Abstract
BACKGROUND: Premature ejaculation (PE) is a common male sexual dysfunction with limited long-term therapeutic options. Pharmacological and behavioral treatments often yield only temporary improvement, and alternative neuromodulatory strategies remain underexplored. Functional neurology, which targets autonomic and sensory-motor regulation, may offer a novel approach. AIM: To evaluate the effect of a single functional neurology intervention on genital thermoregulation and ejaculatory latency in men with PE. METHODS: Fifty-two men diagnosed with PE participated in a pre-post intervention study. Each underwent a single session of functional neurology aimed at modulating nociceptor and mechanoreceptor pathways. Genital thermoregulation was assessed using infrared thermography, and ejaculatory function was measured via intravaginal ejaculatory latency time (IELT) and self-report at baseline, after the first post-treatment sexual encounter, and at 1-month follow-up. Statistical analyses included repeated-measures ANOVA, paired t-tests, Pearson correlation, and multiple regression. OUTCOMES: Significant improvements in IELT and genital temperature were expected following the intervention, supporting its role in enhancing autonomic regulation and microvascular circulation. RESULTS: Intravaginal ejaculatory latency time increased significantly from a baseline of 20.4 ± 11.5 seconds to 439.2 ± 214.5 seconds post-treatment, with sustained effects at 1 month (498.0 ± 171.6 seconds; P < .001). Infrared thermography revealed significant increases in temperature in the glans, testicles, and abdomen (all P < .001), indicating enhanced peripheral circulation. Glans temperature change was the strongest predictor of testicular thermoregulation (β = 0.513, P < .001). Principal component analysis highlighted that glans and testicular areas contributed most to thermal variance post-treatment. A ≥1 °C increase in genital temperature was observed in 60% of participants. CLINICAL IMPLICATIONS: Functional neurology may be a non-invasive, fast-acting intervention for improving ejaculatory control in PE by promoting autonomic balance and vascular function. Thermography proved useful as a biomarker for physiological changes and treatment efficacy. STRENGTHS AND LIMITATIONS: This study is the first to evaluate thermographic and ejaculatory outcomes after a functional neurology intervention in PE. Strengths include objective and subjective measures, while limitations involve the lack of a control group, small sample size, and short-term follow-up. These results should be confirmed through randomized controlled trials. CONCLUSION: A single session of functional neurology significantly improved both genital thermoregulation and ejaculatory latency in men with PE. These findings support the integration of neuromodulatory techniques into multidisciplinary strategies for sexual dysfunction treatment.