The DSM diagnostic criteria of sexual dysfunctions have been widely used by clinicians, researchers and in pharmaceutical trials. However, these diagnostic criteria do not reflect the developments in the field of sexual medicine. These criteria are vague and do not include many of the criteria used in other mental disorders classified in the DSM. Better defined operational criteria are needed to define more homogenous population samples and to help answer some basic research questions.

Some of the issues that need to be addressed in the new revision of the sexual dysfunctions diagnostic criteria include the duration of sexual dysfunction, intensity and frequency of sexual dysfunction, the use of distress as a diagnostic criterion, whether there are specific differences in diagnosing female and male sexual dysfunction, validity of some diagnostic entities (e.g., sexual aversion disorder), reclassifying some sexual dysfunctions (e.g., dyspareunia as a pain disorder), and the overlap of diagnoses.

Further deliberation of sexual dysfunction classification should also include two core questions: a) when does a sexual problem become a sexual dysfunction, and related to that b) what do we consider “normal” and/or what is a biological variation of sexual functioning (e.g., are rapid ejaculation and extremely delayed ejaculation dysfunctions or normal variants of sexual performance at the very ends of the spectrum?).

This presentation will review in detail the deficiencies of the standing diagnostic criteria and will provide suggestions for improvement of these criteria based on evidence from the literature and on recommendations of expert panels.