Disease, Varicocele & Male
Sterility, and Increasing Sperm Motility with Chinese Medicine
Keywords: Chinese medicine, Chinese herbal medicine, Peyronie's
disease, varicocele, male sterility, sperm motility
Peyronie's disease refers to fibrosis of the cavernous sheath
of the penis leading to contracture of the investing fascia of the
corpora of the penis resulting in deviated and painful erection. In
Western medicine, the cause of this condition is unknown. It occurs
in adult men and may prevent intromission. It is rarely seen in those
under 20 years of age. It is a slow and gradually developing disease.
If the fibrosis extends into the corpus cavernosum, it may compromise
tumescence distally. Fortunately for some, resolution of this condition
may occur spontaneously over a period of many months, and minor Peyronie's
disease which does not cause sexual dysfunction does not typically
warrant treatment by Western medicine. Such treatment primarily consists
of surgical removal of the fibrosis and replacement with a path graft.
Unfortunately, treatment results are unpredictable and surgery may
result in further scarring and exaggeration of the condition. Local
injections of verapamil or high-potency corticosteroids may also be
effective. Orally administered corticosteroids are not. In some cases,
a prosthesis may have to be inserted to assist potency. Since Western
medicine's treatment of this condition is not entirely satisfactory,
alternative treatments, and especially nonsurgical treatments, are
desired by many sufferers of this frustrating and embarassing disease.
Recently, Zhang Bao-xing and Zhang Hai published an article on the
Chinese medical treatment of Peyronie's disease. Titled, "The
Treatment of 30 Cases of Penile Sclerosis & Nodulation with Chu
Jie Tang (Eliminate Nodulation Decoction)," this article appeared
in Shan Xi Zhong Yi (Shanxi Chinese Medicine), #4, 2001, on page 43.
All 30 cases included in this study were seen as out-patients at a
hospital attached to the Henan College of Chinese Medicine. Three
of the men were between 20–30, six were 31–40, 12 were
41–50, and nine were 50–60 years old. Ten cases had had
this condition for one year or less, 12 cases had had it 1–2
years, and eight cases had had it for three years or more. All the
patients met the diagnostic criteria appearing on page 227 in Nan
Xing Sheng Zhi Su Wai Ke (External
Medicine for the Male Reproductive System) published by the People's Health & Hygiene Publishing
Co. in Beijing in 1989. These criteria were the same as the Western
medical description given above.
In order to dispel dampness and eliminated phlegm, transform stasis
and soften the hard, and rectify the qi and free the flow of the
network vessels, the following medicinals were administered: Pericarpium
Citri Reticulatae (Chen Pi), 12g, Rhizoma Pineliae Ternatae (Ban
Xia), 10g, Sclerotium Poriae Cocos (Fu Ling), 12g, Rhizoma Curcumae
Zedoariae (E Zhu), 15g, Rhizoma Sparganii (San Leng), 15g, Spica
Prunellae Vulgaris (Xia Ku Cao), 20g, Semen Sinapis Albae (Bai Jie
Zi), 15g, Bulbus Fritillariae Thunbergii (Zhe Bei Mu), 12g, processed
Resina Olibani (Ru Xiang), 10g, processed Resina Myrrhae (Mo Yao),
10g, Fructus Meliae Toosendanis (Chuan Lian Zi), 12g, Radix Bupleuri
(Chai Hu), 10g, Radix Achyranthis Bidentatae (Niu Xi), 12g, Rhizoma
Atractylodis Macrocephalae (Bai Zhu), 10g, Fasciculus Vascularis
Luffae Cylindricae (Si Gua Luo), 15g, and Herba Ranunculi Ternati
(Mao Zhao Cao), 20g. One ji of these medicinals was decocted in
water and administered orally per day, with one month equaling one
course of treatment and three continuous courses being given. During
this time, patients were forbidden to eat acrid, peppery, sweet,
and fatty foods. They were counseled to keep a smooth and easy affect
and to keep their sexual activity suitable. No further explanation
of "suitable" is given by the Chinese authors of this
study. However, sexual activity was not prohibited during therapy.
