Fu Wang

Background: Primary premature ejaculation (PPE) affects men’s sexual confidence, impairs couple relationships, and may lead to anxiety and depression. Compound Jinji Granule (CJG) is a traditional Chinese medicine (TCM) formula for treating PPE. Preliminary rat experiments suggested its potential in delaying ejaculation, and this study aims to further validate its clinical efficacy. Methods: This multicenter, double-blind, double-dummy, randomized controlled non-inferiority trial enrolled patients with PPE diagnosed with liver depression and kidney deficiency pattern. Participants were randomly assigned to an experimental group or a control group for 4 weeks. The experimental group received CJG plus a placebo matching dapoxetine, while the control group received a placebo matching CJG plus dapoxetine. The primary outcome was the change in stopwatch-measured average intravaginal ejaculatory latency time (IELT) during treatment. Secondary outcomes included the premature ejaculation profile (PEP), TCM symptom score, degree of IELT improvement, and clinical global impression of change (CGI-C). Results: A total of 92 subjects were enrolled, with 7 dropouts (4 in the experimental group, 3 in the control group). After 4 weeks of treatment, the average IELT in the experimental group increased from 0.29 ± 0.12 min at baseline to 2.03 ± 0.83 min ( P < 0.01); in the control group, it increased from 0.34 ± 0.15 min to 2.48 ± 1.08 min ( P < 0.01). Both groups showed significant improvements across all PEP outcomes. TCM symptom scores improved significantly in both groups, with the experimental group showing superior improvement compared with the control group. The proportion of patients reporting at least mild improvement was significantly higher in the experimental group than in the control group (73.91% vs. 53.33%, P < 0.05). In addition, no significant between-group difference was observed in the proportion of patients achieving an increase in IELT of >1 min or >3 min ( P > 0.05). Adverse events in the experimental group included diarrhea (n = 1), abdominal bloating (n = 1), dry mouth (n = 1), and constipation (n = 1), while those in the control group included nausea (n = 4), headache (n = 3), and dizziness (n = 2). All adverse events in both groups were mild and well tolerated, and no serious adverse events were reported. Conclusion: CJG significantly prolongs IELT, improves ejaculatory control and sexual satisfaction, effectively alleviates ejaculation-related distress and couple communication, and demonstrates good safety.

Varicocele (VC) is a prevalent male urogenital disorder associated with scrotal discomfort, impaired semen quality, and endocrine dysregulation, in which oxidative stress (OS) is repeatedly implicated as a key pathogenic axis linking venous stasis, hypoxia, hyperthermia, inflammation, mitochondrial dysfunction, and germ-cell injury. This review critically evaluates experimental and clinical evidence on defined botanical drugs and plant-derived metabolites investigated in VC or VC-relevant OS models, with an emphasis on mechanistic plausibility and translational limitations. Across in vivo VC models, toxin-/heat-/hypoxia-induced spermatogenic injury models, and selected clinical studies, multiple interventions have been reported to improve semen parameters, testicular histology, and redox indices (e.g., ROS, MDA, SOD/CAT/GPx, GSH/GSSG), alongside modulation of apoptosis and stress responses. Reported molecular nodes converge on redox- and stress-responsive pathways, including Keap1–Nrf2–ARE/HO-1, PI3K–Akt, MAPK/JNK–p38, HIF-1–related signaling, ER-stress responses, mitochondrial apoptosis (e.g., Bax/Bcl-2/caspases), and, in some models, ferroptosis-related regulation. However, the overall evidence base is constrained by heterogeneity in models and endpoints, limited extract/compound chemical characterization and pharmacological standardization, frequent reliance on in silico predictions, small or non-randomized clinical cohorts, and incomplete reporting of taxonomic and product quality details. Future work should prioritize rigorously designed, adequately powered clinical trials with standardized outcomes, well-defined interventions, and mechanism-aligned biomarkers to clarify which botanical drugs/metabolites offer clinically meaningful benefit as adjuncts in VC management.

