Ray Moynihan - Sex, Lies, and Pharmaceuticals: How Drug Companies Plan to Profit from Female Sexual Dysfunction

SEX, LIES AND
PHARMACEUTICALS

RAY MOYNIHAN
& DR. BARBARA MINTZES

SEX,
LIES

+

PHARMACEUTICALS

HOW DRUG COMPANIES
PLAN TO PROFIT
FROM FEMALE SEXUAL
DYSFUNCTION

D&M PUBLISHERS INC.
Vancouver/Toronto/Berkeley

Copyright 2010 by Ray Moynihan
Chapter 5 Copyright 2010 by Barbara Mintzes

First published by Allen & Unwin Pty Ltd,
83 Alexander Street, Crows Nest, Sydney, NSW, 2065, Australia

10 11 12 13 14 5 4 3 2 1

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ISBN 978-1-55365-508-4 (pbk.)

ISBN 978-1-55365-652-4 (ebook)

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We gratefully acknowledge the financial support of the Canada Council
for the Arts, the British Columbia Arts Council, the Province of British
Columbia through the Book Publishing Tax Credit, and the Government of
Canada through the Canada Book Fund for our publishing activities.

For Toni, who is body surfing the waves of time with
her turtle, adorned with the emu feathers falling from the stars...
in celebration of your fearlessness and strength, your warmth
and generosity, your laughter and love.

CONTENTS

S ex seems to be how most of us got here, apart from the odd case of an immaculate conception or a miracle of medical technology. Sex is also something thatjust like the weather most of us are interested in, more or less. But just so youre under no illusions, while this book is certainly about sex, its also an expos of how medical science is imperceptibly merging with pharmaceutical marketing.

As a disclosure front and centre, for more than a decade Ive been writing about the tangled web of relationships between doctors and drug companies, and the unhealthy impacts of that entanglement on people and public health systems. My coauthored 2005 book describing that problem, Selling Sickness: Howdrug companies are turning us all into patients, laid out ten case studies of disease-mongering: the process of widening the boundaries of illness in order to sell people more treatments. With humility and surprise, I can report that Selling Sickness has since been translated into twelve languages, and reprinted a number of times in North America and elsewhere.

In Sex, Lies and Pharmaceuticals the making of a single modern medical condition is forensically examined, and the resulting story is both fascinating and frightening. The books methods are those of rigorous investigative journalism, targeted at uncovering what happens behind the scenes of contemporary medical science. It draws on many scientific journal articles, medical textbooks, historic works of philosophy and sexuality, as well as some juicy corporate marketing materials and a few very revealing court documents.

I have also interviewed a long list of the key players in the emerging field called sexual medicine, spoken to professors, psychologists, bloggers, doctors and drug company insiders, and attended scientific seminars and medical meetings all over the world. The facts and evidence have been checked meticulously, and an extensive notes section has been included at the end of the book. I should apologise in advance to those who may feel theres too much detail at certain points, but for others this will be the lifeblood of the story. And if you do find a factual error, please let us know so we can correct it in future editions.

Almost everyone approached for an interview agreed to speak with me, and their comments have been invaluable, with many appearing in direct quotations. While a tiny handful declined as is noted when necessaryevery effort has been made to fairly represent their viewpoints, which are readily available through their many publications and presentations.

It is important to say very clearly here that the book does not accuse anyone of lying. The lies in the title refers to the fictions that flow from pharmaceutical marketinglike the notion that one in ten women suffers from a disorder of low desire. As well see, soon that disorder itself may no longer even exist. The corporate need to market drugs for discrete disease labels does not match well with uncertainty over how to understand and classify womens sexual difficulties.

One practical note for the reader is that the terms dysfunction, disorder and disease are used regularly, sometimes interchangeably, as these are the words employed by drug companies and some doctors to describe many of the sexual problems women experience. Others involved in the debate about sex tend to use another set of words, like difficulties, dissatisfactions or discontent, instead of the more medical language. Trying to define the difference between a difficulty and a dysfunction is an extremely challenging task and, as uncovered in the following pages, one that is generating a compelling global debate.

Most importantly, the book readily acknowledges that womens sexual problems can sometimes be disabling, and proven therapiesincluding pillsmay be extremely valuable for some people. Yet it also asks very directly how much discontent is being manufactured through the creation of new sexual norms, and how much dissatisfaction is being exploited for corporate gain.

Finally, Sex, Lies and Pharmaceuticals is offered by co-author Barbara Mintzes and me as an opportunity to join this global debate about the making of a new medical condition. It is part of a conversation, its ideas to be discussed with family and friends, criticised in book clubs and on blogs and debated at public meetings around the world. Please join in, and feel free to bring tomatoes, a copy of the book for signing, or both.

Ray Moynihan
Byron Bay, June 2010
www.raymoynihan.net

Introduction
Sex, lies and pharmaceuticals

Not tonight, dear, the dog ate my testosterone patch.

Dr Leonore Tiefer

D uring the last year or so, has there been a period of several months or more when you lacked interest in having sex? When you felt anxious about your sexual performance or were unable to achieve an orgasm? Was there an extended time when you had trouble getting aroused, experienced pain on intercourse or just didnt find sex pleasurable? If you answered yes to just one of these survey questions, and youre a woman, you could easily be classified as suffering from a brand new medical condition called female sexual dysfunction, or FSD. First described in the textbooks only a few decades back, FSD is set to become the next blockbuster medical condition, coming soon to a doctors surgery near you. As the ups and downs of daily life are re-categorised as the symptoms of medical diseases, soon all of us will be sick.