Against a backdrop of virtual intercourse, online porn, and burgeoning Viagra sales, Sex, Lies, and Pharmaceuticals reveals how women’s sexual difficulties are being repackaged as symptoms of a new disorder. In this compelling book, award-winning journalist Ray Moynihan teams up with drug assessment specialist Barbara Mintzes to investigate the creation of female sexual dysfunction or FSD, and the marketing machine that promises to "cure" it. ...
Against a backdrop of virtual intercourse, online porn, and burgeoning Viagra sales, Sex, Lies, and Pharmaceuticals reveals how women’s sexual difficulties are being repackaged as symptoms of a new disorder. In this compelling book, award-winning journalist Ray Moynihan teams up with drug assessment specialist Barbara Mintzes to investigate the creation of female sexual dysfunction or FSD, and the marketing machine that promises to "cure" it.
The authors go inside the corridors of medical power to visit drug company–sponsored scientific meetings and medical education events where doctors are being trained to see women’s sexual problems as the symptoms of FSD — a pharmaceutically treatable condition. Moynihan and Mintzes explore the underlying causes of sexual dissatisfaction among women and expose how global drug companies exploit those problems in an attempt to create the next billion dollar disease.
" a solid, detailed study of how the influence of the pharmaceutical industry may be distorting medical science"—Library Journal
Moynihan (Selling Sickness), an academic researcher and health journalist in Australia, here monitors the creation of a new medical condition called female sexual dysfunction (FSD). It appears pharmaceutical companies are sponsoring relevant medical research, while helping to design the tools to diagnose FSD. Meanwhile, a feminist backlash is building against making a condition out of low desire. Moynihan reviews the pervasive support that pharmaceutical companies offer to medical associations, conferences, seminars, journals, and research studies. Mintzes (pharmacology, Univ. of British Columbia) contributes a chapter describing how Viagra and similar medications have been promoted. The public now sees erectile dysfunction as a physical problem that can easily be treated. Mintzes is concerned that something similar could happen with new drugs or hormones designed for women. VERDICT Moynihan presents a solid, detailed study of how the influence of the pharmaceutical industry may be distorting medical science. This book will be of most interest to students and those broadly concerned about health issues.—David R. Conn, Surrey P.L., B.C.
Ray Moynihan has been covering the business of health care for more than a decade with the Australian Broadcasting Corporation, the Australian Financial Review, and the British Medical Journal. He is an award-winning journalist and the author of three previous books, including Selling Sickness, which has been translated into a dozen languages.
Dr. Barbara Mintzes investigates the link between clinical trial and pharmacosurveillance evidence on drug safety and effectiveness, and provincial drug financing decisions. She holds a BA in geography from Simon Fraser University and a PhD in health care and epidemiology from UBC. She currently works at UBC in Vancouver as Assistant Professor in the Department of Pharmacology & Therapeutics.
In the last year or so, has there been a period of a few months when you lacked interest in sex? Felt anxious about your sexual performance? Were unable to achieve an orgasm? Was there an extended time when you had trouble getting aroused, experienced pain on intercourse, or just didn’t find sex pleasurable? If you answer “yes” to just one of these survey questions, and you’re a woman, you could easily be classified as suffering from a brand new medical condition called “female sexual dysfunction” or FSD. First described in the textbooks only a couple of decades back, female sexual dysfunction is set to become the next blockbuster disease, coming soon to a doctor’s surgery near you. As the ups and downs of daily life are re-categorized into the symptoms of medical diseases, soon all of us will be sick.
One of the women who actually helped write the definitions of female sexual dysfunction puts it very clearly. “What once was considered normal” wrote the American psychologist Sandy Leiblum, “has come to be considered dysfunctional.” Now days, if a woman lacks desire for sex, and is bothered by it, she could be diagnosed with a disorder of low libido. That’s just one of the four disorders of female sexual dysfunction described in the doctor’s manual of diseases. The others include disorders of arousal, orgasm, and pain. As the evidence will plainly show, forces are fast amassing to tell you, and your doctor, that one in every two women suffers with some form of this new medical condition.