Cure was defined as disappearance of sclerosis and nodulation, no curvature
of the penis during erection, and no aching or pain. Marked effect
was defined as partial softening and lessening of penile sclerosis
and nodulation, improvement in any aching and pain, and curvature
of the penis during erection. Based on these criteria, 23 cases were
cured and seven got a marked effect. Thus the total amelioration
rate was 100%.
According to Zhang and Zhang, this disease is associated with the three
channels of the liver, spleen, and kidney. If the patient's
emotions are unfulfilled, the liver may become depressed and the
qi stagnant. Thus the movement of the blood loses its smooth and
easy flow and there is qi stagnation and blood stasis in the yin
organ. If sexual desire is without limit, this may damage and consume
kidney essence, resulting in yin vacuity and the movement of the
blood becoming slow and relaxed. This may also cause blood stasis
in the yin organ. A predilection for eating fatty, sweet foods and
drinking too much alcohol may cause detriment and damage to the spleen
and stomach, brewing and engendering phlegm and dampness. If this
phlegm and dampness pour downward, they may congeal and bind in the
Based on these disease causes and mechanisms, Zhang and Zhang believe
that the appropriate treatment principles for dealing with this condition
are to dispel dampness and eliminate phlegm, rectify the qi and free
the flow of the network vessels, and transform stasis and soften the
hard. Within this formula, Chen Pi, Ban Xia, Fu Ling, Bai Jie Zi, Zhe
Bei Mu, and Bai Zhu fortify the spleen, dispel dampness, and transform
phlegm. San Leng, E Zhu, Xia Ku Cao, Mao Zhao Cao, Ru Xiang, and Mo
Yao quicken the blood and transform stasis, soften the hard and scatter
nodulation. Chuan Lian Zi, Chai Hu, and Si Gua Luo course the liver,
rectify the qi, and free the flow of the network vessels, while Niu
Xi guides the other medicinals in this formula to move downward to
the reproductive organs. Because these medicinals and these disease
mechanisms are in accord, the treatment effects were completely satisfactory.
Varicocele & male sterility
Varicocele refers to abnormal dilation of the pampiniform plexus vein
draining the testes and is the most common anatomic abnormality causing
male infertility. Twenty-five percent of infertile men suffer from
varicocele and the incidence of this condition is estimated to be
10–15% of the general population. Varicocele results in infertility
because it causes pooling of blood and higher intrascrotal temperatures.
In Western medicine, varicoceles are treated surgically via ligation
of the internal spermatic vein. This procedure has reportedly resulted
in 30–50% pregnancy rates in uncontrolled studies. In issue
#11, 2002 of the Zhe Jiang Zhong Yi Za Zhi (Zhejiang
Journal of Chinese Medicine), Sun Zi-xue published an article titled, "The Treatment
of 65 Cases of Sterility Due to Varicocele with Yi Shen Tong Luo
Fang (Boost the Kidneys & Free the Flow of the Network Vessels
Formula)." Since this protocol purports to offer a nonsurgical
treatment of this condition, a summary of its most important parts
is given below. This article appeared on page 475 of the original
Of the 65 men included in this study, the youngest was 24 and the oldest
was 40 years old, with a median age of 30.1 ± 4.18 years.
The shortest duration of disease was two years and the longest was
10, with a mean disease course of 3.3 ± 1.53 years. Fifteen
cases experienced grade 1 varicocele, 30 cases grade 2, and 15 cases
grade 3. In five cases, there were no obvious clinical symptoms but
ultrasound showed varicocele. Forty-nine of the men in this study
suffered from primary onset infertility and 16 from secondary onset
infertility. In eight cases, there was oligospermia, in 48 cases
there was poor sperm motility, and in nine cases there was both oligospermia
and poor motility. Twenty-one cases had already been treated surgically
with ligation of the internal spermatic vein.
