Healthy Skepticism Library item: 19749

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Magazine

Parnell K
Sex drives drug sales and patient discussion
Australian Doctor 2005 Apr 29
www.australiandoctor.com.au

Full text:

Like many women, Vera, a 68-year-old from Fiji, doesn’t care whether her GP is a man or a woman – until it’s time to have her Pap smear.
Then she always looks for a female GP. And although I am not keen on the “smears and tears doctors” tag, on another level I’m glad such women are still having Pap smears, regardless of who’s on the other end of the speculum.
But after her last Pap smear, Vera had a question that, to my discredit, surprised me from a woman her age.
“My husband, doctor, is much older than me, 79, but he still wants sex. Maybe twice a week. I say okay, but it hurts. What should I do, doctor?”
The same day, Jenny, 48, returned to discuss her test results taken for GI symptoms. But before leaving, she also caught me off guard.
“Is there something I can take to increase my sex drive?” she asked. “I’d love to be interested, but I’m just not. I feel sorry for my husband, but feel I’m missing out too. And it’s not good for our marriage.”
The same week, two new male patients, aged 44 and 68, confirmed my suspicion that people’s reticence to talk about sex is dwindling.
Both men were causal and relaxed when they requested a Viagra script, and clearly thought that sexual matters should be part of a GP’s brief.
However, there is a degree of controversy about taking sex out of the bedroom and into the doctor’s office. Even the scientific community cannot agree about the scale and definition of “female sexual disorders.”
According to one camp, the trend is largely driven by the medicalisation of a normal phenomenon (ie, flagging libidos) by profit-driven drug companies intent on creating a new ‘disease’ for which they can then sell a ‘cure’.
According to others, female sexual dysfunction, dubbed FSD, and hypoactive sexual desire disorder, HSDD. are serious medical conditions affecting “84 million women in the First World alone,” and therefore need treatment.
No prizes for guessing which camp the pharma companies are in, or which one that well-known pharma critic, Ray Moynihan, inhabits.
Earlier this year, Moynihan, an Australian journalist, wrote in the Lancet that the “first step in promoting a blockbuster drug is to build the market by raising the public awareness about the condition the drug is designed to target”.
According to Moynihan, a testosterone patch was the first drug assessed for female sexual dysfunction. It then became the target of a multilayered global marketing campaign which included sponsoring scientific meetings on the condition, funding relevant medical education activities, hiring leading sex researchers as consultants and creating a public web site.
A spokeswoman for Proctor and Gamble, the patch’s manufacturer, told Moynihan this was “not an exceptional amount of firepower”.
Quoting a US academic, Moynihan says the pharmaceutical companies’ strategy is to “create a buzz, get the word out, heighten consciousness, get people talking”.
And talking they certainly are. A Google search for “female viagra” yields more than one million hits, with one of the sites defining HSDD as “an absence of sexual fantasies”.
But maybe, just maybe, the widespread publicity isn’t all bad.
I suspect fewer patients would broach the thorny subject of sex if it were not for the widespread publicity about anti-impotence drugs.
And like me, most GPs have probably picked up a few new male diabetics who presented with sexual problems in mind but ended up with a different diagnosis.
Neither Jenny nor Vera left with a new script, although Jenny is now aware of her options, including transdermal testosterone, and Vera is better equipped to deal with her situation. Both male patients did get their Viagra, which they assure me has changed their lives and those of their partners.
So are the drug companies medicalising a normal phenomena on the name of profit? And even if they are, do the benefits of legitimising the subject of sex outweigh those crass motives? You decide.