Education And Debate

The making of a disease: female sexual dysfunction

BMJ 2003; 326 doi: http://dx.doi.org/10.1136/bmj.326.7379.45 (Published 04 January 2003) Cite this as: BMJ 2003;326:45
  1. Ray Moynihan, journalist (raymond.moynihan@verizon.net)
  1. Australian Financial Review, GPO Box 506, Sydney 2201, NSW, Australia
  1. Correspondence to: R Moynihan, 4/1312 21st Street NW, Washington, DC, 20036, USA

    Is a new disorder being identified to meet unmet needs or to build markets for new medications?

    The corporate sponsored creation of a disease is not a new phenomenon,1 but the making of female sexual dysfunction is the freshest, clearest example we have. A cohort of 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. The most recent gathering, featured Pfizer as chief sponsor and Pfizer-friendly researchers as chief speakers. The venue? The Pfizer Foundation Hall for Humanism in Medicine at New York University Medical School.

    Since the launch of sildenafil (Viagra) in 1998, more than 17 million men have had prescriptions written for it as a treatment for erectile dysfunction, with Pfizer reporting sales in 2001 of $1.5bn.2 The emerging competitors, Bayer's vardenafil and Lilly-ICOS's tadalafil, are likewise expected to have annual markets in excess of $1bn each.

    To build similar markets for drugs among women, companies first require a clearly defined medical diagnosis with measurable characteristics to facilitate credible clinical trails. Over the past six years the pharmaceutical industry has funded, and its representatives have in some cases attended, a series of meetings to come up with just such a definition (table).

    Summary points

    Researchers with close ties to drug companies are defining and classifying a new medical disorder at company sponsored meetings

    The corporate sponsored definitions of “female sexual dysfunction” are being criticised as misleading and potentially dangerous

    Commonly cited prevalence estimates, which indicate that 43% of women have “female sexual dysfunction,” are described as exaggerated and are being questioned by leading researchers

    Controversy surrounds current attempts to medicalise sexual problems and establish “normative data” for a range of physiological …

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