The giant pharmaceutical industry, whose worldwide sales are now approaching a trillion dollars a year, is hungrier than ever for new markets. In order to maximize sales, the industry must “create the need” for it’s newest and most expensive products. That means selling sickness to the wealthy healthy, helping transform common ailments like sadness, shyness or fatness, into widespread conditions that require treatment with the latest pills. Applauded for producing pills that extend life and ameliorate suffering, drug companies no longer simply sell drugs, they increasingly sell the diseases that go with them.
Female sexual dysfunction is perhaps the perfect example of selling sickness, and the commercial firepower behind its forthcoming promotion is unprecedented in human history. “With more than 50 million potential sufferers in the United States, FSD could offer a larger market than male sexual dysfunction,” wrote one enthusiastic market observer. “FSD could be the next boon for pharma companies ” If a drug is approved to treat FSD in the United States, the tsunami of marketing that will be unleashed in the media and on the web will soon swamp the shores of nations everywhere. According to industry sources, one company on the verge of having its product approved for FSD set aside $100 million for the drug’s advertising budget alone.
Three global corporations in particular have been at the forefront of the race to spread the word about this new medical condition, and get their drugs approved to treat it. Pfizer, the biggest pharmaceutical company in the world currently worth around $150 billion, has had high hopes that its wonder drug Viagra will also work for women. Proctor & Gamble, with annual sales of over $80 billion across 80 countries is famous for selling soap to housewives, and now it wants to sell them testosterone patches as well. The third corporation featuring in this drama is a relatively small player on the world stage: the family-owned German outfit Boehringer, which boasts just 50,000 employees in around 50 countries. The German company’s pill targets the brain, with claims it can give women back their lost desire.
So what exactly is this condition called female sexual dysfunction that the drug industry is so keen to tell us about? A careful analysis of the medical literature on FSD suggests the answer depends a little on the solutions being sold at the time you ask the question. If Pfizer is promoting a drug that enhances blood flow to the genitals, then the condition might be best described as an “insufficiency” of vaginal engorgement. If P&G is pushing its testosterone patch as a cure for women, the sexual disorder is discussed as a “deficiency” of hormones. And if Boehringer has a pill that affects the mind’s neuro-transmitters, women with low libido may have a “chemical imbalance” in their brains. In a strange way the disease seems designed to fit the drugs.
That’s not to say that medicines don’t have a role to play in treating some sexual problems. There are women for whom a medical label and a medication may be extremely valuable. The problem is that when the drug company-sponsored tsunami of marketing reaches its full fury in your corner of the planet, women’s common sexual problems will likely be portrayed not merely as aspects of normal sexuality but as the symptoms of medical conditions that are widespread and treatable with pills. The fact that sexual difficulties are often caused by a raft of complex factors, from relationship stresses to religious taboos, may well be washed away in the coming flood of pharma-funded magazine features, celebrity interviews on breakfast TV, and plain-talking advice from sexy bloggers. The first unmistakeable signs of this marketing are already appearing. “What is female sexual dysfunction?” asks one online personality known as Katie, on her slick-looking educational website. ”This health problem is a genuine problem that needs medical attention. Most women suffer from this problem without actually realizing it.”
Yet even before the king tide of corporate marketing has really begun to flow, a backlash has been brewing. Working out of her small home office in Midtown Manhattan, not too far from the headquarters of the world’s biggest drug giant, a feisty feminist scholar has launched a pre-emptive strike. Together with a small group of colleagues, sex therapist Dr. Leonore Tiefer has set up a global grass-roots campaign. The fight is against what they see as Big Pharma’s attempt to turn the ordinary ups and downs of women’s sex lives into medical diseases, in order to sell more drugs. Instead of a medical dysfunction with four neat sub-disorders, the campaigners are proposing a radically different approach to understanding women’s sexual difficulties. As we’ll see, during the extended combat there have been many colourful skirmishes. Like the time Tiefer won a major award from her peers in the sex research community and delivered a speech titled, “Not tonight, dear, the dog ate my testosterone patch.”
Prologue: Sex, Lies & Pharmaceuticals
1. Difficulties or Dysfunctions?
2. The biggest lie of all
3. Measuring pleasure
4. Educating your doctor with ski trips and strip clubs
5. Viagra turns twelve
6. Premature prescriptions
7. Undoing the disorders
Epilogue: what can we do?