AACE Medical Guidelines for the Clinical Practice for Evaluation and Treatment of Male Sexual Dysfunction: A Couple's Problem- 2003 Update

The purpose of these guidelines is to present a framework for the evaluation, treatment, and follow-up of the patient—indeed, of the couple—who presents with sexual dysfunction. The conventional focus on male erectile dysfunction is incomplete because whenever a man experiences erectile difficulties, his wife or sexual partner suffers as well. Furthermore, disruption in other aspects of the male sexual response cycle, such as diminished libido and delayed or premature ejaculation, also may impair the couple’s sexual gratification. Thus, these guidelines also discuss the cause and, when possible, the available treatments to recognize and rectify disorders of sexual desire, orgasm, and ejaculation. Erectile dysfunction is often compounded by sexual difficulties in the partner or relationship issues. Male sexual dysfunction is most appropriately viewed as a chronic disease with medical, psychologic, and behavioral components that must not be treated in a mechanical and purely medicinal manner. The patient and his sexual partner must be active participants in the full continuum of care. These guidelines address the complexity involved in diagnosing the various aspects of the disorder and offer an organized system of care for the couple. In this way, the outcome can be a cost-effective improvement. AACE believes that, although a multidisciplinary approach may be required in many cases, the clinical endocrinologist is the most appropriate specialist to lead and coordinate the evaluation of the problem, to decide on multispecialty consultations, and to provide follow-up care.