The Pinking of Viagra

viagraThe profit-rich path for female sexual satisfaction is paved with denial, from the alleged invention of an illness to the naming of a potential quick-fix pill.

Pfizer, the multinational drug company that has given 17 million men the blue diamond-shaped pill Viagra to spur erections, denies that its employees ever coined the tag "Pink Viagra" to describe a drug currently being tested to boost women's bedroom performance. The company gives sole credit to a journalist for creating the phrase.

A couple of years ago, as Pfizer puts it, a reporter from a newspaper in Israel was among several journalists taken on a tour of the company's research facility. He was told about clinical trials on a women's version of Viagra which, at the time, were "very hush hush." Pfizer spokesperson Craig Regan says this journalist's story contained the first reference to "Pink Viagra."

"The pink absolutely threw everybody,"he says. "Some were a little miffed, to be honest, because at that stage the trial was in the early stages."

Before long, the British editors of the Collins Gem dictionary of buzzwords and phrases had named Pink Viagra as one of the most defining phrases of 2002. "It's the old story," says Regan. "A lot of the coverage of anything to do with Viagra loses perspective. They [journalists] just go feral."

But is it journalists going feral over the potential for women's Viagra, or is the drug maker behaving in not quite the circumspect manner in which it portrays itself?

In a sensationally received critique in the first issue of the British Medical Journal for 2003, Ray Moynihan, a journalist for The Australian Financial Review, labelled the idea of female sexual dysfunction a "corporate [drug company] sponsored creation."

The Australian journalist touched a nerve when he questioned whether a new disorder had been identified to meet unmet needs, or, more cynically, to build markets for new medications. Wrote Moynihan: "[Researchers] with close ties to drug companies are working with colleagues in the pharmaceutical industry to develop and define a new category of human illness at meetings heavily sponsored by companies racing to develop new drugs."

Moynihan plotted a six-year chart showing that, in order to build a Viagra-type market for women, pharmaceutical companies funded a series of meetings to create a "clearly defined medical diagnosis with measurable characteristics to facilitate credible clinical trials."

But, says Moynihan, corporate-sponsored definitions of female sexual dysfunction have been criticized as misleading and potentially dangerous. An estimate by two Pfizer-funded researchers in the Journal of the American Medical Association that 43 percent of women aged 18 to 59 suffer sexual dysfunction had been criticized by other researchers as an exaggeration.

"The role of drug companies in the construction of new conditions, disorders, and diseases needs more public scrutiny," urges Moynihan.

Pfizer's Regan denies that female sexual dysfunction is a condition that has arisen overnight. However, he says, there are four or five broad categories for defining it -- not always as simple as, say, a lack of blood flow to the clitoris, in the way a lack of blood flow to the penis readily defines many men with male sexual dysfunction.

"The debate about the definition and parameters has raged on," says Regan. "It's not just physiological, it includes psychological problems too."

Pfizer contends that female sexual dysfunction is much more complex than male sexual dysfunction. There is no hard and fast definition. "[But] it certainly does exist and the experts tell us it does exist."

Regan is not enamored with the Moynihan critique that questions drug companies' funding of research. "He wants it both ways," says Regan. "He says research funding from pharmaceutical companies should be declared. That's fair enough. Then he lists nine consultative meetings [involving researchers and drug companies]. But the interest of the drug companies was declared at those meetings.

"About 92 per cent of new drug discoveries are funded by pharmaceutical companies," Regan continues. Moynihan "seems to contend that it's wrong to have pharmaceutical companies involved, but it's not. Otherwise, you wouldn't see new medicines."

Yet Moynihan's critique focuses on drug company involvement in the creation of parameters for a disease, rather than the drugs themselves. Moynihan points out that, while male sexual problems can be more readily attributed to physiological barriers, women's sexual dysfunction is more often difficult to quantify as a physical problem, and therefore a drug target. The article fired debate around the world, and brought a huge -- and sometimes emotional -- response back to the British Medical Journal.

"I agree that female sexuality issues should not be exploited by the pharmaceutical companies," responded one woman in a letter to the BMJ. "But as one who has suffered female sexual dysfunction after a hysterectomy, I can reassure you that it is a real physical problem that can have devastating consequences. Your article seems to have undertones that reflect dark age thinking -- women certainly cannot be interested in sex."

Others see the drug companies' efforts rather than its critics as patriarchal and disempowering of women's sexuality. A group calling itself FSD Alert ( www.fsd-alert.org) has set up a Web site, challenging drug companies to look broadly at women's sexual problems. "The pharmaceutical industry wants women to think that sexual problems are simple and offers drugs as magic fixes," says the group's manifesto. "But positive sexual experiences require accurate, unbiased information."

Ray Moynihan says the extent of the reaction to his article surprised him.

"I think it touched a nerve because sex is dear to the hearts of many -- almost all people," he says. "I think people are genuinely astonished when they learn of the extent of the drug companies' role in sponsoring so much of the early scientific work on the definition [of an illness].

"I think the fear among many of the experts and the wider community is that the power and influence of the pharmaceutical manufacturers in this evolving definitional process could tend to reduce the complexity of the problems into simpler 'dysfunctions' or 'diseases' which can then be 'treated' with pills."

Pfizer's Regan says the jury is still out on whether Viagra can be effectively used by women. He won't say how the formula in the initial trial differed from the currently available product of Viagra for men, but that the so far unpublished results were promising. However, he says, a women's version of Viagra remains "years away" from approval and marketing.
Steve Dow lives in Sydney, Australia. He writes for The Age and The Sydney Morning Herald and is the author of "GAY," a collection of journalism on contemporary gay and lesbian issues. This piece originally appeared on his Web site.

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