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The false organic–psychogenic distinction and related problems in the classification of erectile dysfunction

Abstract

The traditional distinction between organic and psychogenic erectile dysfunction (ED) was maintained in the recent report of the Nomenclature Committee of the International Society for Sexual and Impotence Research. Among the major problems with this distinction are that it is based on an obsolete view of mind–body distinctions, does not take into account knowledge of the neurobiology of ‘psychological’ disorders, disregards the fundamental meaning of ‘psychosomatic,’ is too often diagnosed by exclusion, and may imply to the patient that his ED is ‘all in the mind.’ As a result, the distinction has become counterproductive in the diagnosis, classification, and treatment of ED, and in research into the causes of ED. An alternative taxonomy, based on that proposed by the Nomenclature Committee, reclassifies as organic several of the causes of ED now considered to be psychogenic, and considers others as situational ED, a class reserved for episodic occurrences of ED clearly due to particular attributes of sexual encounters.

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Acknowledgements

This paper is dedicated to Julian M Davidson, 15 April 1931–31 December 2001, in fond memory. Some of the ideas presented here appeared first in an earlier article (Sachs 11) and were presented at a symposium at the 9th World Meeting on Impotence Research, Perth, Australia, 26–30 November 2000. An abstract of this paper appeared on 14 June 2002 as a guest editorial in the on-line newsletter UroHealth (http://www.urohealth.org/editorials).

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Correspondence to Benjamin D Sachs.

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Sachs, B. The false organic–psychogenic distinction and related problems in the classification of erectile dysfunction. Int J Impot Res 15, 72–78 (2003). https://doi.org/10.1038/sj.ijir.3900952

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Keywords

  • classification of erectile dysfunction
  • organic erectile dysfunction
  • psychogenic erectile dysfunction
  • situational erectile dysfunction
  • erectile physiology

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