Erectile Dysfunction ED Ayurveda Traditional Treatment and Management

Ayurvedic Medicine for Erectile Dysfunction Treatment and Management

 

Erectile dysfunction is increasing in recent times which is not only a problem for men but a matter of concern for their partners too. Klaibya (Impotence / Erectile Dysfunction) prevents the man from enjoying sex with his partner. Firm erection is needed for gratification and fertilization too. Although Klaibya (Impotence / Erectile Dysfunction) commonly occurs in old age, recently it has started affecting men of all ages. It is not only a medical problem but also a social problem for which Ayurveda treatment may satisfactory and may offer good results.

 

Klaibya (Impotence / Erectile Dysfunction) is the term used to denote sexual dysfunction where the performance of the male partner is incomplete leaving the female partner dissatisfied. Chakrapani, the commentator of Charaka Samhita states that Klaibya (Impotence / Erectile Dysfunction) means erectile dysfunction that is the rigidity or firmness of the erection is insufficient which is necessary for healthy and happy sex and thus the female partner is not completely satisfied.

 

People predominant of Vata or Pitta Prakriti (Constitution) are more susceptible to Klaibya (Impotence / Erectile Dysfunction) because of the presence of less quantity of Shukra (Sperm).

 

Nirukti (Definition) – Klaibya (Impotence / Erectile Dysfunction) is a term used to denote the condition where one cannot enjoy normal sex. This is very critical as it causes social problems because of shyness. The intensity can vary from person to person. Some may have erectile dysfunction only whereas some may have decreased libido and impotence as well.

 

 

Klaibya (Impotence / Erectile Dysfunction) means

• Maithuna asamarthyam – Inability to perform sexual act
• Asatva – Less mental potency
• Rati anabhimukhata – Aversion to sexual intercourse
• Dhavaja Bhango medrasya asthabdtatha – Lack of penile rigidity
• Dhvajothana maithuna asakthi – Unable to perform sexual intercourse even if there is erection.
• Strisu Anutsaha – Lack of interest in female partner.
• Dvajanucharya – Lack of penile erection

 

Thus a person's persistent inability to perform sexual intercourses with his beloved, willing and submissive, partner though having persistent desire, due to the lack of erection and if at all attempted ends into failure without ejaculation due to flaccidity of penis associated with breathlessness and perspiration, is considered as Klaibya (Impotence / Erectile Dysfunction). 

 

 

Nidana (Causative factors)

 

The causative factors mentioned in Ayurveda texts are explained below.

 

1. Aggravation of Doshas, especially Vata Dosha due to Ahita Ahara Vihara (Unwholesome Diet & Lifestyle)
2. Depletion of Shukra Dhatu (Sperm)
3. Mental factors
4. Other factors like trauma to the penis, etc.

 

The above causative factors are explained in detail below.

 

Factors that increase Vata Dosha

 

Aharaja Bhavas (Dietetic factors) - Excess intake of food items which are Lavana (Salty), Katu (Pungent), Kashaya (Astringent), Amla (Sour) tastes, Ruksha guna (Dry in property), Ushna Virya (Hot in potency), Virudhha Ahara (Incompatible food), foods that have high calories or fats, etc. and Akala Bhojana (untimely food intake).

 

Viharaja Bhavas (Lifestyle factors) - Shrama (Over exertion), Vegadharana (Suppression of natural urges)

 

Factors that deplete Shukra Dhatu (Sperm)

 

Vriddha (Old age), Nirodhaja brahmacharya (Prolonged celibacy), Ativyavaya (Excess indulgence in sexual intercourse)

 

Manasaja Bhavas (Mental factors)

 

Chinta (Worries), Shoka (Grief), Krodha (Anger), Bhaya (Fear)

 

Other factors

 

Adhavana (unhygienic condition of penis), Medhra shastra (Injury to the penis due to surgery), Danta Nakha kshata (Trauma to the penis caused by teeth or nails), Vyadhikarshana (Emaciation due to diseases), Phimosis, Micropenis, Peyronie's disease, Torn frenulum, Penile ulceration.

