Sex Science: The Making of a Disease by Brooke Magnanti

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An interesting bookend to the revelations about women and erotica is the parallel discussion about women’s sex lives as they go through the menopause. While we now have evidence that demonstrates women are interested in sex for their own pleasure, a lot of it gets ignored because the stereotypes are just too widespread and too strong.

The flipside of this is the discussion – and pharmaceutical research – concerned with women who experience lack of desire. It’s an issue that relies heavily on stereotypes about women and lack of sexual desire. It also seems to exploit modern insecurities about having the ‘right’ kind of sex, having it often enough, and being perfectly satisfied at all times.

The ‘problem’ of female sexual dysfunction (FSD) has been a research holy grail for drug companies in recent years. It seems partly inspired by the runaway success of Viagra and Cialis, and partly by a new openness among women when it comes to talking about and pursuing good sex. And with people not only living longer lives but healthier ones too, the expectation of continuing to have fulfilling sex continues even after menopause in women. These are all great things that can really affect everyone’s quality of life, but as with so many great things, easily distorted once big businesses get involved.

The first problem is that no drug has emerged to transform female sexual response in the same way that Viagra has for men with erectile dysfunction but the big pharma companies just can’t let it go.

They have tested everything from giving Viagra to women to testosterone patch treatments and developing new drugs altogether, but success has been far from universal. The straightforward approach of increasing blood flow to the genitals or pumping the system with increased hormones doesn’t seem to be the magic sexytime bullet for women in the same way it is for men.

The pharmaceutical industry wields a lot of power. Companies that produce drugs maintain internal research units, fund outside academic activity, and supply sponsorship for conferences. When the industry as a whole becomes interested in a particular topic, it has – far more than any scientists or patients on their own – the means to help direct where research attention goes.

Pharma bods interested in female libido have some impressive-sounding numbers to quote. In 1999, a paper in the Journal of the American Medical Association claimed to have uncovered a widespread phenomenon: that 43% of women suffered from sexual dysfunction – in other words about 50 million American women. The author, sociologist Edward Laumann, based the conclusions on the results of a survey of 1800 women under the age of sixty. The results he reported provided the impetus for a whole raft  of research activity: activity that was, by and large, commissioned by and conducted for Pfizer, the manufacturers of Viagra, and other companies such as Procter & Gamble and Boehringer.

According to Ray Moynihan, a journalist who has written extensively about female sexual dysfunction in the British Medical Journal, ‘The corporate-sponsored creation of a disease is not a new phenomenon, but the making of female sexual dysfunction is the freshest, clearest example we have.’ The industry put their focus on women’s sexual lives, and their agenda – to sell a cure – is clear. [http://www.ncbi.nlm.nih.gov/pubmed/12511464]

One way to convince people they’re unwell is to suggest a problem is widespread. A former manager for a company that worked on a hormonal vaginal cream, described it in the film Orgasm Inc. as‘kind of complicated, because you have to have a disease before you can treat it’. She even went so far as to admit, ‘We’ve been able to get thought leaders involved in female sexual dysfunction, and really work closely with them to develop this disease entity, so that it makes sense.’

‘Developing’ diseases in this way may even include manipulating the data as it is gathered. Asking questions about people experiencing acute symptoms in the recent past will get you far smaller numbers than asking about a range of symptoms occurring over time.

Are pharmaceutical companies massaging the numbers to convince people they have something that might not exist?

The numbers from the original survey on the prevalence of FSD look high, but even in peer-reviewed research it’s important not to simply take statements at face value. The results are from questions asking if the women had experienced pain or lack of desire at any time in the previous year. The rather high 43% is actually a grand total . . . not the proportion of women experiencing this on a regular basis. People who said they sometimes and seldom had problems were also included. ‘When you look at the proportions of women experiencing these sexual difficulties “frequently”, the numbers  collapse,’ says Ray Moynihan in his book on the topic, Sex, Lies and Pharmaceuticals: How Drug Companies Plan to Profit from Female Sexual Dysfunction.

It’s a bizarre sleight of hand to imply that if a woman, at any time and for any reason, lacks desire even once in a year, she has some kind of sexual desire disorder. And equating pain during intercourse – which could be due to all kinds of medical causes, or recent childbirth – with sexual dysfunction? It boggles the mind, it truly does.

So what does the research actually show about women who experience lack of desire, and what approach could be beneficial for those who experience it as a problem? I’ll be exploring these questions in part two.

Brooke Magnanti is author of The Sex Myth which explores many fascinating myths about sex

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