Background: Male infertility accounts for nearly half of infertility cases, with abnormal semen quality being a major cause. Pentoxifylline (PTX), a methylxanthine derivative with antioxidant and anti-inflammatory properties, has been proposed to improve semen parameters, but evidence remains inconsistent. This systematic review and meta-analysis aimed to assess the efficacy and safety of oral PTX supplementation compared with placebo in improving semen parameters and reproductive hormone profiles in infertile men. Methods: PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from inception to July 2025. Randomized controlled trials (RCTs) comparing oral PTX with placebo in infertile men were included. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Primary outcomes included semen parameters (sperm concentration, total motility, morphology, semen volume). Secondary outcomes comprised serum hormones [testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH)]. Data were pooled calculating mean difference (MD) with 95% confidence intervals (CIs). Results: Five RCTs involving 455 participants were included. PTX dosages ranged from 800 to 1,200 mg/day, with treatment durations of 3 to 6 months. PTX supplementation correlated with increased total sperm motility (MD =10.44, 95% CI: 3.57–17.30) and normal morphology (MD =3.86, 95% CI: 1.01–6.71). Sperm concentration transiently improved at 3 months but did not differ significantly from placebo at 6 months. No significant differences were observed in testosterone (MD =0.22, 95% CI: −0.23 to 0.67) or FSH (MD =−1.51, 95% CI: −4.16 to 1.14) levels, whereas LH decreased marginally (MD =−0.97, 95% CI: −1.45 to −0.49). Reported adverse events were predominantly mild and gastrointestinal. Conclusions: PTX supplementation appears to enhance sperm motility and morphology in infertile men with a favorable safety profile. Its effects on sperm concentration and reproductive hormones are less consistent, and evidence on ultimate clinical effectiveness regarding pregnancy and live birth rates remains unproven. Larger, high-quality trials with reproductive endpoints are needed to clarify its clinical role.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a heterogeneous condition with limited ideal therapeutic options. Acupuncture has shown clinical benefits for CP/CPPS, yet its molecular basis remains insufficiently characterized. To elucidate potential molecular mechanisms of acupuncture in CP/CPPS using a network acupuncture strategy. Acupuncture-induced bioactive substances relevant to CP/CPPS were identified through a systematic literature search, and their putative high-affinity targets were predicted using the STRING database. CP/CPPS-associated genes were collected from GeneCards and DisGeNET with integrated screening. Overlapping targets were obtained via Venn analysis. Protein-protein interaction (PPI) networks and an “Acupuncture-Active Substance-Target-CP/CPPS” network were constructed in Cytoscape, and key targets were prioritized using the Maximal Clique Centrality (MCC) algorithm. Functional enrichment analyses were performed using the Database for Annotation, Visualization and Integrated Discovery (DAVID), which is commonly used for gene functional annotation and enrichment analysis. We identified 655 shared targets between acupuncture-related components and CP/CPPS. PPI analysis highlighted IL6, IL1B, IFNG, TNF, IL10, CD4, IL4, CXCL10, IL2, and CXCL8 as the top hub targets, and enrichment yielded 1878 significant Gene Ontology (GO) terms, including 214 Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Acupuncture may exert therapeutic effects in CP/CPPS through coordinated network-level regulation of immune inflammation, tissue repair, and central nervous system remodeling.

Background: Benign prostatic hyperplasia (BPH) is common in middle-aged and older men and frequently causes lower urinary tract symptoms that impair quality of life. Guiyi Tonglong Formula, a…

The monocyte-to-high-density lipoprotein cholesterol ratio (MHR), an indicator of inflammation and lipid metabolism, has demonstrated significant clinical potential. The study aims to investigate the association between the MHR and total testosterone (TT) levels, as well as testosterone deficiency (TD) risk, utilizing data from the NHANES. We analyzed data from 6,194 adult men from NHANES 2011-2016. Multivariate linear and logistic regression analyses were conducted to evaluate associations of MHR with TT levels and TD risk, respectively. Restricted cubic spline (RCS) analyses and subgroup analyses further assessed the robustness of our findings. In the fully adjusted model, each unit increase in log-transformed MHR was associated with a decrease in TT (β = -47.91, 95% CI: -62.39, -33.43, P < 0.001) and an increase in TD risk (OR = 1.81, 95% CI: 1.46, 2.24, P < 0.001). RCS analysis confirmed a linear relationship, and the findings were consistent across subgroup analyses. This study showed that in the United States (US) adult men, a high MHR is linked to low TT levels and a higher TD risk. These findings suggest MHR could be a useful marker for early detection of low testosterone and TD risk, warranting further prospective research for confirmation.

