Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
To the Editor: The Clinical Crossroads by Dr
Morgentaler1 covers important topics related
to male sexual dysfunction, but there is a central point that it does not
address. If a man can get a firm erection at some time (via masturbation,
foreplay, or during sleep) then the physiology for penile erection is intact,
not compromised. A simple sleep study test that measures penile erection is
a reasonable confirmatory procedure. Unfortunately, many men (and their sexual
partners) believe that the cause is organic. They miss the opportunity to
deal with the responsible underlying psychological problem and thereby the
opportunity for a more fundamental resolution. Anxiety, low self-esteem, and
depression are commonly expressed in the sexual sphere of activity. This phenomenon
is now extensively used by pharmaceutical companies to promote the use of
medications such as the phosphodiesterase type 5 inhibitors, with the strong
potential for inappropriate use as well as the lack of appropriate intervention.
Breiner SJ. Male Sexual Dysfunction. JAMA. 2004;292(22):2722–2723. doi:10.1001/jama.292.22.2722-a
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