In reading through literature of the past 10years, it is clear that the standardized and validated means of assessment of sexual dysfunctions (SD) often only measure the dysfunctional aspects of the sexual function and take little account of the variations they may undergo according to psychological and social context. The cognitive aspects that are included generally only relate to levels of satisfaction, and very little to intimacy or the quality of the relationship; indicators of “psychological vulnerability” are totally lacking (Bonierbale, 2006Bonierbale M. Plaidoyer pour une sexualité ordinaire Sexologies 2006 ;  15 : 237-238 [inter-ref]

Cliquez ici pour aller à la section Références). Only the efficacy of a drug is measured, rather than the efficiency of a “real life” treatment. A recent report on the progression of erectile dysfunction (ED) assessment in the rise in ED in the MMAS [J Urol 177 (2007) 241–6] showed that after nine years the ED is not irreversibly worsened by age, spontaneous remission is not uncommon (35%), and that over time cases of spontaneous remission are in fact much more common than was previously thought. This contribution brings to the fore the concept that ED can be a temporary symptom, a difficulty, a variation over time, and that taking account of changes in lifestyle at the point in time in question could provide useful clues as to the reasons for its onset at least as much as the dynamic aspects of the lack of erection itself at a given time taken outside of its context. In clinical practice, sexual problems should therefore be investigated from two angles: changes in the physiological aspects of the sexual function (the dysfunction) and changes in the relationships that are part of the sexual experience. There is still insufficient research into the entanglement of psychosocial factors with sexual problems, although if we do not take them into account, we will be treating sexual function as an isolated aspect of the human being, which it is obviously not. Clinical distinction between difficulties and dysfunctions is the cornerstone of any assessment of sexual problems for our patients and the development of management strategies that are tailored to the patient rather than “one size fits all”.