Yi Shen Tong Luo Fang consisted of: cooked Radix Rehmanniae (Shu Di)
and Radix Astragali Membranacei (Huang Qi), 20g each, Radix Salviae
Miltiorrhizae (Dan Shen), 30g, Semen Cuscutae Chinensis (Tu Si Zi),
Herba Epimedii (Xian Ling Pi), Radix Morindae Officinalis (Ba Ji
Tian), and Radix Cyathulae (Chuan Niu Xi), 15g each, and Hirudo Seu
Whitmania (Shui Zhi), 3g ground into powder and swallowed with the
decoction. If there was dampness of the scrotum, 20 grams of Semen
Plantaginis (Che Qian Zi) and 15 grams of uncooked Semen Coicis Lachryma-jobi
(Yi Yi Ren) were added. If testicular sagging, distention, and pain
was asevere, 12 grams of Semen Litchi Chinensis (Li Zhi He) and 15
grams of vinegar-processed Rhizoma Corydalis Yanhusuo (Yan Hu Suo)
were added. One packet of these medicinals was decocted in water
and administered orally per day in divided doses. Three months equaled
one course of treatment, and the ejaculate was examined each month
during treatment. If there was conception, the medicinals were stopped.
Eleven of the 65 cases were considered cured. This meant that their
partner conceived. This also meant that the cure rate was 16.92%.
Another 25 patients experienced what was termed a marked effect.
Although these men's partners did not conceive, their sperm
count increased and their sperm motility returned to normal. A further
18 patients got some effect. This was defined as an increase in sperm
count and improvement in sperm motility. Eleven patients got no effect.
Therefore, the total amelioration rate was 83.07%.
According to Dr. Sun of the Henan Provincial Chinese Medical Hospital,
although all patients with varicocele have stasis obstructing the
vessels and network vessels, the main disease mechanism of their
infertility is kidney qi debility and vacuity. Based on the author's
long clinical experience in treating this condition, he believes
that it should be treated by boosting the kidneys and quickening
the blood, transforming stasis and freeing the flow of the network
vessels. Therefore, within the formula he has used Shu Di and Tu
Si Zi to supplement the kidneys, nourish yin, and foster the essence.
Xian Ling Pi and Ba Ji Tian to warm the kidneys and invigorate yang.
Dan Shen and Chuan Niu Xi quicken the blood, transform stasis, and
free the flow of the network vessels. Chuan Niu Xi can also lead
the other medicinals to move downward to reach the site of the disease.
A small amount of Shui Zhi is used to enter the blood aspect and
break and crack static blood, scatter nodulation and free the flow
of the network vessels. Huang Qi is used because the qi commands
the movement of the blood. By boosting the qi, one can also quicken
the blood. When Huang Qi is combined with Shui Zhi, Huang Qi supplements
without causing congestion and stagnation and Shui Zhi breaks the
blood without damaging the righteous. As this clinical trial shows,
when oligospermia and decreased sperm motility are due to varicocele,
this formula is able to get notable improvement in those conditions.
As Dr. Sun notes, the total marked effectiveness rate was 55.38%.
Increasing sperm motility
Male infertility is often due to problems with sperm count, motility,
and/or morphology. Spermatogenesis is continuous and requires from
72–74 days for maturation from germ cell. Semen analysis is
the major test for evaluating male infertility. Semen is evaluated
for volume, viscosity, gross and microscopic appearances, sperm count,
motility, and morphology. In men with moderate oligospermia but no
endocrine defects, clomiphene citrate may improve sperm counts. However,
sperm motility and morphology do not seem to improve significantly.
For azoospermia, insemination with donor sperm is an option. Since
Western medicine does not have a lot of treatments to offer men with
sperm motility and morphology problems, alternatives would be welcome.
Internally administered Chinese herbal medicine based on individual
pattern discrimination has been shown to improve both motility and
morphology. For instance, in issue #8, 2002 of Hu
Bei Zhong Yi Za Zhi (Hubei Journal
of Chinese Medicine), Zhang Ke published an article
titled, "The Treatment of Dead Sperm Condition with Yi Shen
Sheng Jing Tang (Boost the Kidneys & Engender the Essence Decoction)," on
page 46. A précis of that article appears below.
The 18 patients in this study were 24–45 years of age and all
had been diagnosed with dead sperm. Among these, eight were infertile.
