LAURA: I’M LAURA SESSIONS STEPP AND THIS IS SEX REALLY. NINE YEARS AGO, FILMMAKER LIZ CANNER WENT TO WORK AT A COMPANY THAT WAS DEVELOPING A TOPICAL CREAM TO FIX LOW SEXUAL DESIRE IN WOMEN. THIS FIRM, LIKE OTHERS IN THE FIELD, CALLED THE CONDITION, “FEMALE SEXUAL DYSFUNCTION,” OR FSD.
CANNER QUICKLY STARTED HAVING QUESTIONS. SHOULD PHARMACEUTICAL COMPANIES DEFINE A DISORDER, DEVELOP A PRODUCT TO TREAT THAT DISORDER, AND THEN MAKE MONEY OFF WOMEN WHO THINK SOMETHING’S WRONG WITH THEM?
SOME ANSWERS CAN BE FOUND IN CANNER’S TOUGH, TOUCHING AND OCCASIONALLY FUNNY DOCUMENTARY CALLED ORGASM, INC. THE FILM IS PLAYING IN THEATERS ON COLLEGE CAMPUSES AND ELSEWHERE, BOTH IN THE U.S. AND ABROAD.
Liz Canner: How many drug companies do you think there are out there are developing drugs for FSD?
Drug Representative: There’s probably at least twelve, developing all different types of things. [race music.] We’re all in a race to see who can be first to market. The top four contenders for FDA approval are approaching the start…
LAURA: EVER SINCE THE PHARMACEUTICAL GIANT, PFIZER, STARTED SELLING VIAGRA TO MEN MORE THAN A DECADE AGO, THE DRUG INDUSTRY HAS BEEN SCRAMBLING TO COME UP WITH A FEMALE VERSION.
AS RECENTLY AS LAST MONTH, A FIRM APPEARED BEFORE THE FEDERAL DRUG ADMINISTRATION SEEKING APPROVAL FOR A PILL CALLED FLIBANSERIN.
Flibanserin Representative: I would like to thank the FDA for allowing us today to present the results of our clinical development program.
THE COMPANY, BOERINGER-INGELHEIM, SOUGHT TO SELL FLIBANSERIN TO WOMEN AS YOUNG AS 18.
Flibanserin Representative: We believe that 100mg daily dose of Flibanserin is effective in increasing desire, in decreasing distress, and is effective in increasing the number of satisfying sexual events…
LAURA: A WOMAN’S PROBLEMS WITH SEXUAL DESIRE AND PERFORMANCE – NO MATTER HER AGE – ARE COMPLICATED. ATTENTION FROM HER PARTNER, THEIR RELATIONSHIP, HOW MANY OTHER DEMANDS SHE’S JUGGLING, WHETHER SHE’S DEPRESSED….SUCH FACTORS PLAY INTO HER SEX LIFE AND ARE NOT SOLVED EASILY.
DESIRE IS HIGHLY SPECIFIC TO AN INDIVIDUAL. SO HOW CAN YOU DESIGN A DRUG THAT WILL TREAT EVERYONE? LEONORA TIEFER, A PSYCHIATRY PROFESSOR IN THE MOVIE, OBJECTS TO COMPANIES MEDICALIZING WOMEN’S SEXUAL PROBLEMS.
Leonora Tiefer: What I’m concerned about is that there is a shift going on in the meaning of sexuality in the culture towards this commodified, individualized thing that has a normal level, and if you don’t experience it in that way, there is something wrong with you and you need medical help. I just want to say it ain’t so simple.
LAURA: FEW PEOPLE DISPUTE THAT SOME WOMEN SUFFER FROM LIBIDO LOW ENOUGH TO REQUIRE MEDICAL INTERVENTION. AND CERTAINLY, SOME SCIENTISTS SEARCHING FOR THE FEMALE VIAGRA ARE MOTIVATED BY CONCERN AS WELL AS PROFIT.
AN ARTICLE IN THE NEW YORK TIMES SUGGESTS THAT AT LEAST 10 PERCENT OF WOMEN DO HAVE PROBLEMS, BUT IT ALSO NOTES THAT SUCH ESTIMATES, REPORTED IN MEDICAL JOURNALS, COME FROM STUDIES DONE BY DRUG COMPANIES.
