ABSTRACT
INTRODUCTION: A PARS DESTRUENS The field of sexology arose in the medical environment. Originally, there was no clear distinction between physical (sometime called “organic” or, without reason, “physiological”) and psychological function. The interpretation of erectile dysfunction (ED), here used as a paradigm of all other sexual dysfunctions, as a psychogenic symptom is mainly due to psychoanalytic tradition and the founders of modern psychosexology, Masters and Johnson (1). On the basis of their assertion that over 90% of impotence is psychogenic, diagnosis and therapy have been left to the psychologist (i.e., to a medical nonexpert) for at least 15 years, condemning legions of patients with ED to learn to live with their disorder rather than cure it. However, the spread of radioimmunological measurement, echo Doppler flowmetry, and neurophysiological procedures has overturned the assumption of these two masters who, of course, did not have access to these techniques. It is now know that the etiology of ED is predominantly organic, making the sexologist’s role in the diagnostic and therapeutic process of apparently secondary importance in comparison with that of the doctor (2). Thus, from one error (ED is always psychogenic, i.e., psychological reductionism) another arose: that ED is exclusively a medical issue, that is, medical reductionism. In fact, this fault may persist if a simple medical therapy-even if etiological and targeted-is considered as sufficient in itself to completely restore erectile function. In reality, anxiety and depression almost always accompany ED (3) and if unexplored and untreated can invalidate an exclusively “medical” therapy.