All 18 patients were treated with Yi Shen Sheng Jing Tang which consisted
of: Herba Epimedii (Xian Ling Pi), cooked Radix Rehmanniae (Shu Di),
and Herba Cistanchis Deserticolae (Rou Cong Rong), 15g each, Semen
Cuscutae Chinensis (Tu Si Zi) and Fructus Lycii Chinensis (Gou Qi
Zi), 20g each, Radix Astragali Membranacei (Huang Qi), 30g, and Radix
Angelicae Sinensis (Dang Gui), 10g. If there was yin vacuity fire
effulgence, uncooked Radix Rehmanniae (Sheng Di) was substituted
for Shu Di and 15 grams each of Rhizoma Anemarrhenae Aspheloidis
(Zhi Mu) and Radix Rubrus Paeoniae Lactiflorae (Chi Shao) and 30
grams of Herba Taraxaci Mongolici Cum Radice (Pu Gong Ying) were
added. If there was damp heat pouring downward, 15 grams each of
Rhizoma Dioscoreae Hypoglaucae (Bi Xie) and Semen Plantaginis (Che
Qian Zi) and 30 grams of Rhizoma Smilacis Glabrae (Tu Fu Ling) were
added. If there was liver depression and blood stasis, 10 grams each
of Radix Bupleuri (Chai Hu), Radix Rubrus Paeoniae Lactiflorae (Chi
Shao), and Radix Albus Paeoniae Lactiflorae (Bai Shao) and 15 grams
of Tuber Curcumae (Yu Jin) were added. If there was kidney qi depletion
and vacuity, 15 grams of Radix Morindae Officinalis (Ba Ji Tian)
and 30 grams of Radix Dioscoreae Oppositae (Shan Yao) were added.
One packet of these medicinals was decocted in water and administered
per day, and one month equaled one course of treatment.
Cure was defined as a 70% or more increase in live sperm and good sperm
motility. Some effect was defined as a 60–70% increase in live
sperm although sperm motility may have been still a bit slow. No
effect meant that there were 40% or more dead sperm and sperm motility
was weak. Based on these criteria, seven cases were judged cured,
eight cases got some effect, and three cases got no effect.
Representative case history:
The patient was a 30 year-old male who had been married for two years
without his wife becoming pregnant. The patient's wife had
been tested and it was confirmed that she was not infertile. Accompanying
symptoms included low back and knee soreness and limpness, lassitude
of the spirit, lack of strength, a relatively soft erection, weak
ejaculation, weak libido, a pale tongue with white fur, and a deep,
fine, weak pulse. Sperm analysis showed live sperm at 25%. However,
sperm motility was good for those sperm which were alive. In order
to warm yang and boost the qi, supplement the kidneys and engender
essence, the following medicinals were prescribed: Herba Epimedii
(Xian Ling Pi), Herba Cistanchis Deserticolae (Rou Cong Rong), and
Radix Morindae Officinalis (Ba Ji Tian), 15g each, Semen Cuscutae
Chinensis (Tu Si Zi), cooked Radix Rehmanniae (Shu Di), and Fructus
Lycii Chinensis (Gou Qi Zi), 20g each, Radix Astragali Membranacei
(Huang Qi) and Radix Dioscoreae Oppositiae (Shan Yao), 30g each,
and Radix Angelicae Sinensis (Dang Gui) and Radix Bupleuri (Chai
Hu), 10g each. One packet of these herbs was decocted in water and
administered per day. After 60 packets of these medicinals with additions
and subtractions, the patient's clinical symptoms had disappeared
and his live sperm rate had increased to 70%, his sperm motility
was good, and his sexual desire had returned to normal. One half
year later, the patient succeeded in impregnating his wife.
Within this formula, Xian Ling Pi, Tu Si Zi, and Huang Qi warm the
kidneys and boost the essence, boost the qi and supplement vacuity.
These are the ruling ingredients in this prescription. Gou Qi Zi
evenly supplements the liver and kidneys and boosts the essence and
blood. Rou Cong Rong warms and supplements kidney yang while also
boosting the essence and blood. Dang Gui supplements the blood and
is also able to quicken the blood. Shu Di nourishes the blood and
enriches yin so that essence and blood engender each other.
Copyright © Blue Poppy Press, 2004. All rights reserved.
1. This medicinal is sweet, acrid, and warm and enters the liver and
lung channels. It treats scrofula, subcutaneous nodulations, pulmonary
tuberculosis, and malaria-like disease. When taken internally as
in decoction, its dose is 0.5–1 liang. It is classified as
a heat-clearing medicinal. This medicinal's common English
name is Cat's Claw, and it is a species of buttercup. In the
U.S., it is available from both Mayway Corp. and Nuherbs Co.