Chronic Prostatitis and Pelvic Pain Syndrome — Relieving Lower-Abdominal Discomfort with Korean Medicine
Table of Contents
The unique nature of chronic prostatitis
About 90% of chronic prostatitis cases are non-bacterial chronic prostatitis / chronic pelvic pain syndrome (CPPS), in which no bacteria are detected. A heavy ache or discomfort in the perineum, lower abdomen, testicles, or inner thigh persists for more than three months and is often accompanied by burning on urination, frequency, and post-ejaculatory pain. Because antibiotics are largely ineffective, patients suffer significantly.
Damp-heat pouring downward and qi-stagnation with blood stasis
Korean medicine explains chronic prostatitis through two main pathologies.
- Damp-heat pouring into the lower jiao: Alcohol, oily food, and stress generate damp-heat that gathers in the lower jiao, creating an inflammatory environment in the prostate and bladder. Urine appears yellow and hot, and there is heat and heaviness in the perineum.
- Qi-stagnation with blood stasis: Long hours of sitting (office work, driving) cause stagnation of pelvic qi and blood, leading to blood stasis. The pain is fixed and stabbing in nature and tends to worsen at night.
Modified Longdanxiegan-tang
Longdanxiegan-tang is a formula that powerfully clears damp-heat from the liver meridian and the lower jiao. Gentian, gardenia, and skullcap clear damp-heat; akebia, plantago seed, and alisma drain damp-turbidity through urine; and bupleurum, Chinese angelica, and rehmannia soothe liver qi and nourish yin and blood.
- When blood stasis is present: Add peach kernel, red peony, and Yanhusuo to invigorate blood and stop pain
- When residual urine sensation is severe: Add Dioscorea hypoglauca and Pyrrosia to drain dampness and unblock urinary passages
- When the condition has become chronic with qi deficiency: Add Astragalus and ginseng to support the right while expelling pathogenic factors
The importance of lifestyle management
Avoid sitting for long periods and stand up to walk or stretch for at least five minutes every hour. Alcohol, caffeine, and spicy foods worsen symptoms. Warm sitz baths (40°C, 15–20 minutes) improve pelvic blood flow and relax muscle tension. Kegel exercises that strengthen the pelvic floor are also supported by evidence.