Genesis of the loss of meaning in contemporary medicine and sexology

SummaryThe aim of this paper is to explain the role of science in the decline of subjective analysis in clinical assessments and our approach to sexual disorders. Everyone has noticed in publications and congress papers on the subject of sexology and sexual health over the past 15 years that subjective factors have progressively disappeared, to the point of becoming virtually extinct, with emphasis now placed on clinical assessment and biological investigations: psychological factors are only considered at all when biological and clinical tests come back negative. Another example of the current approach is the general acceptance of the supposition that erectile dysfunction (ED) is a sign of cardiovascular disease. Although this can be true for elderly subjects or when associated with specific pathologies, it is rarely the case for subjects aged less than 50, especially when the subject is young, where ED is more generally symptomatic of a relationship disorder within the couple. And yet, recent works have demonstrated how the efficacy of pharmacological treatments can be improved by adding a psychological dimension to our approach. A clear link between premature ejaculation and social phobia has also been evidenced. How can we explain the current supremacy of Evidence Based Medicine and the consequential elimination of subjective factors? How did we reach this incomprehensible loss of sense? What is the responsibility of science for the decline of subjectivity and in the way that man is now seen as no more than a “bio-neuro-genetic” machine? These are questions the author tries to answer in this paper.