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Female Sexual Dysfunction: Is “Sick” the New Normal?

A low libido may have a new cure. 

Attention, women: Do you occasionally have a low sex drive? Do you ever have trouble getting or staying aroused during sex? Do you ever have trouble experiencing orgasm? If you answered yes to even one of these questions, congratulations, because it turns out that what you thought were the everyday highs and lows of your libido are actually symptoms of female sexual dysfunction. But don’t worry, there’s a pill for that—or at least there will be very, very soon.

Only a few decades ago, these dips and valleys in women’s sexual desire would have been seen as mere variations on normalcy. In fact, women on the whole were often characterized as having low libidos, a state doctors and aggrieved husbands condescendingly called “frigidity.” Doctors usually recommended that sexual dysfunction was best worked out by the couple themselves, or with the help of a supportive therapist. Then drug companies entered the discussion—and decided that these otherwise normal dips in desire represented a huge potential market for pharmaceuticals. But before they could sell the drug, they had to sell the disease itself.

Redefining Disease
Pharmaceutical companies enjoyed a profit bonanza when male erectile-dysfunction drugs hit the market (and once they had convinced men that they should be able to perform on command even well into their seventies), but the real brass ring is a pill that will increase libido and sexual desire for women—a vast, untapped market full of potential customers. Viagra, Cialis, and Levitra have brought their manufacturers billions of dollars, and if a chemical treatment to increase women’s sexual desire or orgasmic ability were to be found, it could potentially be the next blockbuster drug, prescribed to every woman who complained of even occasionally low libido or who reported any amount of sexual dissatisfaction.

According to journalist Ray Moynihan in his book Sex, Lies, and Pharmaceuticals: How Drug Companies Are Bankrolling the Next Big Condition for Women, the drug companies have already spent millions of dollars “educating” doctors on the perils of female sexual dysfunction and how their soon-to-be-patented treatments can help. With the help of doctors who moonlight as pharma consultants, they’ve categorized FSD as taking four main forms: lack of desire, inability to become aroused, inability to achieve orgasm (anorgasmia), and painful intercourse (dyspareunia). A woman may experience one or more symptom at a time, and the symptoms can be mild to severe or chronic to acute. The problem is that these standards are far from concrete and objective; they are flexible, arbitrary, and open to interpretation. Any woman who experiences any of the four, even intermittently, can be said to suffer from FSD, according to treatment guidelines. The drug manufacturers tout pharma-funded studies claiming that 43 percent of women report some degree of dysfunction, as well as self-commissioned surveys finding that most women experience some form of FSD at some point in their life. Moynihan reports that 95 percent of the medical experts who assisted the drug companies in creating the new definition of FSD have financial ties to one of the companies developing drugs to treat the condition.

For all their work in defining FSD as a treatable disease, the drug companies haven’t yet settled on what causes the condition. Women’s sexual responses are much less easy to stimulate than men’s and are often affected by nebulous psychological issues, such as stress, depression, anxiety, and relationship problems, or physical causes, such as menopause, recent childbirth, chronic diseases, and the side effects of medication. (For what it’s worth, all of these things can affect men’s sexual performance, too.) According to Moynihan, there are three major products being developed to treat FSD—a female version of Viagra, testosterone therapy, and an antidepressant-like drug that changes neurochemistry—all of which target a different potential cause. The maker of Viagra asserts that FSD results from insufficient blood flow to the genitals. The makers of testosterone products claim that the problem is a hormonal deficiency, and the makers of the antidepressant claim that it’s a chemical imbalance in the brain. FDA approval for treatments intended to treat FSD have been stymied because clinical trials have so far found that none of the drugs work any better than a placebo.

In Search of the Little Pink Pill
The truth is, most women probably do experience low desire or other sexual issues at some point in their lives, and that’s not news. What is new is the recommendation that women treat the problem with drugs instead of seeking counseling, exploring their bodies through masturbation, performing kegel exercises, or working out their relationship issues with their partner. “The giant pharmaceutical industry—with worldwide sales now approaching a trillion dollars a year—is hungrier than ever for new markets,” writes Moynihan. “In order to maximize sales, the industry must ‘create the need’ for its newest and most expensive products. Sometimes that means selling sickness to the wealthy healthy, helping transform common ailments into widespread conditions that require treatment with the latest pills.” In other words, the occasional dip in libido or the occasional period of unsatisfying sex or sparse orgasms are what used to be considered normal. The pharmaceutical industry is discouraging women from working to discover the emotional or psychological causes of their unsatisfying sex lives, and convincing them to instead ameliorate the symptoms with pricey medicine solely for the industry’s benefit.

It’s also true that some FSD is more than just fleeting phases of low desire. There are women with legitimate physical conditions that lead to painful, uncomfortable, or unsatisfying sex, and they could absolutely benefit from medical intervention. Also, even intermittent or sporadic bouts of low libido or sexual dysfunction, if they are worrying or bothersome, should be investigated by a doctor to help determine the cause and map out a treatment plan.

But just as recent years have seen an explosion of new “disorders,” such as premenstrual dysphoric disorder, fibromyalgia, attention deficit disorder, social anxiety disorder, and other conditions that doctors aren’t even sure truly exist, female sexual dysfunction is another instance of the pharmaceutical industry’s pushing drugs when simple lifestyle changes and therapy would be a better solution for the vast majority of people. Respected authorities, such as the American Academy of Family Physicians and the Mayo Clinic, still recommend nonpharmaceutical treatment options to treat symptoms of sexual dysfunction, once underlying medical causes have been ruled out.

There’s no one-size-fits-all approach when it comes to sexuality. Some women have a low sex drive. Some men do, too. Those who are bothered should feel comfortable seeking a doctor’s help, and those who accept their own personal norm shouldn’t feel pushed into a medication they may not want or need. Big pharma may love peddling lifestyle drugs for fun and profit, but when it classifies most people as abnormal, then the people don’t need changing—the definition of “normal” does.

Photo source: amayzun (cc)

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