Male sexual impotence, known as erectile dysfunction, is a complex condition that affects various aspects of sexual response. This condition influences organic, relational, and psychological factors. It has been suggested that both endocrine and non-endocrine causes (neurological, vascular, and iatrogenic) may be involved in its onset (Yafi et al., 2016). In this post, we discuss a recent study published in the journal Nature.

Introduction.

Numerous recent studies have highlighted the efficacy of stimulating specific acupuncture points to treat various disorders. According to traditional Chinese medicine, qi and blood maintain the vital balance of the human body, and meridians and acupuncture points are the channels that facilitate their flow. In this article by Zihao et al., (2024), low-frequency transcutaneous electrical stimulation is employed along with meridians and acupuncture points to treat erectile dysfunction. Additionally, it combines infrared thermography with an intelligent electrophysiological diagnostic system to identify abnormal meridians in patients with erectile dysfunction and determine the most effective treatment parameters.

Thermography and Erectile Dysfunction

A total of 62 patients with erectile dysfunction (ED) were recruited. The sample was divided into two groups:

• Intervention group (with treatment): subjected to electrical stimulation at specific points of the detected abnormal meridians, using previously determined parameters. Treatment sessions were applied twice a week for a period of six weeks.
• Control group (without treatment): received sham treatments to compare the results of real treatment.

Patients with ED who participated in the study met the following criteria:

• Low scores on the International Index of Erectile Function (IIEF-5)
• Good physical health
• Absence of recent medical treatment for ED.

Additionally, before and after treatment, patients completed health questionnaires and underwent infrared thermography to assess the results. How were these points detected? To determine where to apply electrical stimulation most effectively, observation of changes in body temperature during the procedure was used.

To evaluate the clinical outcomes of the treatment, the following tools were used:

• International Index of Erectile Function-5 (IIEF-5)
• Erection Hardness Score (EHS)
• Patient Health Questionnaire-9 (PHQ-9), for psychological assessment of patients.
• Generalized Anxiety Disorder-7 (GAD-7), for psychological assessment of patients.

Key findings in patients with erectile dysfunction

The results varied significantly between groups. The following was observed:

• In group 1 (treatment group), after receiving treatment, patients’ IIEF-5 scores improved (p<0.001). Additionally, PHQ-9 (p<0.001) and GAD-7 (p=0.003) scores decreased. The EHS score improved with a significance of p=0.007.
• In group 2 (sham therapy group), there were no statistically significant improvements in any of the scores. Afterward, these patients received the treatments. For this condition, they showed positive results similar to group 1. Improved IIEF-5 scores (p<0.001), decreased PHQ-9 (p<0.001) and GAD-7 (p<0.001) scores were observed. The EHS score also improved (p=0.003).

Left: infrared images before treatment. Right: infrared images after treatment.

Clinical outcomes of pre- and post-electrophysiologic treatment in group 2 (control)

Conclusions

Despite the positive results, the authors note some limitations of the study (such as the placebo effect in patients with ED). However, the statistically significant improvement in scores suggests the potential efficacy of the applied treatment. The authors reflect the following conclusions:

• Proper stimulation of meridians and acupuncture points may play an important role in the prevention and treatment of various diseases.
• The results obtained in the study, where low-frequency electrical stimulation was used along with thermography, indicate a significant improvement in IIEF-5, PHQ-9, GAD-7, and EHS scores after treatment.
• Thermography identified abnormal meridians, guiding personalized treatments.
• The efficacy of the proposed intervention in identifying and treating abnormal meridians in patients with ED is supported.

References.

Yafi, F. A., Jenkins, L., Albersen, M., Corona, G., Isidori, A. M., Goldfarb, S., … & Hellstrom, W. J. (2016). Erectile dysfunction. Nature reviews Disease primers, 2(1), 1-20.

Zihao, W., Kaifeng, L., Shengmin, Z., Yongzhan, G., & Pengjie, L. (2024). Accurate diagnosis and effective treatment of abnormal meridians in erectile dysfunction patients based on infrared thermography: an electrophysiological technique study. International Journal of Impotence Research, 1-7.