Did Big Pharma Create Female Sexual Dysfunction?

November 26 2020 | Written by Rhea Kumar (She/Her)

Disclaimer: Throughout this article, we make reference to females and women. Unfortunately, large pharmaceutical companies have failed to recognize that not all females identify as women. At Marlow, we recognize that female is a sex assigned at birth and gender is a social construct. The medication mentioned throughout this article was strictly designed for cis-gender women and hence the terminology used throughout.  

Certain conditions such as Endometriosis and Vaginismus may impact your ability to comfortably engage in sexual activities. Should you have pain or difficulty engaging in sexual activities, it is important to see a medical professional to determine the cause/source of pain. This article focuses on Orgasmic Disorder, Sexual Arousal Disorder, Hypoactive Sexual Disorder and Sexual Aversion Disorder - all of these are subcategories of FSD. There are many other subcategories listed under FSD including Sexual Pain Disorders and Female Androgen Insufficiency Syndrome. For more information, please check out this website. 

In 1998, the world was introduced to Pfizer's little blue pill, which has since shaped the sexual dysfunction market as we know it. Viagra, chemically known as sildenafil, was developed as a treatment for hypertension and cardiovascular disease. Since its approval by the FDA, Viagra has changed the lives of men suffering from erectile dysfunction while generating billions of dollars. Today, Viagra still dominates the sexual dysfunction market, holding close to 70% of the entire market. 

Because of Viagra's fast and enormous success, it was only a matter of time before the pharmaceutical industry decided that females should have their own 'little pill' too. Sounds pretty great, right? Well, maybe not. During their quest to create a 'female Viagra', a complex of pharmaceutical giants and financially motivated medical professionals created the disease, Female Sexual Dysfunction (FSD), to ensure that there would be a solidified market of female Viagra consumers once the drug hit the market. 

As Dr. Ranee Thackar points out, sexual health is dependent on physical, mental, and social dimensions. 

A woman's decreased sex drive can stem from many factors including age, emotional factors, major life changes, hormones, lifestyle, etc. The possible reasons for low libido is a wide cast net. So how can a bodily function that is so multifaceted be improved with one miracle drug? The bigger question is: how far were pharmaceutical companies willing to go to make females believe that dissatisfaction with their sex drive was actually a "disease?"

In 1997, medical researchers, clinicians, and drug company representatives came together to discuss the "future direction of clinical trials" of FSD, and to create a mutual definition of the disease once and for all. The problem? The meeting was completely sponsored by pharmaceutical companies. This is what journalist Ray Moynihan, author of Selling Sickness, calls "the making of a new disorder."

Moynihan says that there is something inherently wrong when the people who have the resources to make a cure are also involved with the making of the disease.  

The biggest milestone in FSD's creation was when its definition and prevalence were published in 1999 in the Journal of the American Medical Association (JAMA) - a highly reputable medical journal. FSD subsequently received medical acceptance as a new disease. The numbers were startling as the article stated that the total prevalence of sexual dysfunction in females aged 18-59 was 43%. The problem? Two of the doctors who published the findings disclosed financial ties to the drug industry-but the editor at the Journal of the American Medical Association did not mention this connection nor the amount of money paid to the doctors due to an “oversight.”

To give you an idea of the extent of the financial complex between doctors and pharmaceutical companies, let’s look at Dr. Laura Berman. During the peak of FSD’s media attention, Berman became the media’s go-to ‘sex-pert’ and subsequently became the ‘face of FSD.’ Berman admitted to being involved with “just about all” drug companies who were involved in the FSD cure. The Los Angeles Times reported that Berman was paid up to    $75,000 a day for media campaigns and media appearances. 

This created the race amongst some of the world's largest pharmaceutical companies to find a cure for this 'disease ' at the start of the 2000s. Pharmaceutical giants like Pfizer, Vivus, and Boehringer Ingelheim believed that they could rewrite the narrative of female sexuality while making billions of dollars. For a short time, when the race for an FSD cure was at its peak, these corporations were very close to having that chance. 

In Liz Canner's 2009 film, Orgasm Inc., the CEO of Vivus, a pharmaceutical company headquartered in California, was asked why he had even decided to begin drug experiments for FSD without a concrete definition of what FSD was. He was unable to answer the question and, ultimately, Vivus' drug for FSD did not receive FDA approval. 

