Over time, the conceptualisation of erectile dysfunction (ED) and the approaches to its treatment have changed considerably. However, there remains an important need to challenge the Manichean dichotomy of viewing ED as either psychogenic (arising from the mind) or organic (biological) in nature. This chapter provides an overview of the evolution of sexual medicine throughout the past centuries, highlighting key paradigm shifts in the understanding of sexual dysfunctions, including ED. Through an analysis of the praiseworthy but sometimes overused biopsychosocial model, the Manichean or dichotomous approach to diagnosis and the modern systems sexology (SS) perspective, we argue that the term psychogenic is not only redundant in modern practice but is also an affront to the progress made in sexual medicine, potentially harming patients, research, and the entire field. A SS approach is needed to integrate the effects of the systems of mind, body, experiences and society to understand how they produce sexual health or sexual dysfunctions, such as ED. Thanks to this innovative perspective, clinicians can fully understand how sexual health is a powerful and effective biomarker of overall health, just like the famous canary in the coalmine, which warns early that something is wrong and risks are developing. Thanks to SS, we can clearly understand the identity between sexual medicine (SM) and systems medicine (SM), the part of internal medicine dedicated to non-communicable chronic diseases. The two SMs recognize lifestyles, dramatically influenced by culture and subculture, society and the choices (or inchoate choices) of governments and economists, as a primary risk factor, with the same inflammatory mechanism, of sexual dysfunctions. Thus, SM+SM=SS is not a mere equation or a play on words, but an effective tool for increasing sexual health, an essential and indispensable part of the overall health of humanity.