There are basically two ways to put the body in communication with the environment that surrounds it: electrical transmission, based on the depolarization of a cellular membrane subsequent to the one from which the stimulus starts - known as nerve conduction - and chemical transmission, based on the minimal transformation of chemical substances into hormones, that is, the most powerful biological signals known, both for the selectivity of the action, and for its specificity, and for the formidable ability to act at very low concentrations. it is therefore no coincidence that the sexual function, the most important of all from a purely biological, if not Darwinian, point of view, is regulated by hormones trough psychoneuroendocrine mechanisms.

The relationship between hormones, neurohormones, neurotransmitters and human and animal sexuality is in fact absolutely incontrovertible. Sex itself is determined, both in differentiation and ontogenesis, and in its phenotypic aspect, and in its behavioral aspects, first of all by these substances. In a fascinating way, behavior then acts on the one hand by neuromodulating neuronal plasticity, on the other hand on hormonal production itself, on hormone levels and on their biological activity. The environment itself has similar actions on hormones: think for example of endocrine disruptors or contamination by microplastics, the result of specific political and economic choices.

Hence the systems of the mind, those of experience, those of society and those of the body are intertwined, the four pillars that support the new and innovative concept of Systems Sexology, which integrates the well-known (and somewhat uncritically abused) Bio-Psycho-Social model. Systems Sexology, like its older and well-known sister, Systems Medicine, in fact, focuses its doctrine on three concepts: that of lifestyle, that of inflammation and that of chronic non-transmissible diseases (NCDs) which are at the basis of the majority of human sexual dysfunctions.

With all these premises, the endocrinologist, the internist, the metabolist should be the main actors on the scientific sexological scene. Instead, for a whole series of reasons, many of which are truly stupid, endocrinologists rarely seem interested in sexuality and even in its hormonal regulation. A short-sighted, foolish and unscientific position. Scientific journals of endocrinology rarely publish articles on sexology and endocrino-metabolic congresses are rarely capable of reserving space for sexology.

I am therefore particularly proud of the invitation received from IJIR: Your Sexual Medicine Journal to select from the vast collection of this journal, historically the first dedicated to the medicine of sexuality, a series of articles that, in my opinion, represent well the correlation between endocrinology and sex. Two lines of research particularly struck me: the more traditional one, relating to hypogonadism, the second to metabolic disorders. The day that diabetologists understand the importance of taking charge of sexual disorders in their patients, a new era in the treatment and in the treatment adherence of major metabolic diseases will dawn). Interestingly, many authors of the articles I selected are from China, a region of the world which is giving excellent and numerous scientific products.

What is missing? I would say what is always missing when examining scientific production with the eye of Gender Medicine: attention to female sexuality and female sexual dysfunctions. If Athens cries but Sparta doesn’t laugh: even in the gynecological field, female sexuality is often neglected. But I firmly believe that this is the future of sexual medicine: to deal even more carefully with the couple as a whole, with the women’s sexual dysfunctions, the hormonal regulation of their sexuality at all ages of life and how their behavioral choices impact their hormonal, metabolic and therefore sexual health.

I am sure that IJIR will be at the forefront of this virtuous direction.