Lakshanas (Symptoms)

According to Acharya Charaka, due to loss of penis erection or rigidity, a person having strong sexual desire cannot perform satisfactory sex with a beloved partner. Also if the erection is achieved, but the psychological component will cause failure. The anxiety he gets will cause dyspnoea and excess sweating and the attempts to have a successful sex will result in frustration and failure.

According to Acharya Charaka, the symptoms of Klaibya (Impotence / Erectile Dysfunction) can be classified into two types.

1. Samanya Lakshana (Common symptoms of all Klaibya (Impotence / Erectile Dysfunction)
2. Vishesa Lakshana (Specific Symptoms of each type of Klaibya (Impotence / Erectile Dysfunction)

 

Rupa (Clinical features)

 

The Samanya lakshana (Common symptoms) of Klaibya (Impotence / Erectile Dysfunction) which are found in all type of Klaibya (Impotence / Erectile Dysfunction) are as follows.

 

1. Mlana Sishnata, that is improper erection or rigidity which does not last till the sexual act.
2. Linga Shaitilya, that is inability to perform sexual act normally even though other factors like sexual desire and right partner are there because of flaccidity of penis
3. Nirbija or Nirvirya, that is absence of sperms or lack of ejaculation
4. Mogha Sankalpa Cesta, that is futile sexual activity
5. Dhvajanucchraya, that is lack of erection
6. Suratasaktata, that is incapability to perform sexual act.
7. Although erection occurs, but semen ejaculated will be less in quantity
8. Sometimes there is erection but problems in seminal ejaculation
9. Reduced sexual desire
10. Onset of fatigue, dyspnoea, sweating and problems in insertion of penis upon trying to perform sexual act
11. Depression and Anguish

 

Types of Klaibya (Impotence / Erectile Dysfunction)

Various types of Klaibya (Impotence / Erectile Dysfunction) are explained in the classical texts based on their causes. Acharya Charaka has explained four types of Klaibya (Impotence / Erectile Dysfunction) whereas Sushruta has explained 6 types  and Bhavaprakasha has explained 7 types. Classification of Klaibya (Impotence / Erectile Dysfunction) according to different Acharyas is listed in the below table.

 

 

Charaka	Susruta	Bhavaprakasha
Bijopaghataja	Manasa	Manasa
Dhvajabhangaja	Saumya dhatukshayaja	Doshaja / Pittaja
Sukra Kshayaja	Sukra Kshayaja	Sukra Kshayaja
Jarasambhavaja	Pumsatva-Upaghataja	Vyadhija / Medhra Rogaja
	Sahaja	Agantuja / Virya Vahini Sira Chedja
	Sthira Sukranimittaja	Sukrastambha nimittaja
		Sahaja

 

All the above classification are explained below in detail.

 

Classification according to Acharya Charaka

 

Beejopaghaataja Klaibya (Impotence / Erectile Dysfunction due to vitiation of Sperm)

 

Nidana (Causative factors)

Aharaja (Dietetic causes) - Excess intake of sour, pungent, salty, cold and dry food items regularly, incompatible food, unwholesome food, over eating, indigestion

Viharaja (Lifestyle factors) – Fasting, abhorrence towards women, Excessive indulgence in sexual activities, strenuous exercise more than one’s capacity, indulgence in intercourse at an early age, lack of interest in female partner, prolonged celibacy, suspicious nature on female partner, improper application of Panchakarma (Detoxification).

Mansajanya (Mental factors) – Sorrow, worry, anxiety, fear

Samprapti (Pathogenesis) – Vata Dosha increases because of the above mentioned causative factors which in turn vitiates the Shukra Dhatu (Sperm) and decreases its quantity leading to Beejopaghaataja Klaibya.

Rupa (Clinical Features)

This type of Klaibya (Impotence / Erectile Dysfunction) causes the following problems in a person afflicted with it.

