Ancient South Asian traditions and the cultural foundations of sexual medicine: from kāma to clinical care

INTRODUCTION: Contemporary sexual medicine increasingly recognizes the need to move beyond a narrow biomedical model and incorporate culture, dignity, pleasure, relationships, and patient context. METHODS: This editorial reflects on ancient South Asian traditions, including kāma, the Kāmasūtra, epics, temple art, Ayurveda and culturally embedded sexual beliefs, and interprets their relevance to modern clinical care. RESULTS: South Asian traditions historically framed sexuality as relational, moral, social, reproductive, spiritual, and pleasure-oriented. These traditions remain relevant because many patients continue to experience sexual distress through ideas of shame, masculinity, fertility, marital duty, semen anxiety, and family expectation. Clinical examples include unconsummated marriage, masturbation myths, Dhat syndrome, and misuse of traditional claims by social media influencers. CONCLUSION: Ancient traditions should neither be romanticized as medical science nor dismissed as mythology. Their greatest value lies in promoting culturally literate, evidence-based, compassionate, and patient-centred sexual medicine.