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Female sexual dysfunction: Is it real — or a case of disease-mongering?

Get ready, women. The first drug to “cure” female sexual dysfunction, flibanserin, may be coming on the market within a couple of years or so.

And you thought all those Viva Viagra commercials on TV were annoying.

Last week, the German pharmaceutical firm Boehringer Ingelheim reported the findings of large-scale clinical trials of flibanserin. The company said that women with “hypoactive sexual desire disorder” (HSDD) who took 100 mg daily of the drug for six months experienced 0.8 more “sexually satisfying events” each month, on average, than women with HSDD who took a placebo.

Specifically, the women on flibanserin reported an increase from 2.8 to 4.5 sexually satisfying events (not necessarily orgasms, however) each month compared to 3.7 in the placebo group.

According to Boehringer, that’s a statistically significant result — and a medical breakthrough for women “suffering from a lack of sexual desire.”

Ho-hum significance?
Women health activists (and many scientists of both genders) are less impressed. Writes Christine Ottery in the British Guardian newspaper:

If you were a man taking 100 mg of Viagra every day, you might expect more action than an extra couple of events a month.

And, as one clinical psychologist told New Scientist magazine, it’s “very debatable” whether Boehringer’s results represent any kind of improvement for women, noting that “[a]n effect that’s statistically significant may not be clinically meaningful.”

A pseudo-disease?
Of course, the bigger issue is the whole controversy swirling around the definition and causes of female sexual dysfuntion (FSD) and HSDD (considered the most common form of FSD) — and whether, as Boehringer and others claim, one in 10 women suffer from it. (The 1999 U.S. study that sort of launched this whole debate concluded that 43 percent of American women experience FSD at some point in their lives.)

Notes Ottery:

[S]ome are concerned that FSD has been fabricated to monitise women’s sexual insecurities. An article in the journal Sexualities posits that the pharmaceutical industry was looking to replicate the [$1.6 million] success of Viagra and so introduced the concept of FSD. In PLoS (Public Library of Science), a peer-reviewed science and medicine journal, an article called FSD “a textbook case of disease mongering.” Also in PloS, scientists argue that corporate-sponsored researchers are defining pseudo-diseases.

As reported in Time magazine, some women health activists are highly skeptical of all the hoopla around flibanserin and other attempts to find pharmaceutical solutions to low libido in women:

Certainly, there may be women who will do better after taking flibanserin, says Judy Norsigian, executive director of the women’s health advocacy Our Bodies Ourselves, based in Cambridge, Mass. But she thinks the diagnosis of HSDD unnecessarily medicalizes women’s sexual lives. Attempting to treat low libido with a pill ignores the fact that many women’s level of desire is deeply affected by everyday life stress and interpersonal relationships. Add to that a cultural milieu that at once promotes shame and ignorance about women’s sexuality while wildly inflating their expectations for sex.
In many cases, says Norsigian, the proper solution to a lack of sexual desire would involve a number of non-drug approaches, such as therapy, mind-body techniques and getting partners involved in the solution. “That could be equally successful while at the same time not exposing women to the [potential] long-term adverse effects of drugs,” says Norsigian, who suggests testing drugs like flibanserin against drug-free therapies. “Moreover, the non-medication approaches often address root causes for lack of libido and thus reflect a prevention approach that is usually much wiser.”

A disempowering message
The bitter irony of the FSD controversy, says the Guardian’s Ottery, is “the disempowering message that women who are having sexual problems are all ill.”

For women, one of the primary causes of loss of sexual desire is “relationship issues,” she says, “so feeling empowered to communicate what you want could be crucial in resolving this. Nevertheless, some women will want a magic bullet solution to their sex life problems. It is a tempting idea in our time-poor lives to pop a pill and not take the time to work out the root cause of issues and address them.”

As I said, get ready for more annoying commercials.

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Comments (1)

  1. Submitted by Jehnavi pat on 04/22/2010 - 02:08 am.

    A useful model for exploring disturbances in female sexual response considers traditional and innovative, psychiatric and medical, and psychological and physiological perspectives. For some women, dysfunction or dissatisfaction is defined by a loss of interest in sex (low libido) and the inability to become aroused or to achieve orgasm when participating in sex. Many are dissatisfied because their partners are uneducated or inattentive and do not understand female arousal and its anatomical basis. For others, a medical evaluation uncovers a physiological problem that impairs sensitivity. The concept of female sexual dysfunction, or dissatisfaction, remains poorly defined.

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