• Paleness of skin,
• Weakness, Fatigue, Exhaustion
• Debility with diminished vitality
• Affliction with dyspnoea, heart problems, digestive troubles like colic, loose bowels, cough, fever, etc.
• Less excitement and low desire

Dhwajopaghataja Klaibya (Impotence / Erectile Dysfunction due to penile problems)

Nidana (Causative factors)

Aharaja (Dietetic causes) - Excess intake of sour and salty food, incompatible food, water, starchy food, heavy to digest food items, curd, milk, meat of animals from marshy regions

Other factors – Chronic illness, emaciation, lack of proper hygiene of penis, anger or hatred with partner, lack of sexual desire, sexual intercourse with a female who is suffering from chronic disease or having infected vagina or is menstruating, intercourse with female who does not maintain proper hygiene of the genital, indulgence in anal sex, oral sex or masturbation, injury to genital organ, trauma caused by teeth or nails, compression of penis, suppression of natural urges.

Rupa (Clinical Features)

This type of Klaibya (Impotence / Erectile Dysfunction) causes the following problems in a person afflicted with it.

• Swelling, pain and redness of the penis.
• Formation of boils and inflammation of the penis.
• Fleshy growth on the penis which soon becomes ulcer causing severe pain.
• Suppuration discharge from ulcer which resembles rice wash water, that is turbid or reddish or blackish colour.
• Foul smell from the discharge of the penis.
• Ulcer may heal quickly sometimes and sometimes the healing can be prolonged and ulcer can become infected.
• Ridge formation and hard indurations below glance penis
• Burning sensation occurs in the scrotum, groin and urinary bladder.
• Discharge of red, black, blue, turbid secretions from urethra
• Pain at urinary bladder, testicles, perineal sutures and groin. 
• Sometimes viscous, yellow coloured secretions from the penis. 
• Moderate swelling, numbness and scanty discharge from the penis
• Sloughing and foul smelling at genitals. 
• Falling off of glance penis, penis or of the testicles. 
• Fever, intense thirst, giddiness, fainting, vomiting can be other associated symptoms.

Dhwajopaghataja Klaibya is further sub classified into 5 types based on the predominance of Doshas – Vataja Dhwajabhanga, Pittaja Dhwajabhanga, Kaphaja Dhwajabhanga, Raktaja Dhwajabhanga and Sannipatika Dhwajabhanga. The symptoms of these sub-types will be based on the predominance of Doshas and Rakta Dhatu (Blood tissue). According to Chakrapani and Gangadhara, the symptoms of the 5 types of Dhwajopaghataja Klaibya are similar to the 5 types of Updamsha (Syphillis) mentioned in the ancient text book of Susrutha Samhita.

Symptoms of Vataja Dhwajopaghataja Klaibya

• Medhra Vedana (pain in the penis)
• Medhra Svayathu (Swelling of the penis)
• Medhra Raga (Redness of the penis)

Symptoms of Pittaja Dhwajopaghataja Klaibya

 

• Tivra Sphota (rashes on penis)
• Linga Paka (Acute inflammation of the penis)

Symptoms of Kaphaja Dhwajopaghataja Klaibya

• Mamsa Vrddhi (Abnormal growth)
• Vrana (Ulcer formation)
• Pulakodaka (Rice water like discharge)
• Syavarunasrava (Blackish and Reddish coloured discharge)
• Kathina valaya (circular hard constriction formed just above the glans penis)

Symptoms of Raktaja Dhwajopaghataja Klaibya

 

• Jvara (fever)
• Trsna (thirst)
• Bhrama (giddiness)
• Chardi (vomiting)
• Raktakrsnasrava (Reddish - blackish discharge)
• Nilavilalohitam (Blue, turbid or sanguineous discharge)