In 2009, Boehringer Ingelheim, the world's largest privately-owned pharmaceutical company,created a "Decreased Sexual Desire Scanner," and claimed that the screener diagnostic tool allowed them to diagnose a woman with FSD in a reduced amount of time. Then, in 2010, it finally tried to seek approval for its cure to FSD, an antidepressant drug called flibanserin, but this request was rejected as the treatment exhibited very little change in female libido based on two studies.  

Pfizer, whose stake in the FSD race was considered significantly high considering its Viagra success, also failed to produce a little pink pill. In a 2004 New York Times article, Pfizer was revealed to have stopped testing Viagra on females after eight years, and over 3,000 females in their studies. Although Pfizer's test proved that Viagra, when used on females, was able to promote outward signs of arousal- they discovered that (surprise, surprise) females and males are not biologically the same, and female psychology played a big role in participants’ ability to achieve an orgasm. 

In the film Orgasm Inc., individuals didn't just seek the aid of drugs to cure their supposed FSD. Females across America were so concerned about their 'diseased' bodies, that they were willing to try anything. One woman desperately participated in early clinical trials for a device called the Orgasmatron (yes, that's its real name)- which involved inserting an electrode into the base of the spine (ouch...) to stimulate the brain and thus signal an orgasm. The trials for the Orgasmatron failed as its risks outweigh the benefits, according to Canner's movie. 

In other desperate efforts to cure FSD, many females went under the knife despite the life-threatening risks associated with such procedures. In Orgasm Inc., one woman underwent laser vaginal rejuvenation. Touted as a method to 'give females more choices' to achieve sexual stimulation, the procedure makes an incision to push the bladder back up to the position it would be in a young female, and then it pushes the vaginal muscles back together. 

In this type of surgery, the clitoris could be mutilated and damaged beyond repair. 

In 2015, flibanserin, the antidepressant once proposed by Boehringer Ingelheim, got FDA approval and is now marketed as Addyi. Addyi has had poor performance clinical trials and carries many risks including "low blood pressure, dizziness, drowsiness, nausea, and when mixed with alcohol, unconsciousness"- hence its rejection twice prior.  

The makers of Addyi, Sprout Pharmaceuticals, used a gender-equality narrative to push its drug onto the market, which makes its reputation as the 'first female Viagra' all the more upsetting. Sprout Pharmaceuticals used aggressive lobbying and a public relations campaign disguised as a 'grassroots campaign' to convince the FDA to approve the drug. 

Sprout’s "Even the Score" campaign was touted as an effort to push Addyi's FDA approval while exposing gender bias at the FDA. Essentially, Sprout made the argument that "Men have Viagra, and women have none. Women need their own sex-booster too." 

The problem? The campaign worked.

The FDA not only approved but issued a press release stating that the "FDA strives to protect and advance the health of women." Addyi's approval somehow became conflated with gender parity and as a result the FDA ignored its dangerous side effects. 

Let's make one thing clear:

If the makers of Addyi produced a drug that posed less risk and more benefit to those seeking help with orgasms, there would be something worth celebrating- and perhaps we could even pull out the 'gender equality' banner just as the FDA did. 

But this isn't the case. Females have lost in all ways. They've been told that they are medically diseased if they are unable to have sex in a way that satisfies them. Then, the supposed cure for their disease is not only ineffective, but a health hazard. 

So what’s next?

First of all, know that you are not alone. Stimulation is possible- it's just a matter of finding out what works for you. Orgasms are experienced differently, some individuals enjoy vaginal stimulation, where others enjoy clitoral. Remember, sexual pleasure isn’t all about the big O and the pressure to have an orgasm can actually lead to a decrease in sexual arousal. Trying new things, either with yourself or with an understanding partner, may increase sexual arousal. The myth that an orgasm is a big, loud, explosion of fireworks that resembles the ones in the movies, paired with the myth that sexual performance can be 'diseased', has damaged the relationship that some individuals have to their sexualities. Not achieving an orgasm during every sexual interaction doesn't make you diseased, it makes you human.