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

Background: The ancient Chinese corpus of sexual knowledge, known as Fangzhongshu (ancient Chinese sexual techniques, ), 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 focusing predominantly on male sexual health.

Objectives: This study aims to analyze 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 (MSDs).

Material and methods: We performed a narrative review on the topic by retrieving the relevant literature from both English and Chinese databases to identify studies or classical texts discussing Fangzhongshu and related sexual practices.

Results: Fangzhongshu has undergone significant evolution across the centuries, 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 Masters and Johnson's 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, offering a structured approach grounded in traditional theories of energy regulation.

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 are needed to validate its efficacy and safety. Nevertheless, Fangzhongshu offers a unique perspective for sexual medicine research and holds potential for enhancing sexual health and well-being.