Symptoms of Sannipataja Dhwajopaghataja Klaibya

• Savedana - Basti, Vrshana, Sivani, Vankshana (intense pain in pelvic region particularly hypogastric area, testicles, perineum and groins)
• Agnidagdha Tivra Daha (intense burning sensation like experienced by burns)
• Picchila Pandu Srava (slimy - pale discharge)
• Manda Svayathu (mild swelling)
• Stimita - Alpasrava (feeling of wetness with scanty discharge)
• Chirata Paka (delayed suppuration)
• Shigra Pramucyate (quick recovery)
• Krimi (appearance of maggots)
• Kleda Putigandha (Moist, foul smell)
• Mani - Mushka - Medhra – Visirna (Necrosis of glans penis, testicles and scrotum and penis)

Shukra Kshayaja Klaibya (Impotence / Erectile Dysfunction due to decreased Sperm)

Nidana (Causative factors)

Aharaja Bhavas (Dietetic factors) - Ahita Ahara (Unwholesome food), intake of Sushka Anna (Dry food) or Upavasa (fasting) by a person who is already emaciated.

Viharaja Bhavas (Lifestyle factors) - Chinta (Worries), Krodha (Anger), Shoka (Grief), Irshya (Jealousness), Vyadhikarshana (Emaciation due to diseases), Vegadharana (Suppression of natural urges), Upavasa (Fasting), Shukra Vegadharana (Controlling semen at the time of ejaculation)

Samprapti (Pathogenesis)

Due to the above mentioned causative factors, the quality of the first Dhatu (Tissue), Rasa Dhatu (Plasma, Lymph) will be affected which in turn affects the quality of succeeding Dhatu (Tissue) and hence the last Dhatu, Shukra Dhatu (Sperm tissue) will be affected in it quality and quantity as well. If the person indulges in sexual intercourse with this decrease in Shukra Dhatu (Sperm tissue) without taking Vajikarana preparations (Aphrodisiac herbal preparations), then the Shukra Dhatu (Sperm tissue) will be depleted further and the person will fall prey to this type of Klaibya (Impotence / Erectile Dysfunction). So such a person should follow regulated sex or abstinence till the Shukra Dhatu (Sperm tissue) comes back to normalcy and strength or the tissue is regained, that is the quality and quantity is back to normal.

Rupa (Clinical features)

The person having this type of Klaibya (Impotence / Erectile Dysfunction) will experience the following symptoms.

• Weakness
• Fatigue
• Low sperm count
• Less or no ejaculation

Jarasambhavaj Klaibya (Impotence / Erectile Dysfunction due to old age)

Nidana (Cause) and Samprapti (Pathogenesis)

Jara means old age. Just as the word indicated, this type of Klaibya (Impotence / Erectile Dysfunction) occurs in old age. Sperm tissue gets depleted in old age as a natural phenomenon. As the Dhatus (Tissues) get depleted gradually in old age, the Shukra Dhatu (Sperm tissue) also gets depleted thereby resulting in decreased quality and quantity of Shukra (Sperm). Especially if the person does not consume Vrishya Ahara (Aphrodisiac diet) and Vajikarana Dravya (Aphrodisiac herbal preparations), the Shukra Dhatu (Sperm tissue) will be unnourished and get depleted soon. The symptoms of Klaibya (Impotence / Erectile Dysfunction) increase with degradation of body strength, vitality and life, loss of appetite, easily fatigues, etc. Person becomes old, weak and susceptible to various ailments. Also indulgence in excess physical activity, food and lifestyle that aggravates Vata Dosha like eating cold food items & raw food in excess, consumption of bitter and pungent food items in excess, eating fast, doing things hurriedly, etc. will precipitate Jarasambhavaj Klaibya.

Rupa (Clinical features)

·      Balakshaya (Diminution of strength)

·      Veeryakshaya (Decreased sexual potency)

·      Indriya Balakshaya (Diminution of strength of sense organs)

·      Varnakshaya (Dull complexion)

·      Malnourishment

Classification according to Bhavaprakasha

 

Manasika Klaibya (Impotence / Erectile Dysfunction due to mental factors)

 

Flaccidity of penis, stressed mind and inability to perform sex due to affliction of mind by sorrow, fright, worries, anguish, abhorrence etc. or due to performing sex with a woman who is not liked by the self. 

