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Altostrata

Did drug companies get female sexual dysfunction into DSM-5?

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Altostrata

For many, many years, since before the approval of Viagra in 1998, the pharmaceutical industry has been trying to define a woman's lack of a satisfying sex life as a medical disorder.

 

This is despite evidence, dating from Masters and Johnson in 50 years ago, that much of female "sexual dysfunction" can be alleviated by educating the woman and her partner about the physiology of female sexual response.

 

This pharma campaign against women has featured the usual "medical researchers" paid consulting fees by drug companies, planted news stories, and hyperbole about medical necessity.

 

A year ago, the pharmaceutical company Boehringer's campaign for FDA approval of a "female Viagra," based on flibanserin, a failed antidepressant, flopped (see June 18, 2010 NY Times Drug for Sexual Desire Disorder Opposed by Panel.) The FDA refused to approve the drug, citing low efficacy relative to side effects.

 

This year, BioSante, another pharmaceutical company, has been placing news stories to promote the need for its testosterone-based treatment for "sexual dysfunction" in menopausal women.

 

Now here comes the draft DSM-5, available for public comment. As psychiatric diagnoses, it includes Female Orgasmic Disorder and Sexual Interest/Arousal Disorder in Women.

 

How does psychiatry propose to treat these "mental disorders"? There are no approved treatments for women. Most antidepressants tend to have a deleterious effect on sexual functioning. What can a psychiatrist offer a woman who is not having satisfactory orgasms? You can bet it's not sex therapy. Those women who get sucked into a psychiatric diagnosis are going to spend years of mock treatment with various unproven drugs, finally get called "bipolar," and put on antipsychotics.

 

There is no psychiatric basis for these fictitious disorders of women. In fact, much of female sexual dissatisfaction seems to originate in lack of knowledge about sex, particularly the existence and function of the clitoris, in either the woman or her partner. But there's no profit in that, is there?

 

Sources:

 

January 4, 2003, British Medical Journal, The making of a disease: female sexual dysfunction: Many of the medical experts brought forth to legitimize the medicalization of female sexuality have been drug company consultants.

 

April 2006, PLoS Medicine Female Sexual Dysfunction: A Case Study of Disease Mongering and Activist Resistance traces the propaganda and controversy over diagnosing female sexual dysfunction.

 

World J Urol. 2002 Jun;20(2):127-36. Psychotherapeutic interventions for treating female sexual dysfunction.

Leiblum SR, Wiegel M. Abstract at http://www.ncbi.nlm.nih.gov/pubmed/12107544

 

Women Health. 2005;42(1):117-38.

The incidental orgasm: the presence of clitoral knowledge and the absence of orgasm for women.

Wade LD, Kremer EC, Brown J. Abstract at https://www.ncbi.nlm.nih.gov/pubmed/16418125

 

J Sex Marital Ther. 2000 Jan-Mar;26(1):51-65. The female sexual response: a different model. Basson R.

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cinephile

The more things change...

 

Women have always been soft targets for psychiatry and you're right in that these latest developments of the DSM 5 are in that grand tradition. Sheesh. It's really not rocket science that women have different anatomy and different physical needs (gee? ya think?) and that for many women, emotional intimacy is the key to sexual gratification. And how in the HELL is a couple going to learn about each other sexually and emotionally if one (or both!) of them is zonked out on psych meds?! I also think that the cultural stereotype that women are somehow "hard to please" sexually helps feed into this -- it's practically the punchline of every sitcom joke these days. Um, not to get too graphic here, but in my experience, it's really not that hard if you just LISTEN. Lol. If only psychiatry could give men a pill that makes us listen lol!

 

But actually, that's just the point. If you think about it, a lot of psychiatric damage in the general population could have been avoided if someone just LISTENED instead of prescribing. And listening is key for a relationship, both outside and inside the bedroom. But that takes time and effort, and why bother with that if there's a pill, and since psychiatric science is improving every day, and breakthroughs are just around the corner...

 

And by the way: why even call it "female orgasmic disorder?" I've spoken to more than a few women that actually aren't crying over not having orgasms regularly because it's the emotional intimacy that is most important to them. By calling the inability to have an orgasm a "disorder" it frames a woman's problems into a male paradigm, where the orgasm is the ultimate sexual achievement. Now, I'm not saying there shouldn't be treatment for a woman's sexual dysfunction, but the language of the disorder, like so many in the DSM, is simultaneously unintentionally hilarious and demeaning.

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Altostrata

And don't forget to send your comments to the DSM committee at dsm5@psych.org !!!

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