Drug Industry Seeks Viagra-Like Remedy for Women

Print More

Sex therapist Leonore Tiefer

(WOMENSENEWS)–Since the launch of Pfizer’s tremendously popular erectile-dysfunction drug Viagra in May 1998, pharmaceutical companies have been scrambling to find the next big sex drug–this time, for women.

Investors’ hopes were dashed in May 2000 when researchers announced that Viagra, which earned Pfizer $1.3 billion in 2000, doesn’t work in women. Start-up pharmaceutical companies and enterprising physicians jumped into the fray to treat what is believed to be the underserved market of sexually dysfunctional women.

While 10 million men around the world take Viagra, according to Pfizer’s 2000 annual report, the market for a sex drug for women may be even bigger. Sociologists say that women consult physicians about twice as often as men, and women spend three out of four of all health care dollars.

Most significant, according to a much-cited February 1999 article in the Journal of the American Medical Association, 43 percent of all women suffer from sexual dysfunction, compared with 31 percent of all men.

While Viagra is routinely covered by insurance companies, contraceptives often are not. It remains to be seen whether insurers will cover the gels, sprays, creams and devices to treat women’s sexual problems. Most but not all insurance plans cover the lone FDA-approved device to treat female sexual dysfunction currently on the market. Other products are still in development, but drug company executives are optimistic.

The near-epidemic level of female sexual dysfunction routinely cited by drug companies is the subject of roiling debate among sex therapists, urologists and feminists. Some feminists, such as sex therapist Leonore Tiefer, argue that drug companies and the researchers they fund are manufacturing a medical problem where none exists, then pushing pills and products to make a buck off women’s feelings of inadequacy in bed.

For $359, Achieve Orgasm With a Clitoral Vacuum Pump

In April 2000, the Food and Drug Administration approved the first product to treat female sexual dysfunction, called FSD, which it defines as decreased sexual desire, decreased sexual arousal, pain during intercourse or inability to climax.

The $359 EROS clitoral therapy device, a small vacuum pump that applies suction to the clitoris, is currently available by prescription only. Although insurance coverage for the product varies, according to manufacturer UroMetrics, most insurers are picking up the tab. Dozens of other products to alleviate female sexual dysfunction, including nasal sprays, body creams, and even a remote-control device, are currently in clinical trials. Some of these products may make it to market as early as 2004, according to drug company spokespersons.

EROS clitoral therapy device"Four in ten women have female sexual dysfunction," says Matthew Haines, director of corporate communications at Nastech, a nasal drug manufacturing company. Nastech has recently started the second of three phases of FDA-required clinical trials for its apomorphine hydrochloride product for women, which is designed to improve blood flow and lubricating secretions in female genitals. The product comes in a small vial with a nasal spray applicator, which women would spritz into their nostrils about 20 minutes before having sex.

The company expects to bring the nasal spray to market within a few years, when it will be available by prescription. The cost, Haines says, will depend on whether insurance companies offer reimbursements for the product.

BioSante Pharmaceuticals expects results from Phase 2 clinical trials of their female sex drug, LibiGel, by the fall. LibiGel is a clear gel that women would rub onto their shoulders or arms, releasing libido-increasing testosterone into their bodies for up to 24 hours.

As women age, their testosterone levels go down, and women who have undergone total hysterectomies have 50 percent lower testosterone levels. Studies show that testosterone replacement therapy can boost sexual desire, according to a BioSante press release. LibiGel may hit the market in four years, says BioSante’s chief executive officer Stephen M. Simes, and would cost about $1,000 a year for daily therapy. He expects insurance companies to cover most of the cost.

Orgasm on Demand With Neural Implant–Remote Controlled

"Just like men who take Viagra who don’t have erectile dysfunction, there are individuals who will want to have an orgasm on demand," says North Carolina pain specialist Dr. Stuart Meloy. In January Meloy was issued a patent for a remote-controlled neural stimulation device to trigger orgasms.

In 1998, Meloy, like many other pain specialists, noticed that a surgically implanted neural stimulation device routinely used to alleviate chronic pain in patients sometimes triggered orgasms instead. At first he considered it a "funny, unwanted side effect," until he realized that "this unwanted side effect was something that may be quite desirable in another clinical setting."

Meloy expects to start clinical trials in the near future. But who will want to spend $15,000 on a surgical procedure to have push-button orgasms? About 23,000 women with orgasmic dysfunction are not responsive to simpler therapies, Meloy estimates. "Frankly, for that individual who has the cash in hand, it is kind of on par with cosmetic surgery," he says. And like cosmetic surgery, probably would not be covered by insurance.

