bubble_chart Concept

No ejaculation refers to the inability to expel semen during intercourse. In mild cases, a small amount of semen may be discharged, while in severe cases, none at all. This condition is one of the causes of sterility.

bubble_chart Pattern Analysis

1. Yin Deficiency︰During intercourse, there is no ejaculation process, no ejaculation or only minimal semen discharge. Priapism with easy erection, penile distending pain, nocturnal emission spermatorrhea, dysphoria, dark urine, constipation, dry mouth, red tongue, and thready rapid pulse. Due to kidney yin deficiency, yin deficiency with effulgent fire, and frenetic stirring of ministerial fire, this leads to priapism with easy erection or even persistent erection, or nocturnal emission spermatorrhea, accompanied by symptoms of yin deficiency with effulgent fire such as dark urine, dry mouth, red tongue, and thready rapid pulse. Treatment should focus on enriching yin and draining fire, using formulas such as Kanli Jiji Decoction or Modified Anemarrhena, Phelloendron and Rehmannia Pill.
2. Static Blood︰During intercourse, there is no ejaculation, accompanied by a sullen and irritable temperament, chest tightness and discomfort, pain in the genital area, a purple tongue or with ecchymosis, thin tongue coating, and a deep, choppy pulse. Due to prolonged illness, qi stagnation and blood stasis obstruct the seminal pathway, resulting in aspermia, a sensation of distending pain in the genital area, as well as symptoms such as chest tightness, irritability, a purple tongue, and a deep, choppy pulse—all caused by qi stagnation and blood stasis. "The kidney stores essence, generates marrow, and the brain is the sea of marrow... Treating the brain is akin to treating the heart, as the heart governs blood and vessels, and the vessels are the house of blood." Therefore, the treatment should focus on invigorating blood and resolving stasis. The recommended prescription is Blood House Stasis-Expelling Decoction supplemented with Cnidium Fruit and Allium Tuber Seeds to invigorate the yang pathway. "Regulate the qi and blood, restore their harmony, and achieve balance." ("Selected Experiences of Chun Shen Lao Chinese Medicine: Yan Dexin's Medical Notes")

The condition of no ejaculation is generally caused by excessive sexual activity leading to injury of kidney qi. For those with yin deficiency and effulgent fire, enriching yin to reduce fire is necessary; for those with static blood obstruction, the root is deficiency while the manifestation is excess, so dispelling static blood should also involve tonifying kidney qi.