 

Doshaja Klaibya (Impotence / Erectile Dysfunction due to vitiation of Doshas)

 

Aggravation of Doshas, especially of Pitta Dosha due to intake of pungent, sour, hot, salty, harsh, dry type of food causing depletion of Shukra (semen). 

 

Shukra Kshayaja Klaibya (Impotence / Erectile Dysfunction due to decreased Sperm)

 

Person who indulges in sexual intercourse excessively without taking proper Rasayana (Rejuvenation) and Vajikarana (Aphrodisiac) therapies ultimately suffers from depleition of Shukra (Sperm) and flaccidity of penis, that is Shukrakshayaja Klaibya.

 

Vyadhija Klaibya (Impotence / Erectile Dysfunction due to diseases of the penis)

 

Inability to perform sex due to affliction of diseases at site of penis like Uapadamsha (Syphilis), Firanga (Venereal diseases), Shukadosha (Disease due application of insects for elongation of penis), Vidradhi (Abscess formation), Kushtha (Leprosy). 

 

Aagantuja Klaibya (Impotence / Erectile Dysfunction due to injury or trauma to the genital organs & associated structures)

 

Flaccidity of penis and inability to perform sex due to injury or trauma of the various blood vessels and nerves supplying to penis. 

 

Shukra Nirodhaja Klaibya (Impotence / Erectile Dysfunction due to abstinence)

 

Impotency caused due to forcible abstinence of sex. 

 

Classification according to Susrutha

 

Sahaja Klaibya  (Impotence / Erectile Dysfunction due to congenital deformities)

 

Sushruta Samhita explains a type formed due to congenital deformities and calls it Sahaja Klaibya and is further classified as Asekya, Saugandhika, Kumbhika, Eershaka and Shandaka.

 

Aasekya / Mukhayoni

 

Congenital defect where the person performs oral sex with other males first after which he will be able to perform sex with a female partner.

 

Saugandhika 

 

Person afflicted with this type can perform sex only after smelling penis or vagina. 

 

Kumbhika 

 

In this type of Klaibya (Impotence / Erectile Dysfunction), a person gets erection at penis and can perform normal sex only after sodomizing another male.  Sodomy with a female before performing normal with her is also possible in a Kumbhika. 

 

Eershaka

 

In this erection occurs only after becoming jealous on viewing other people performing sex. 

 

Shandaka

 

When a person abnormally aroused and deliberately performs sex especially in a woman on top position during her ovulation period and if she gives birth to a male child, that male behaves like  females and is called as Shandaka. Further with woman on top position, if a female child is born, she will behave like a male throughout her life and will be termed as Nari Shanda.  

 

Aasekya, Sugandhi, Kumbhika and Eershaka are classified as impotent with normal seminal count and qualities.  Those who lack normal seminal count are classified as Shandaka.

 

Sadhyasadhyata (Prognosis)

 

Manasika Klaibya, Doshaka Klaibya, Shukra Kshayaja Klaibya and Shukra Nirodhaja Klaibya are curable. However Vyadhika Klaibya, Agantuja Klaibya, Sahaja Klaibya and Jarasambhavaja Klaibya are incurable or in some cases condition can be improved but not fully cured.  

                                     

Recommended Panchakarma (Detoxification therapies)

 

Panchakarma (Detoxification), Rasayana (Rejuvenation) and Vajikarana (Aphrodisiac) therapies help to detoxify the body and improve the health of the sperm tissue, thereby helping in the treatment of Klaibya (Impotence / Erectile dysfunction). Panchakarma (Detoxification) procedures mainly Virechana (Therapeutic purgation) and Basti (Medicated enema) are effective in Klaibya (Impotence / Erectile dysfunction).

