Medical and sexual comorbidities: when the integrative approach is key

Sexual function requires the integrity of the main systems of the body: hormonal, nervous, vascular, muscular, metabolic, immunitary. When one or more of these systems are dysfunctional, comorbidity with sexual problems increases with the severity of the primary disease: this is a solid concept in male sexual dysfunctions, specifically when erectile deficit emerges as the alerting symptoms of depression, cardiovascular diseases, low testosterone, or neurological problems. This is much less evident in women, where until recently the emphasis on psychosexual and relational issues has shadowed the importance of biological factors.