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October 3, 1980

Impotence Is Not Always Psychogenic

Author Affiliations

Millbrae, Calif

JAMA. 1980;244(14):1558-1559. doi:10.1001/jama.1980.03310140018013

To the Editor.—  The recent article "Impotence Is Not Always Psychogenic: Newer Insights Into Hypothalamic-Pituitary-Gonadal Dysfunction" by Spark et al (243:750, 1980) deserves comment. The title implies that impotence (an inappropriate word that sexologists have replaced with "erection problems") has been established by paradigm as always being psychogenic, which is not so. The training of all sexologists and reputable sex therapists concentrates on the differential elimination from sex therapy of all patients with physical or longterm emotional problems. Such patients should be referred for appropriate medical or psychiatric treatment.The association of erectile dysfunction with hormonal deficit is tenuous. While the exogenous administration of androgens to women has been shown to create sexual desire, similar administration to men has thus far only been linked to aggressive behavior and metabolic effects. Zilbergeld1 wonders "how many men have accepted a sexless life because the testosterone shots failed to help and the