ONE DANGER OF ALL THIS ATTENTION, OF COURSE, IS THAT HEALTHY WOMEN WILL BEGIN TO BELIEVE THEY’RE SICK.
Charletta: All of my life I’ve had difficulty achieving orgasm. I’m in this to heal myself.
LAURA: THAT’S CHARLETTA, A MARRIED WOMAN IN THE MOVIE WHO WAS FITTED WITH ELECTRODES IN HER SPINE AS PART OF A CLINICAL TRIAL. SHE WAS PROMISED THAT SHE THEN WOULD HAVE ORGASMS WITH HER HUSBAND ANY TIME SHE WANTED. WHEN THE DEVICE – CALLED, OF ALL THINGS, AN ORGASMATRON – DIDN’T WORK, SHE STILL THOUGHT THERE WAS SOMETHING WRONG WITH HER.
Charletta: So, I’m not without orgasms; I can have orgasms. But it’s just not the normal situation where two people get together and they have sexual intercourse and they each have an orgasm. But like I say, maybe that’s not real.
CHARLETTA EVENTUALLY LEARNS THAT THERE’S NOTHING WRONG WITH THE WAY SHE’S BEEN HAVING SEX– INVOLVING STIMULATION OUTSIDE THE VAGINA.
Charletta: I’m normal! I’m normal! I’m not diseased; I’m just normal, honey.
LAURA: AS I LISTENED, I WONDERED: IF A MIDDLE-AGED WOMAN CAN BE SUCKERED INTO A DEVICE WITH A NAME LIKE ORGASMATRON, WHAT MIGHT A MORE NAIEVE WOMAN DO? I PUT THAT QUESTION TO FILMMAKER, LIZ CANNER:
Laura: Do these problems with female sexual desire affect women in their 20s?
Canner: Well, I think it affects people of all ages, but there is no medical definition, there’s nothing that says what is the correct level of desire. That is totally subjective. There is nothing that says you should have thirty sexual thoughts in a day to be healthy.
Laura: Well, to build on that, do you think it will make younger women start to see problems where there aren’t any problems?
Canner: That’s right. I think that’s part of the problem, that there’s been this marketing campaign to really try and make women think that perhaps they have a neurotransmitter dopamine level. So that women, who may be in a bad relationship, might instead think that their desire problems are caused because of something that’s physically wrong with them. That’s the risk here when you take away the sort of social contextual things that could cause sexual issues and you try and make it purely a medical problem. It’s interesting, I’ve been doing a lot of talk shows lately, and it’s been mostly men that have been calling in and saying that they think this drug should be approved. I think that really needs to be looked at. What kind of pressure is going to be put on women in relationships to start taking these kinds of drugs?
Laura: Now the industry says: “Just pop a pill.” If you pop a pill, you won’t have to talk about it; you won’t have a problem.
Canner: Right. I think we live in this strangely, schizophrenic society. On the one hand, children start looking at pornography at the average age of eleven. On the other hand we teach abstinence only in the schools. We have media that sells sex. And so we’re given very mixed messages about sexuality. But the one thing that we’re really not given is a very good sex education. In school, we don’t teach about the clitoris when we teach genital anatomy. We don’t tell women that seventy percent of them need direct clitoral stimulation in order to have an orgasm, which a lot of women unfortunately don’t realize.
LAURA: LET’S FACE IT. POPULAR CULTURE TELLS US THAT WE SHOULD BE HAVING GREAT SEX ALL THE TIME. IF WE’RE NOT, THERE’S SOMETHING WRONG WITH US. NEWS REPORTS SAY SOME YOUNG WOMEN –AND EVEN SOME TEENAGE GIRLS - ARE HAVING THEIR VAGINAS SURGICALLY ALTERED FOR A BETTER ORGASM. A PILL WOULD BE EVEN EASIER.
Canner: You can go to the pharmacy and you see all these performance-enhancing products, and especially around sexuality. So, there’s this pressure on us to perform. And if you don’t look like you’re one of these people in the movies, if you’re not having sex like that, that there’s somehow something that you’re not living up to and often that’s a fabrication and a fantasy.
LAURA: ORGASM, INC. HAS BEEN SHOWN ON TELEVISON IN CANADA, FRANCE AND OTHER. BUT NOT IN THE U.S. WHY?
