When Big Pharma creates a diagnosis—must-read interview

You know what would be great for pharmaceutical profits? If there was a reason for women to need their own Viagra. Of course, there's no clear-cut, physical sexual dysfunction disorder prevalent among women the way erectile dysfunction haunts older men. But, when life hands you lemons, you can always make your own diagnostic tools and call them lemonade, anyway!

Australian journalist Ray Moynihan has been following the battles over so-called Hypoactive Sexual Desire Disorder, and the Pharmalot blog has an interview with him that gets past the initial outrage and into the complex realities of trying to treat problems some women really do feel they have, while avoiding the unethical creation of a junk diagnosis meant to sell more pills. It's a great example of how the right questions and playing devil's advocate can lead to a deeper conversation.

Moynihan: It's actually been endemic in the development of this condition, but I would say the emergence of this diagnostic tool last year. One of the companies was hoping to promote it all over the world as a way for doctors to diagnose women with sexual disorders. The drug company said it could be used by doctors without expertise in this area and to accurately diagnose women in a few minutes. It was a very naked attempt by industry to develop a sort of quick route to mass diagnosis.

Pharmalot: Which company and which tool?

Moynihan: It was Boehringer and it was for measuring pleasure.

Pharmalot: But what's wrong with that?

Moynihan: If you talk to experts who are not aligned with industry, they are horrified by the idea that there's a quick test to determine whether a woman has a sexual disorder—it's quick and crude…There's no way you can get to the complexities of sexual disorders—there's the root cause and there can be relationship problems—in the space of a few minutes. It underscores the sort of absurdity to reduce sexual difficulties to a simple diagnostic assessment and a simple solution in the form of a pill. And there's a huge controversy within the healthcare establishment about whether this is a dysfunction. Tests assume there's a well established medical dysfuntion that can be quickly diagnosed. This is a marketing myth.

Pharmalot: But isn't true that there is female sexual dysfunction and this is a legitimate issue that deserves a response?

Moynihan: I'd be very happy to be quoted saying sexual problems are widespread, sometimes are debilitating and sometimes, there is a genuine medical label and therapeutic options available, possibly including medications, which may be the best thing. Sexual problems are real and legitimate and cause suffering. There's no question about that. The real question is whether there are discreet, well-defined and certain disorders or dysfunctions that effect large proportions or large numbers of people. And on that question, there's huge controversy. There are sex researchers who do not like the word dysfunction—it can imply that millions of healthy women who are adapting to life circumstances, but have some sort of dysfunction or malfunction. Yet there may in fact be nothing wrong, but they are in abusive relationships or they don't like their partner or have young children and that erodes feelings or the time needed to work on a relationship.