Holistic TCM Approach for Chronic Prostatitis: Say Goodbye to Frequent Night Urination and Perineal Pain

For patients with chronic prostatitis, frequent nighttime urination is already torturous, but the dull, distending, or stabbing pain in the perineum makes life even worse — the pain intensifies when sitting for long periods, walking causes discomfort, and daily activities are affected. In fact, Traditional Chinese Medicine (TCM) provides comprehensive management for chronic prostatitis, not only easing nighttime urination but also effectively relieving perineal pain. Here’s a complete explanation.

Chronic Prostatitis: The Common Cause Behind Both Night Urination and Perineal Pain

Many patients wonder why prostatitis causes both frequent nighttime urination and perineal pain. The answer lies in the prostate’s location and the effects of inflammation.

The prostate is located at the bottom of the pelvis, close to the perineum and surrounded by nerves and blood vessels. When chronic inflammation occurs, it irritates the urethra and compresses the bladder, leading to increased nighttime urination. Meanwhile, the congestion and swelling of the prostate press against the nerves in the perineal area. The inflammatory exudates also irritate nearby tissues, causing perineal pain. This pain often manifests as dull or heavy discomfort, which worsens after sitting for a long time, holding urine, or fatigue. Some patients may also experience sacral soreness or groin discomfort, creating a “dual trouble” of pain and urinary problems.

Perineal Pain from a TCM Perspective: More Than Just Inflammation

In TCM theory, perineal pain caused by chronic prostatitis is not merely due to “inflammation.” It is often related to Qi and blood stagnation, damp-heat accumulation, or liver and kidney deficiency, requiring differentiated treatment.

Qi and blood stagnation:

When inflammation persists for a long time, local Qi and blood flow become sluggish — “where there is blockage, there is pain.” This causes fixed, stabbing perineal pain that worsens under pressure, and the prostate may feel harder on examination.

Damp-heat accumulation:

If the patient often eats spicy, greasy food or drinks alcohol, “damp-heat” tends to form and move downward to the prostate and perineum. This causes distending or burning pain, accompanied by dark-yellow urine and scrotal dampness.

Liver and kidney deficiency:

Long-term illness weakens the liver and kidneys — “where there is deficiency, there is pain.” The perineal pain tends to be dull and persistent, worsening with fatigue and accompanied by symptoms like weakness, soreness in the lower back and knees, and poor spirit, commonly seen in chronic and weak patients.

TCM “Targeted Regulation”: Relieving Perineal Pain from the Root

To relieve perineal pain caused by chronic prostatitis, TCM follows the principle of syndrome differentiation and treatment, combining internal herbal medicine and external therapy to target the root cause and improve overall balance. Among herbal treatments, the Diuretic and Anti-inflammatory Pill plays an important role in pain relief.

Besides its effects in clearing heat, detoxifying, and promoting urination, its blood-activating and stasis-resolving ingredients (such as safflower, peach kernel, and angelica) effectively improve blood circulation in the prostate and perineum. By reducing congestion and swelling, it relieves nerve compression and alleviates the “pain from stagnation.” Moreover, its gentle tonic effect strengthens vital Qi, reduces damp-heat accumulation, and prevents recurrence.

For damp-heat type pain, enhancing its clearing and draining actions helps relieve burning or distending pain; for liver and kidney deficiency type, combining tonic herbs achieves more thorough pain relief and long-term balance, reducing relapse.

External TCM Therapies for Pain Relief

(1) Herbal Sitz Bath: Dual Relief of Warmth and Medicine

Adding herbs with blood-activating and damp-clearing properties (such as Sophora flavescens, Phellodendron, Salvia, or safflower) into warm water allows medicinal effects to penetrate the perineal skin and reach the prostate area.

Method: Boil the herbs, filter, and mix with warm water at about 40°C. Sit for 15–20 minutes once daily. The heat relaxes muscles while herbs clear stagnation and dampness. After 1–2 weeks, most patients report reduced perineal pain and burning sensations.

(2) Acupuncture and Massage: Unblocking Meridians and Relieving Pain

Acupuncture: Stimulates specific acupoints to regulate Qi and blood. Common points include Huiyin (perineum), Xuehai (2 inches above the knee’s inner side), and Taichong (between the first and second metatarsal bones). Treatments 2–3 times per week help alleviate pain through meridian activation.

Massage: Gentle massage of the perineum, lower abdomen, and sacral area promotes circulation and relaxes tight muscles. Ideal for perineal heaviness or pain after sitting too long; each session lasts 10–15 minutes, 1–2 times weekly.

(3) Herbal Plaster: Long-Acting Topical Therapy

Herbs like frankincense, myrrh, artificial musk, and borneol can be made into plasters and applied to the perineum, Guanyuan (lower abdomen), or Shenshu (lower back). The medicine penetrates the skin slowly and continuously, improving circulation and relieving pain. Each patch is kept for 8–12 hours, best applied overnight.

(4) Moxibustion: Warming Meridians and Dispelling Cold Pain

For patients with cold-type pain (worse in cold, better with warmth), moxibustion is ideal.

Apply moxa over Guanyuan, Qihai (1.5 inches below the navel), or Mingmen (lower back) for 20–30 minutes, 2–3 times per week. The warmth unblocks meridians, dispels cold, and enhances blood flow — particularly beneficial during cold seasons or for weak constitutions.

Daily Care Tips: Preventing Pain Aggravation

While receiving TCM therapy, daily care is vital for faster recovery:

• Avoid prolonged sitting or standing: Move every 30–40 minutes to relieve prostate pressure; use soft, breathable seats.
• Control sexual frequency: Overactivity or prolonged abstinence can worsen congestion; moderate, regular activity (about once or twice weekly) helps discharge prostate secretions.
• Keep the perineum warm: Avoid cold environments or thin clothing around the waist. Warmth prevents vascular constriction and pain flare-ups.
• Reduce local irritation: Avoid cycling and hard pressing on the perineum. Use mild warm water for cleansing — no harsh soaps or hot water.

Conclusion

Through syndrome-based regulation, TCM not only reduces nighttime urination but also effectively relieves perineal pain from chronic prostatitis by addressing its root causes. Combined with the Diuretic and Anti-inflammatory Pill, external therapies, and healthy lifestyle adjustments, most patients can gradually escape urinary and pain distress and return to normal life. 

If you are struggling with these symptoms, TCM offers a safe, natural path to lasting recovery.