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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 . . . [Full Text of this Article]

Sander J. Breiner, MD, FA, PA
sjbreiner@comcast.net
Department of Psychiatry
Michigan State University
East Lansing

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