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Female Sexual Problems Being 'Medicalized'

NEW YORK (Reuters Health) - The drug industry is attempting to "medicalize" female sexual problems under the umbrella term "female sexual dysfunction," creating a disorder to build a market for new drugs, according to some experts.

But not all experts share this opinion. And some voice concerns that accusing the drug industry of over-inflating the problem will cause medical professionals to overlook the women who truly suffer from debilitating sexual problems.

Drug company financial backing of discussions regarding the disease itself and how to treat it may be the best way to bring these women relief, according to Dr. Irwin Goldstein of Boston University.

"We desperately need therapy, research, and diagnosis," Goldstein told Reuters Health. "More than anyone can know."

In the January 4 issue of the British Medical Journal, journalist Ray Moynihan claims that, after the success of Viagra for treating men's sexual problems, drug companies are looking to make money off drugs that treat sexual problems in women.

But there must be a disease before there can be a drug to treat it, Moynihan argues, and the drug industry is actively pushing the idea of female sexual dysfunction as a medical problem that needs treatment, priming women to buy up new products the second they emerge.

Techniques used to publicize female sexual dysfunction include over-inflating the prevalence of the problem and sponsoring numerous medical meetings on the topic, Moynihan writes.

Drug companies often argue that 43% of women suffer from sexual dysfunction, a figure first cited in a 1999 article from the Journal of the American Medical Association. The number is based on responses from 1,500 women who reported whether or not they had experienced a sex-related problem for at least 2 months, such as lack of desire and lack of lubrication.

Many researchers have since criticized this figure, Moynihan writes, noting that changes in sexual desire are normal, and not necessarily a sign of a "disease."

Ed Laumann of the University of Chicago, one of the original authors of the JAMA article, told Reuters Health that many of the sexual difficulties in the study participants appeared to be linked to other problems. For instance, women whose income had dropped by 20% in recent years were more likely to report feeling sexual problems. Another set of results showed that women in their 20s who have children younger than 6 are up to 3 times as likely to report a lack of interest in sex, he said.

Many women may feel a lack of sex because they are under stress or exhausted, Laumann said. While a pill that restores desire might help some of those women, "that's a therapeutic that would address dysfunction without really solving the more general problem," he said.

And lumping all women with sexual problems under the category of a disease that needs a pharmaceutical treatment may be a "fundamental misinterpretation of what sexuality is all about," Laumann added.

In an interview, Goldstein said he agrees that not all women with sexual problems can be helped with a pill, but that the problem is serious and deserves the attention of the research community. He added that 43% is likely an accurate figure for how many women have sexual problems, but that many are not bothered enough by their troubles to seek medical help.

"Not all 43% of people are banging down doctors' doors," he said.

Moynihan cites as evidence the drug industry is molding female sexual problems to its own benefit the fact that all but one of the recent 7 meetings on the topic have included up to 22 different drug company sponsors.

That fact is irrefutable, Goldstein noted, but "virtually all" medical meetings have the sponsorship of drug companies. And the money comes in the form of "unrestricted educational grants," he added.

"There's no way that we would allow the drug companies to tell us the content, tell us what to say," he said.

Moynihan notes in the current report that Goldstein is a "regular speaker" and drug industry-funded meetings, and serves as a consultant to many drug companies.

SOURCE: British Medical Journal 2003;326:45-47.

Reference Source 89


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