Canner: I think part of the difficulty in the United States is that we have direct-to-consumer advertising. The United States and New Zealand are the only countries in the world that have direct-to-consumer advertising, and that has an affect on the media coverage of the pharmaceutical industry. They are one of the largest funders of the media through their advertising. So, when you do a documentary that’s critical of this industry, it does hamper your options in terms of where you can get the film seen.
LAURA: COLLEGE STUDENTS ARE AMONG CANNER’S MOST RECEPTIVE AUDIENCES. SEX REALLY SENT A REPORTER TO THE UNIVERSITY OF CALIFORNIA SAN FRANCISCO, WHERE MEDICAL STUDENTS WERE SPONSORING A SCREENING OF ORGASM INC.
ONE THING THAT GOT THE STUDENTS’ ATTENTION WAS THE IDEA THAT SOME DOCTORS RECOMMEND CERTAIN SEX DRUGS WITHOUT REVEALING THAT THEY’RE GETTING PAID BY THE COMPANIES THAT MAKE THOSE DRUGS.
Lauren: I’m Lauren. I’m a first-year medical student at UCSF. I think it’s important for people to be able to understand that pharmaceutical representatives may not be coming to them with a pure intent, and just to be able to recognize that so they can think more critically about it.
LAURA: ANOTHER STUDENT WAS CONCERNED ABOUT CONFLICTS OF INTEREST CLOSER TO HOME.
Serena: I’m Serena Casara (sp?). In our class, there’s been a movement to have all the professors disclose whatever financial relationships they have to prevent the use of pharmaceutical money to educate medical students. So my classmates specifically are very conscious of pharmaceutical’s influence over doctors’ prescriptions.
LAURA: ONE YOUNG MAN THOUGHT THE FILM NEEDED MORE BALANCE.
Nabim: It’s not like the disease itself doesn’t exist. So, I was a little disappointed with that aspect of it. It seemed to minimize all the problems and say there was no problems, and I don’t think that’s the case. Other than that, I really liked the fact that it exposed how pharmaceutical companies work behind the scenes without you actually realizing. And all of these experts you see on television, talking about stuff like they know something about it. So, yeah- a lot of questions raised.
LAURA: THE DRUG INDUSTRY CAN PUSH THESE ALLEGED SEX-ENHANCING PRODUCTS, BECAUSE MANY OF US KNOW SO LITTLE ABOUT OUR BODIES WORK.
Rebecca: My name is Rebecca Taub and I’m a first-year medical student at UCSF. There is sort of this veil of mystery sometimes that can surround female sexual pleasure. The reason we have Viagra and we don’t have a pill for women is that it’s much more complicated. I think the pharmaceutical industry seems to have really seized the opportunity to take advantage of that and to sort of dictate what is normal and what isn’t normal, and what constitutes having an illness, and what constitutes needing potentially a medication. And who should be making these decisions for women? I think it’s something we need to take control of and take into our own hands.
LAURA: A SHORT POSTSCRIPT. THE FDA COMMITTEE DECIDED AT ITS JUNE HEARING NOT TO APPROVE FLIBANSERIN. THE PANEL SAID THE PILLS APPEARED TO HELP PRODUCE ABOUT ONE MORE SEXUAL EPISODE PER MONTH, BUT IT DID NOT DEMONSTRATE INCREASED DESIRE. ALSO, THE RESULTS DID’T JUSTIFY THE RISKS, WHICH COULD INCLUDE DIZZINESS, NAUSEA AND FATIGUE.
BUT THE PUSH FROM FLIBANSERIN’S COMPANY, AND OTHER PHARMACEUTICAL FIRMS, IS FAR FROM OVER. AND OTHER DRUGS ARE IN THE RESEARCH PIPELINE.
IN CLOSING, LET’S LISTEN TO THE RESEARCH CANNER SAYS IS NEEDED.
Canner: I think we really should be looking at how effective is comprehensive sex education, for instance. Think about our ideas of how to address this in a broader way, not just think about a medicine. But maybe think about other things that would probably do a better job of improving the sex lives of most women then just simply a drug.
LAURA: I’M LAURA SESSIONS STEPP AND THIS IS SEX REALLY. VISIT US IN TWO WEEKS FOR OUR NEXT PODCAST, WHICH REVEALS THAT A SURPRISING NUMBER OF YOUNG PEOPLE THINK THEY COULD BE INFERTILE.
What Do You Think?