(411) The Past, Present, and Future of Fangzhongshu (Ancient Chinese Sexual Techniques)

Introduction The ancient Chinese corpus of sexual knowledge, known as Fangzhongshu (Ancient Chinese Sexual Techniques, 房中术), encompasses a variety of concepts related to sexual physiology and psychology, sexual behavior techniques, and therapeutic approaches to sexual dysfunctions. As a part of the traditional Chinese medicine (TCM), Fangzhongshu has been representing an essential guideline for sexual health in large parts of the Oriental context, albeit focused almost exclusively on male sexual health. Objective This study aims to analyse the ancient Chinese literature and available articles related to Fangzhongshu and to provide a unique perspective of an integrated Western and TCM treatment approach for male sexual dysfunctions (MSD). Methods Based on the in-depth literature review and critical analysis of ancient Chinese literature and published articles regarding Fangzhongshu, we evaluated its potential value as a behavioral therapy for MSD, exploring its feasibility in combination with other therapeutic modalities by integrating ancient wisdom with contemporary Western medicine. Results Fangzhongshu has undergone significant evolution across the centuries and the various Chinese dynasties, integrating sexual practices with the principles of health preservation and longevity, ultimately forming a comprehensive theoretical and practical system that aligns with each of the four stages of the sexual response cycle: excitement, plateau, orgasm, and resolution. Fangzhongshu offers distinctive behavioral techniques for managing MSD, particularly premature ejaculation, that parallel-but also enrich-Western methods. For instance, the "Three Peaks Foreplay" (stimulating tongue, breasts, and vulva sequentially) resembles Western sensate focus, but is more structured and grounded in energy regulation. Similarly, the "Suppressing Yin and Raising Qi" technique, which involves pressing a specific acupoint below the scrotum when ejaculation is imminent in order to delay it, shares goals with the Western squeeze technique but adds a meditative dimension absent in typical cognitive-behavioral protocols. Conclusions The future development of Fangzhongshu faces several challenges, including integrating it with contemporary therapeutic models and establishing standardized protocols and guidelines for clinical practice. High-quality randomized controlled trials (RCTs) to validate the efficacy and safety of Fangzhongshu, thereby enhancing its acceptance in the international medical community and its integration into clinical practice, are needed. Nevertheless, Fangzhongshu offers a unique perspective for sexual medicine research and holds potential for enhancing sexual health and well-being. Disclosure No