Low libido, erection problems, tiredness that won’t lift, poor sleep and a back or neck that always aches are all common in men, and many live with some combination of them for years without mentioning it to anyone. Chinese medicine has long-established ways of approaching each of these problems, though it has rarely explained itself well to men. This article sets out what acupuncture can offer, where the evidence is good and where it’s thin, and why your GP belongs in the conversation from the start.
Why men put it off
Men see their GP less often than women do. A 2013 study of UK general practice records, published in BMJ Open by Wang and colleagues, found a crude consultation rate 32% lower in men, with the widest gap between the ages of 16 and 60. Visits related to reproductive health explained part of the difference, but not all of it.
The reasons will sound familiar to many men: embarrassment, the hope that the problem will sort itself out, and a feeling that it isn’t serious enough to bother anyone with. Sexual problems in particular tend to stay unspoken, even though they’re common and often have a treatable cause.
Start with your GP
Some of these symptoms need a medical check before anything else, and erection problems come first.
The NHS describes erectile dysfunction as very common, particularly in men over 40, and says that occasional problems are normal and often linked to stress, tiredness or alcohol. If it keeps happening, the NHS advises seeing a GP or a sexual health clinic, because conditions such as high blood pressure, high cholesterol, diabetes, depression, anxiety and hormone problems can cause it, and so can some medicines.
Erection problems can also give early warning of heart disease. A large Australian study of more than 95,000 men aged 45 and over, published in PLOS Medicine in 2013 by Banks and colleagues, found that the more severe a man’s erectile dysfunction, the higher his risk of later going into hospital with cardiovascular disease. The authors concluded that their findings support checking heart and circulation risk in men with erectile dysfunction who haven’t already had that check. Your GP can measure your blood pressure, cholesterol and blood sugar, and that check matters far more than any complementary treatment.
Other symptoms deserve the same attention:
- Low sex drive has many common causes. The NHS lists relationship problems, stress, anxiety and depression, lower hormone levels with age, some medicines (including some for blood pressure and some antidepressants) and drinking too much alcohol, and notes that long-term conditions such as heart disease, diabetes and an underactive thyroid can also affect it.
- If you've felt tired for a few weeks and don't know why, the NHS advises seeing a GP. Possible causes include anaemia, diabetes, sleep apnoea and depression.
- The NHS calls the term "male menopause" misleading. Testosterone falls slowly, by about 1% a year from around the age of 30 to 40, and a genuine deficiency (late-onset hypogonadism) is uncommon. Stress, work, relationships or low mood often explain the symptoms instead, and a GP can check your testosterone with a blood test if needed.
How Chinese medicine sees these problems
Chinese medicine looks for the pattern that links a man’s symptoms. In Five-Element terms, the Water element, associated with the Kidneys, governs vitality, willpower, fertility and the deep reserves a person draws on, so exhaustion alongside a fading sex drive often points there. The Fire element, associated with the Heart, relates to circulation, sleep and intimacy. Stress usually appears somewhere in the picture too: in traditional Chinese medicine, long-running frustration and pressure restrict the free flow of Qi, which can show up as tension, irritability, poor sleep and pain.
A first appointment therefore covers a lot of ground: sleep, digestion, energy through the day, mood, work, relationships and sex. I ask about all of these routinely, so nothing you tell me will seem unusual. The aim is to understand which element sits at the root of the problem and to treat that, alongside the symptoms that brought you in.
Treatment may include acupuncture, moxibustion and practical advice. That advice overlaps a good deal with the NHS’s own list for erection problems: lose weight if you’re overweight, stop smoking, eat a healthy diet, exercise every day, try to reduce stress, keep alcohol within 14 units a week, and take a break if you cycle for more than three hours a week.
What the evidence shows
Evidence for acupuncture varies a great deal from one problem to another, so it helps to take them in turn.
Pain and headache have the strongest support. NICE’s 2021 guideline on chronic primary pain (long-term pain with no underlying condition that explains it) tells clinicians they can consider a single course of acupuncture for people aged 16 and over, within set limits. NICE’s headache guidance suggests considering up to 10 sessions over 5 to 8 weeks to help prevent chronic tension-type headache, and for migraine prevention when the usual preventive medicines haven’t worked or aren’t suitable. NICE does not recommend acupuncture for low back pain, and I think you should know that.
The evidence for erectile dysfunction is weak. A 2016 systematic review in BioMed Research International, by Cui and colleagues, found only three randomised trials, with 183 men between them, and concluded that the evidence that acupuncture alone improves erectile dysfunction was insufficient. I won’t promise that acupuncture will restore erections, and I’d be wary of anyone who does.
I’m not aware of good-quality trials of acupuncture for low energy or low libido in men specifically.
In my view, acupuncture serves men’s health best as a considered, whole-person approach alongside medical care, with NICE support for some kinds of pain and headache and much weaker evidence elsewhere. Part of the value also lies in the conversation itself: an hour to describe your sleep, energy, mood and sex life to someone who takes all of it seriously, and to leave with practical changes to make.
Starting the conversation
If any of this sounds familiar, a few simple steps make the conversation easier.
- Before any appointment, write down what you've noticed: when it started, how often it happens, and anything that makes it better or worse.
- Bring a list of your medicines to your first acupuncture appointment, and tell your GP about any complementary treatment you have.
- Keep taking anything your doctor has prescribed. Acupuncture works alongside medical treatment and never replaces it.
None of these problems is a reason for embarrassment. Raising them early, starting with your GP, gives you the best chance of finding out what lies behind them.