Introduction Into the Diagnostics and Treatment of Premature Ejaculation: Subspecialty Training in Sexual Medicine

Abstract

Although the authors are justified in complaining about the lack of medical care for patients with sexual dysfunction, they have regrettably neglected crucial aspects which are specific for sexual medicine. The term premature ejaculation, used in the title and text of the article, would have needed commenting and is inappropriate – although used in ICD-10 and DSM-IV: it is the man’s orgasm that is premature, not his ejaculation. Furthermore, the authors correctly emphasize the need for a comprehensive sexual history. But two major points are missed in this regard, namely that one has to be trained in taking a sexual history, and that, wherever possible, the female partner should participate in the consultation: sexuality always affects the couple. The authors write from their specifically urological perspective and hence fail to consider the particularities of sexual medicine as an interdisciplinary, cross-sectional discipline, i.e. the focus on the couple in diagnostics and therapy and a biopsychosocial understanding of the etiology and treatment of sexual dysfunction. However, particularly these aspects caused the German Medical Association in 1995 – at the initiative of the Academy for Sexual Medicine (ASM) – to encourage the establishment of an independent curriculum in sexual medicine (1). In accordance with this curriculum sexual therapeutic interventions therefore do not require a specialization in psychotherapy, but in sexual medicine. Meanwhile sexual medicine has been included as a certified subqualification into the regulations for postgraduate education by the Berlin Medical Association (2). Aspects of sexual medicine have also been included into the regulations for subqualification in andrology and, again at the behest of the ASM, in the intensive courses of the German Society of Andrology. At the European level, a curriculum that incorporates these standards is being offered by the European Academy for Sexual Medicine (EASM) (3).