each session; an insertion depth of 0.5-1.5 cun (depending on location of the needle) was used. Manipulation of the needle with thrusting and lifting technique (reinforcing) was applied until De Qi was achieved. For 6 weeks, the patient was treated with acupuncture 2 times weekly, then once weekly. She received 15 acupuncture sessions.

RESULTS
In the 6th treatment session, the patient's thick, white coating of the tongue decreased, her pale tongue had normalized, and she began to experience De Qi. By the 8th session, she reported that her libido returned and she began to have interest in sexual contact. By the 10th session, the patient reported normal libido and the desire to resume sexual relations. After the 12th session, she received acupuncture treatment once weekly. She reported improved sexual ability and increased sexual confidence.

At the end of 15 sessions of acupuncture treatment, the patient reported the ability to achieve sexual gratification with her husband and her emotional state was greatly improved.

DISCUSSION
Rationale for Points Chosen:

BL 23 and GV 4 warm and tonify primary Yang of the Kidney.
CV 4 and CV 3 directly warm the genital region by increasing blood supply in this region.
CV 6, CV 4, and CV 3 dispel cold from the uterus.
LU 9 is an influential point dominating pulse and vessels, which promotes blood circulation in the genital area.
ST 36 and SP 6, the crossing of 3 Foot Yin meridians, strengthens the spleen, promotes menstrual flow, and nourishes Yin to tonify Yang.
GV 20 and ST 36 raise the sunken Yang.
GB 20, GB 41, and LI 4 eliminate Wind and Cold.
CV 6 reinforces Qi, strengthens Yang, and promotes menstrual flow.

This patient typically displayed the need for acupuncture in combination with moxibustion. However, the author intentionally performed acupuncture only because of the need to ascertain the results of acupuncture as monotherapy.

According to TCM, the patient's sexual dysfunction was caused by an unfulfilled desire to bear children, which damaged the heart and spleen as well as the kidney (mental injury).¹⁰CONCLUSIONS
Acupuncture treatment as a monotherapy without moxibustion for this patient was successful. Acupuncture may be a powerful tool and useful (alternative) therapy to treat sexual dysfunction.

REFERENCES

Dengbu Z, Guangzhong D. Acupuncture-Moxibustion Therapy. Jinan, China: Shandong Science and Technology Press; 1996.
Ganglin Y, Zhenhua L. Advanced Modern Chinese Acupuncture Therapy. Beijing, China: New World Press; 2000.
Aung SHK. Sexual dysfunction: a modern medical acupuncture approach. Med Acupuncture J. 2003;13(2):7-9.
Yubin L. Pulse Diagnosis. Jinan, China: Shandong Science and Technology Press; 1996.
Nian Fang S, Liang WQ. Diagnostics of Traditional Chinese Medicine. Jinan, China: Shandong Science and Technology Press; 1990.
Liangyue D, Yijun G, Shuhui HJ, et al. Chinese Acupuncture and Moxibustion. Beijing, China: Foreign Languages Press; 1999.
Qunhui M. Effective Points Therapy of Acupuncture. Beijing, China: Foreign Languages Press; 1998.
Gongwang L, Liya C, Goto S. Clinical Acupuncture & Moxibustion. Tiajin, China: Tianjin Science & Technology Translation & Publishing Corp; 1996.
Beijing College of Traditional Chinese Medicine, Shanghai College of Traditional Chinese Medicine, Nanjing College of Traditional Chinese Medicine, The Institute of Academy of Traditional Chinese Medicine. Essentials of Chinese Acupuncture. Beijing, China: Foreign Languages Press; 1993.
Watere W. Acupuncture and moxibustion for erectile dysfunction. Med Acupuncture J. 2004;15(3):32-33.

AUTHOR INFORMATION
Dr W. Watere specializes in Internal Medicine, Physical Medicine and Rehabilitation, and Medical Acupuncture; and is Chief of TCM-Centre, Elisabeth Hospital, Recklinghausen, Germany. Dr Watere is a Fellow of the German Academy of Medical Postgraduate Training and German Acupuncture Society Düsseldorf.
W. Watere, MD, PhD*
Zentrum für TCM, Elisabeth Hospital
Röntgen Strasse 10
45661 Recklinghausen
Germany
Phone: 49-2361-60 13 66 • Fax: 49-2361-60 13 80 • E-mail: watere@t-online.de • Web site: www.akupunktur-watere.de

*Correspondence and reprint requests

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