Background: Asthenozoospermia is a leading cause of male infertility with limited treatment options. Emerging evidence implicates epigenetic alterations, particularly DNA methylation, in its pathogenesis. The Qixiong Formula (QXF) has shown clinical efficacy in improving sperm motility, yet its underlying epigenetic mechanism remains unclear. This study therefore aimed to investigate the therapeutic effects of QXF and its regulation of genome-wide sperm DNA methylation in a rat model of asthenozoospermia. Methods: Asthenozoospermia was induced in male Sprague-Dawley rats via oral administration of ornidazole (400 mg/kg/day) for 28 days. Rats were treated with low, medium, or high doses of QXF. Semen parameters, testicular and epididymal histology, organ coefficients, and liver and kidney function were assessed. Reduced representation bisulfite sequencing (RRBS) was used to profile genome-wide DNA methylation in sperm and identify differentially methylated regions (DMRs), followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. Results: QXF significantly improved sperm motility without affecting sperm concentration or systemic toxicity. Histological analysis showed partial recovery of epididymal architecture in QXF-treated rats. RRBS revealed that QXF induced a shift toward global hypomethylation in sperm DNA, reversing the hypermethylation pattern observed in the model group. Enrichment analyses implicated several key signalling pathways in QXF’s action, particularly cAMP, cGMP-PKG, and PI3K/Akt pathways, which are known to regulate sperm motility and survival. Conclusions: QXF improves sperm motility and reverses aberrant methylation patterns in a rat model of asthenozoospermia. These findings suggest that QXF exerts its therapeutic effect through dual regulation of DNA methylation and activation of sperm-related signalling pathways, offering new insights into the epigenetic basis of its action.

Background: 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 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.

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Background: Lycii Fructus (dried goji berry), the dried ripe fruit of Lycium barbarum L., has long been used in traditional Chinese medicine for its functions of tonifying the kidney, nourishing essence, soothing the liver, and improving vision. It has been widely applied to enhance male reproductive function. In recent years, modern pharmacological studies have revealed that Lycii Fructus is rich in various bioactive metabolites, particularly Lycium barbarum polysaccharides, betaine, carotenoids, and flavonoids, which exhibit antioxidant, anti-apoptotic, and hormone-regulating effects. This review aims to systematically summarize existing clinical and mechanistic studies on the protective effects of Lycii Fructus and its key metabolites on male infertility.Methods: A literature survey was conducted on studies reporting the effects of Lycii Fructus and its bioactive metabolites on male reproductive parameters, including spermatogenesis, hormone regulation, testicular structure, and molecular signaling pathways.Results: Evidence suggests that Lycii Fructus and its metabolites can improve male reproductive function and sperm quality by modulating the hypothalamic–pituitary–gonadal axis, alleviating oxidative stress, inhibiting testicular cell apoptosis, suppressing pro-inflammatory factors, reducing testicular fibrosis, and regulating autophagy. Animal studies have shown that these effects may be mediated through key signaling pathways such as PI3K/Akt, SIRT1/Nrf2, and AMPK/PGC-1α, thereby enhancing testicular steroidogenesis and antioxidant capacity, among other benefits, and mitigating reproductive damage induced by diabetes, obesity, radiation, and environmental toxins. Although clinical evidence supporting the use of Lycii Fructus alone to improve male infertility is still lacking, traditional Chinese medicine compound formulas containing Lycii Fructus have demonstrated good efficacy and safety in treating oligoasthenozoospermia. Given the increasing attention to the safety and preventive health potential of natural botanical medicines, Lycii Fructus is emerging as a promising natural therapeutic agent for the treatment of male infertility.Conclusion: Lycii Fructus and its metabolites show promising therapeutic potential for male infertility by improving sperm quality, protecting testicular structure and function, and mitigating damage induced by various stressors.