Bill Totten's Weblog

Friday, November 13, 2009

Restless Vagina Syndrome

by Terry J Allen

In These Times (October 27 2009)

It's not your fault, ladies (and certainly not your partner's), that you don't orgasm every time you have intercourse, or that you lack the libido of a seventeen-year-old boy. You have a disease: Female Sexual Dysfunction, and the pharmaceutical industry wants to help.

You are among the "43 percent of American women [who] experience some degree of impaired sexual function", according to a Journal of the American Medical Association article. The Food and Drug Administration's evolving definition of Female Sexual Dysfunction includes decreased desire or arousal, sexual pain and orgasm difficulties - but only if the woman feels "personal distress" about it.

So, convincing women to feel distress is a key component of the drug company strategy to market a multi-billion-dollar pill that will cure billions of women of what may not ail them.

By promoting the belief that "normal" women have explosive sex all the time, BigPharma helped launch the disease. However, the Food and Drug Administration has yet to approve a treatment for women who fall short. Until then, they could try the Orgasmatron: a dial-a-delight spinal implant that rarely works - and risks infection and paralysis. Or, for $60 per month, pop LexaFem pills - containing (how-could-it-not-work) "horny goat weed extract" in order to "feel like a real woman today". Its website promises, "You won't ever feel unhappy again with LexaFem in your arsenal".

But the big swinging dicks of global Female Sexual Dysfunction marketing (and off-label marketing) are Pfizer - whose stop-gap strategy is selling women Viagra based on the fact that it works for men, and Procter & Gamble, which, using the same logic, has put its money on testosterone.

Viagra's failure in trial after trial to work on women has not stopped doctors from writing 1.4 million off-label prescriptions. Female Sexual Dysfunction is "a classic example of starting with some preconceived, and non-evidence based diagnostic categorization for women's sexual dysfunctions, based on the male model", said John Bancroft, director of the Kinsey Institute, in an interview with BMJ (British Medical Journal).

No drug follows the male model more literally than testosterone. Despite Food and Drug Administration refusal to approve Procter & Gamble's testosterone patch Intrinsa, US doctors wrote two million off-label testosterone prescriptions in 2007. Like Pfizer's little blue pill, the Intrinsa patch doesn't really work for women. No wonder: Researchers don't even know what constitutes a "normal" female testosterone level, and women with low levels of the hormone are as likely as those with high levels to be happy with their sex lives. And as filmmaker Liz Canner shows in her excellent new documentary Orgasm, Inc, (, testosterone is usually teamed with estrogen, which increases risks for stroke, cancers and dementia.

The companies and clinics that narrow the range of sexual normality to porn industry standards suffer their own disease. Symptoms include: a compulsion to concoct illnesses and then develop drugs to treat them, and vice versa. Either way, the syndrome is typically accompanied by a rash of conflicts of interest.

A Pfizer survey in Malaysia found that Malay women are even more diseased than their American counterparts, with "69.6 percent experiencing some form of Female Sexual Dysfunction", according to the Journal of Sexual Medicine, which also published an industry-supported supplement on Female Sexual Dysfunction. Journal editor and urologist Irwin Goldstein denies a conflict of interest. "Science is science", he says. "It comes down to the bottom line. What the data shows, the data shows." Actually, no. Drug company-funded studies are more likely than independent studies to find the new drug superior to the old. Perhaps the bottom line Dr Goldstein refers to is his income as a paid consultant for drug companies, including Procter & Gamble and Pfizer.

Goldstein established an Female Sexual Dysfunction clinic with Dr Jennifer Berman, who now heads a Beverly Hills clinic and appears on Oprah. As one of the health professionals on a 1998 panel that received financial sponsorship from eight pharmaceutical companies, she helped define female sexual dysfunction. Some 22 drug companies, including Pfizer, had financial ties to eighteen of the nineteen authors of that panel's report, the revealed.

"Maybe the best approach is not ineffective, over-hyped drugs with nasty side effects, but an end to disease mongering and a strong dose of comprehensive sex education", says filmmaker Canner. Her film hits female erogenous zones that pharmaceutical fixes can't find: your brain and your funny bone. 


Terry J Allen, an In These Times senior editor, has written the magazine’s monthly investigative health and science column since 2005.

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Bill Totten


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