Critics say that peddling such technology preys upon insecure women everywhere. Some argue that many of the symptoms of female sexual dysfunction may simply be normal responses to the challenges of life. Others say that, while the reported problems may be real, the solutions for the vast majority of women are psychological and social, not medical–namely, alleviating the stress, isolation, and overwork plaguing many women’s lives. Most agree that when pharmaceutical companies seeking new markets underwrite sex research, the results can be questionable.

"Women may be saying they have these symptoms" of lack of desire, arousal or orgasm, says Cynthia Graham, a sex therapist at the Kinsey Institute, "but they may not consider it a problem."

What Is a Sexual Problem? What Isn’t? Who Gets to Decide?

Graham’s point goes to the heart of the murky world of sexuality research. What is a sexual problem and what isn’t, and who decides? The 43 percent figure published in the Journal of the American Medical Association was derived from a reanalysis of data from a 1992 University of Chicago study of sexual practices in the United States.

The study’s author, sociologist Edward O. Laumann, categorized as suffering from sexual dysfunction all the women who reported lack of interest in sex, arousal difficulties, orgasm difficulties or pain during intercourse for a few months over the previous year–whether or not they reported being upset by these symptoms.

Laumann’s 43 percent figure quickly took on a life of its own, and it was cited in company press releases, on television and in almost 100 scientific papers. The race to find a female Viagra, ignited in 1998 by the drug’s launch, was on, and the concept of female sexual dysfunction exploded onto the national scene.

Two sisters, urologist Jennifer Berman and sex therapist Laura Berman, spearheaded a popular crusade to urge women to consider medical solutions to their sexual problems. They founded women’s sexual health clinics in Boston and Los Angeles to treat female sexual dysfunction and they appeared on a raft of television and radio shows, including the Oprah Winfrey Show and Good Morning America. An annual conference on female sexual dysfunction, held at Boston University and sponsored by major pharmaceutical companies, was launched in 1998.

The second annual female sexual dysfunction conference in 1999, however, encountered opposition.

"The purpose of this conference," feminist sex therapist Tiefer wrote in the October 1999 issue of the monthly feminist magazine Sojourner, "is to promote the medicalization of women’s sexuality, a process of establishing universal norms and then declaring all variations disordered and in need of treatment."

Feminists Advance New View of Women’s Sexual Problems

Tiefer and a handful of feminists distributed leaflets at the conference and went on to form the Working Group on a New View of Women’s Sexual Problems. Tiefer set off on an international speaking tour, and her anthology, "A New View of Women’s Sexual Problems," will be available from Haworth Press in November.

Laumann, meanwhile, has distanced himself from the furor set off by his journal article, which cited 43 percent sexual dysfunction among women.

"I’ve been somewhat annoyed that because this study was published in a medical journal, it has been spun in a very medical direction," he said in an interview. "The vast bulk" of women who report sexual dysfunction symptoms "are probably undergoing social stresses" and don’t need medical attention, Laumann says. He currently is consulting for Pfizer on an international study of sexual practices.

Tiefer says that, as sex research becomes increasingly beholden to the pharmaceutical industry for financing, there arises a vested interest in painting a picture of sick, dysfunctional women in need of new drug treatments. And whether the number of women who need medical solutions to their sexual problems is large or small, virtually all of them will be subject to mass-media marketing of female dysfunction products.

Drug companies say they plan to run direct-to-consumer advertising campaigns on mass-media outlets for their female sexual dysfunction products.

UroMetrics, the makers of the EROS clitoral pump, plans to run spots on radio stations and in print media in 10 cities, according to their public relations spokesperson. Both LibiGel and Nastech’s nasal spray are similarly likely to be advertised directly to consumers.

"Like Viagra," says Nastech spokesperson Matthew Haines, "this is something consumers will be hearing about directly."

Sonia Shah is a free-lance writer in Connecticut and former editor at South End Press.

For more information, visit:

Working Group on A New View of Women’s Sexual Problems:
http://www.wellnessweb.com/Female_Sexual_Dysfunction/a_new_view.htm

Network for Excellence in Women’s Sexual Health:
http://www.newshe.com/

UroMetrics:
http://www.urometrics.com/fsd.html

Piedmont Anesthesia and Pain Consultants:
http://www.papc.com/patent.htm

Nastech Pharmaceutical Company Inc.:
http://www.nastech.com/

BioSante Pharmaceuticals:
http://www.biosantepharma.com/


Comments are closed.