Acupuncture for sexual dysfunction in male substance abusers: a narrative review

Acupuntura para la disfunción sexual en hombres consumidores de sustan-cias: una revisión narrativa

Sexual dysfunction in male substance abusers represents a multifactorial condition influenced by neuroendocrine imbalances, vascular dysfunction and psychological comorbidities, often exacerbated by substance-induced neurochemical and hormonal disruptions. This review evaluates acupuncture as an adjunctive therapy for addressing such sexual dysfunction, emphasizing its mechanisms in modulating the hypothalamic-pituitary-gonadal axis, enhancing nitric oxide-mediated cavernosal blood flow, and alleviating anxiety through acupoint stimulation (e.g., Shenshu (BL23), Taichong (LR3)). While acupuncture demonstrates efficacy in psychogenic or functional cases—particularly those involving psychological dependence or stress—its utility is limited in irreversible organic pathologies, necessitating integration with pharmacotherapy and psychosocial interventions. Clinical evidence highlights acupuncture’s role across addiction treatment phases: mitigating withdrawal symptoms during detoxification, reducing agitation in rehabilitation, and diminishing cravings in relapse prevention. Trials report superior outcomes for electroacupuncture over pharmacotherapy in opioid withdrawal management, reduced alcohol relapse rates, and lower cocaine-positive urine screens. Tailored protocols (4–8 weeks, 2–3 sessions/week) combined with lifestyle modifications (substance cessation, exercise) amplify therapeutic effects. Despite sociocultural barriers to addressing sexual health in addiction care, acupuncture’s cost-effectiveness, safety and holistic benefits position it as a viable component of multi-disciplinary strategies. Critical considerations include Traditional Chinese Medicine-based diagnostic differentiation of functional versus organic etiologies, contraindications for cardiovascular or bleeding disorders, and personalized acupoint selection (e.g., Guanyuan CV4 for kidney deficiency). This synthesis advocates for acupuncture’s integration into comprehensive treatment plans, prioritizing individualized evaluation to optimize outcomes in this clinically underserved population.

Resumen

La disfunción sexual en hombres consumidores de sustancias es una condición multifactorial influenciada por desequilibrios neuroendocrinos, disfunción vascular y comorbilidades psicológicas, frecuentemente exacerbada por alteraciones neuroquímicas y hormonales inducidas por las sustancias. Esta revisión evalúa la acupuntura como terapia coadyuvante para abordar dicha disfunción, destacando sus mecanismos en la modulación del eje hipotálamo-hipófisis-gonadal, la mejora del flujo sanguíneo cavernoso mediado por óxido nítrico y la reducción de la ansiedad mediante la estimulación de puntos acupunturales (ej., Shenshu (BL23), Taichong (LR3)). Si bien la acupuntura demuestra eficacia en casos psicógenos o funcionales—especialmente aquellos relacionados con dependencia psicológica o estrés—, su utilidad es limitada en patologías orgánicas irreversibles, requiriendo integración con farmacoterapia e intervenciones psicosociales. La evidencia clínica resalta el papel de la acupuntura en las fases del tratamiento de adicciones: mitigar síntomas de abstinencia durante la desintoxicación, reducir la agitación en rehabilitación y disminuir los antojos en la prevención de recaídas. Estudios reportan resultados superiores de la electroacupuntura frente a la farmacoterapia en el manejo de la abstinencia a opioides, menores tasas de recaída en alcohólicos y reducción de pruebas de orina positivas para cocaína. Protocolos personalizados (4–8 semanas, 2–3 sesiones/semana) combinados con cambios en el estilo de vida (abstinencia de sustancias, ejercicio) potencian los efectos terapéuticos. A pesar de las barreras socioculturales para abordar la salud sexual en el tratamiento de adicciones, la rentabilidad, seguridad y beneficios holísticos de la acupuntura la posicionan como un componente viable en estrategias multidisciplinarias. Consideraciones clave incluyen la diferenciación diagnóstica basada en la medicina tradicional china (etiologías funcionales vs. orgánicas), contraindicaciones en trastornos cardiovasculares o hemorrágicos, y selección personalizada de puntos (ej., Guanyuan CV4 para deficiencia renal). Esta síntesis aboga por integrar la acupuntura en planes de tratamiento integrales, priorizando evaluaciones individualizadas para optimizar resultados en esta población clínicamente desatendida.

Acupuncture; Male; Sexual dysfunction; Substance abuse

Palabras Clave

Acupuntura; Hombre; Disfunción sexual; Abuso de sustancias

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