Pathological analysis of sudden loss of libido and clinical treatment with integrated traditional Chinese and Western medicine

For both men and women, the most frustrating thing is the sudden loss (or reduction) of libido. This phenomenon can occur in healthy people and lead to a series of secondary symptoms. Fortunately, most patients can improve through counseling and treatment. (1) Causes of sudden loss of libido. ① Mental and psychological aspects ● Anxiety. Excessive tension and fear triggered by various situations, such as fear of pregnancy, fear of insecurity, fear of being discovered by others, interference from non-sexual factors such as worries about the economy or career, and unconscious inner conflicts. ● Inhibition. Depression, self-deprecation, decreased self-esteem, self-abandonment, and despondency caused by unfortunate events or hidden internal processes. ● Hostility. Overt or covert hostility, such as rage after discovering a partner's infidelity or past infidelity, frustration due to lack of enthusiasm or being ignored, hostility due to jealousy, and hostile emotions caused by other factors. ② Organic factors. Various physical diseases and medications. Organic lesions are usually more obvious, including any disease with obvious pain, such as trauma. Limitations in physical strength or endurance, such as acute connective tissue diseases. In these problems, low libido will become less noticeable because there are more important primary problems to focus on and treat. There are many drugs that can reduce libido. You can try the lowest dose that can maintain the original effect or replace it with other drugs that do not reduce libido. (2) Psychotherapy: Since libido is an emotional factor that can be affected by internal and external environment, the most effective way is still psychological counseling. The main methods are: ① General measures. Counseling is best conducted in the clinic because although most of them are psychological problems, physical examinations should also be done when necessary. Patient privacy should be respected and the consultation should be conducted in a calm and unhurried manner. It is best not to adopt a condescending and lecturing manner. Each meeting should be kept to 20-30 minutes, and generally not exceed 45 minutes. ④ Eliminate concerns. Decreased libido is a normal phenomenon in middle-aged people, but decline does not mean complete disappearance, and temporary disappearance does not mean permanent disappearance. As long as this physiological change is correctly understood and psychological adjustment is made, sexual interest can be fully restored and maintained through counseling and treatment, restoring sexual relationships to their former state. A physical examination report and detailed explanation are also key to eliminating patient concerns. ③ Expressing inner feelings. Allowing patients to freely express their fears, anger, grief, anxiety, and other uncomfortable emotions helps clear their minds of confusion and is a crucial step in reducing their negative impact. Doctors must be compassionate, and the consultation room must be conducive to confidentiality and free from external interference. ④ Psychological desensitization. For those psychological confusions that are causing interference and cannot be resolved, it is necessary to repeatedly mention them. Repeatedly raising the issue can gradually reduce or even eliminate its impact on the patient. ⑤ Support. Provide comfort and encouragement to the patient, making him or her feel that the situation can be changed and there is hope. Offer various possible solutions and allow the patient to choose a practical approach. Avoid making decisions for the patient. Before the patient makes a decision, explain the pros and cons of various methods. Helping the patient solve many practical problems is essential for alleviating the crisis. ⑥ Insight. Through detailed analysis of the patient's conversations, uncover inner conflicts, correct misconceptions, and allow the patient to discover the problem themselves, which is more meaningful. ⑦ Advice and guidance. It is best to reduce direct advice to a minimum. Point out the drawbacks of focusing too much on performance ability, as this only increases anxiety. Focusing on improving one's own and the partner's pleasure, and finding and eliminating the pressure of the causes of low libido, can itself promote the re-emergence of libido, at which point all kinds of psychological pressure will disappear. Men should not only get rid of their own negative emotions, but also help their partners overcome these psychological obstacles. ⑧ Provide counseling services to the partner. Help the partner understand the nature and possible causes of the problem, so that he or she can avoid putting pressure on the patient, promote communication between the two, avoid negative and pessimistic emotions, and ignite a flame of hope for the patient. Sometimes, women conceal and suppress their pain and resentment during the man's prime (e.g., premature ejaculation), only to express it in strange and sarcastic ways now that he is failing. In such cases, it's crucial to remind her to manage these feelings and emotions appropriately. What the man needs is sympathy, support, and understanding, not suspicion, ridicule, and blame. Otherwise, it will only further damage his self-esteem and confidence, worsening the situation and ultimately harming her own interests. ⑨ Referral. If you are unsure how to manage the situation yourself or encounter difficulties, you can refer to a more experienced doctor. If a patient finds treatment ineffective or uncomfortable with a particular doctor, they can seek treatment from another physician.

Drug treatment for low libido: (1) Western medicine treatment ① Methyltestosterone. 10 mg each time, 3 times a day, orally, or testosterone undecanoate, intramuscular injection, 250 mg each time, once a month. ② Yohimbine. 6 mg each time, 3 times a day, orally, for 3 consecutive months. (2) Traditional Chinese medicine prescription ① Rehmannia glutinosa 20g, Cornus officinalis 15g, Cuscuta chinensis 30g, Eucommia ulmoides 15g, Morinda officinalis 10g, Epimedium brevicornu 15g, Lycium barbarum 15g, Aconitum carmichaelii 6g, Cinnamomum cassia 4g. Decocted in water and taken twice a day, 1 dose per day. This prescription is a modified version of Yougui Wan. It is suitable for low libido due to kidney yang deficiency. ② Rehmannia glutinosa 30g, Cornus officinalis 15g, Paeonia suffruticosa 10g, Poria cocos 10g, Alisma plantago-aquatica 10g, Dioscorea opposita 15g, Testudinis plastrum 15g, Lycium barbarum 10g. Decocted in water and taken twice a day, 1 dose per day. This formula is a modified Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). It is suitable for decreased libido due to Yin deficiency. ③ Codonopsis pilosula 20g, Poria cocos 10g, Atractylodes macrocephala 10g, Glycyrrhiza uralensis 6g, Angelica sinensis 12g, Paeonia lactiflora 10g, Ligusticum chuanxiong 10g, Rehmannia glutinosa 20g, Astragalus membranaceus 20g, Schisandra chinensis 10g. Decocted in water and taken twice daily, one dose per day. This formula is a modified Bazhen Tang (Eight-Treasure Decoction). It is suitable for decreased libido due to Qi and Blood deficiency.