 

Virechana (Therapeutic purgation) balances Pitta Dosha by decreasing the heat quality of Pitta in the body and corrects Agni (Digestive and metabolic fire) thereby helping in proper formation and nourishment of Shukra Dhatu (Sperm tissue). It removes obstruction of Vata Dosha by Kapha Dosha in the Shukravaha Srotas, thereby regulating the function of Vata Dosha and improving the quality and quantity of Shukra (Sperm). Mahatiktaka Ghrita or Panchatiktaka Ghrita is used for Ghritapana (Internal oleation) for the purpose of Virechana because bitter herbs have healing properties, also they balance Pitta Dosha and when medicines are administered in the form of ghee, it balances Vata Doshas as well because of the unctuousness property.

 

Basti (Medicated enema) - In erectile dysfunction, there is derangement of Vata Dosha, especially Apana Vata which is a subtype of Vata and Dosha aggravated in its own seat is difficult to cure. Thus Basti (Medicated enema) is effective in regulating the functions of Vata Dosha, especially Apana Vata, a subtype of Vata which is present in the reproductive system. The Sneha (Unctuous material) in the Basti helps in the nourishment of the Dhatus (tissues), especially Shukra Dhatu (Sperm tissue) and increases the production of sperms. Niruha Basti (Concoction enema) increases strength and Anuvasana Basti (Unctuous enema) increases sperm production. Vrishya Basti, Ksheerabasti, Madhuyukta Basti, Drakshadi Niruha Basti, Shukrakara Basti are some of the Basti (Medicated enema) formulas mentioned in Ayurveda texts for Klaibya (Impotence / Erectile dysfunction). Acharya Susrutha has mentioned that by giving 18 Basti (Medicated enema), it will improve the quality of Shukra Dhatu (Sperm tissue). Uttarabasti is a type of Basti (Medicated enema) administered through the urethra which has a direct local action in the reproductive system.

 

Nasya (Nasal Medication) and Shirodhara (Third eye treatment) helps to decrease anxiety and stress hence beneficial in erectile dysfunction caused due to psychological factors.

 

Recommended Herbs Ayurvedic Medicine for Erectile Dysfunction

 

Herbs that are Madhura Rasa (Sweet taste), Guru (Heavy) & Snigdha (Unctuous) properties, Madhura Vipaka (Sweet Post-Digestive effect) and Shita Virya (Cold potency) have properties similar to Shukra (Sperm) and hence balance Vata Dosha which is the cause of Klaibya (Impotence / Erectile Dysfunction). The Vrishya (Aphrodisiac), Balya (Strength promoting), Brmhana (Stoutening) and Rasayana (Rejuvenation) property of these herbs improve muscle tone and helps in Klaibya (Impotence / Erectile Dysfunction).

 

Ashwagandha (Withania somnifera), Musli (Chlorophytum borivilianum), Gokshura (Tribulus terrestris), Kapikacchu (Mucuna Pruriens), Bala (Sida cordifolia), Yashtimadhu (Glycyrrhiza glabra), Ashwagandha Ghrita, Ashwagandhadi Lehya and Local application of Srigopala taila on penis are effective in erectile dysfunction.

 

Pathya – Apathya (Wholesome & Unwholesome Diet & Lifestyle)

 

Pathya Ahara (Wholesome Diet) – Rice, Wheat, Green gram, Green leafy vegetables, Milk, Ghee, White meat, Seasonal fruits, Amalaki (Indian Gooseberry)

 

Pathya Vihara (Wholesome Lifestyle) - Adequate sleep at night, body massage, clean & calm environment, walking, light exercise, non-suppression of urges.

 

Apathya Ahara (Unwholesome Diet) – Curd, Excess water intake, Fasting or less intake of food, Heavy to digest food, Incompatible food combinations, Fried food, Fast food, Bread, Tea, Coffee

 

Apathya Vihara (Unwholesome Lifestyle) – Intercourse with female during her menstruation period, suppression of natural urges especially that of seminal ejaculation, excess use of alcohol or tobacco, smoking, fasting and increased stress.

 

Thus, Ayurveda therapies, herbs along with wholesome diet & lifestyle will increase vigor, vitality, libido, sperm volume and motility thereby helping in Klaibya (Impotence / Erectile Dysfunction)