Female sexual "disease", depression, and drugs -- A toxic syndrome?
FEMALE SEXUALITY - A TIMELESS PROBLEM
The British Medical Journal (BMJ) expose [1] on
the role of pharmaceutical companies in defining female sexual dysfunction
as a DISEASE has triggered controversy about a problem dating back 4000
years in medical corpus [2]. The fact that common female "neuroses" have
been caused by the failure of intercourse to provide orgasm for women has
been an enigma of gender relating from past to present. The cover story
"No sex, please, we're married"
in a recent issue of Newsweek magazine [3] blames the problem on "stress,
kids, and work." But one married
woman ponders, "[M]aybe, it's all those libido-dimming antidepressants
we're taking." Her question may reflect
a morbid syndrome that has obscured the real problem and created
additional ones. Neither the BMJ nor the Newsweek article addressed the
most timeless problem of female sexuality and new researches that have
been effective
in "treating" the problem.
AN HERSTORIC OVERVIEW
In a landmark book "The Technology of Orgasm" (1999), Rachel P.
Maines documents the problem of female sexual frustration dating back to
400BC with Hippocrates masturbating women for "hysteria." [4] Maines
recounts
that next to fevers, the greatest part of a physician's caseload consisted
of women suffering from lack of sexual satisfaction. Female orgasm
invoked by treatment modalities like hand massage, hydrotherapy, and
electrotherapy was called "paroxysm" so that women's frustration would not
embarrass men; it was more expedient to burn women as witches than to cope
with them as sexual beings. Maines' chapter 1, "The job nobody wanted,"
documents how weary husbands passed the woman's sex problem on to
physicians,
who passed the job on to midwives. The invention of the vibrator was a
major medical innovation that cut the time
of treatment from an hour to 10 minutes - a practical solution, for
physicians.
WHAT DOES A WOMAN WANT?
In his quest to solve the sex-related problem
of female "hysteria," Sigmund Freud (1925) envisioned
the function of coital orgasm as a regulatory mechanism essential for
mental health. He used the term "actual neurosis" to classify common type
of neuroses caused by frustration from typical "failed" intercourse -- a
problem that could not be solved by psychoanalysis (pp. 25-26). [5] The
etiology of failed intercourse--not clear to Freud--is clearly defined by
historian Rachel Maines, a woman: "[P]enetration unaccompanied by direct
stimulation of the clitoris is an...ineffective way to produce orgasm in
women" (Chapter 5, "Revising the androcentric model", p. 115). [4] That
simple description of coitus in the standard missionary position explains
why Freud's patients never succeeded
at the goal of "vaginal" orgasm.
CONFUSING THE SYMPTOM WITH THE CAUSE?
If classic female sex problems--loosely termed "hysteria" and
"frigidity"--were so widely recognized throughout medical history, how is
it possible that in recent decades the sex problems suddenly "disappeared"
from view? A most common symptom of sexual dissatisfaction
for women has always been DEPRESSION. The May 2003 issue
of "Contemporary Sexuality" (Newsletter of the American Association of Sex
Educators, Counselors and Therapists) contains the article "Medication
induced sexual dysfunctions associated with treatment of depression" that
poses a logical question about the relationship between depression and
sexual dysfunction. [6] Author, Gordon Dickman ponders: "Which came
first? Was the client depressed and that resulted…in sexual concerns…?"
Or, he probes, "were they experiencing [sexual problems] and then became
depressed
as a result of that?"
ANTIDEPRESSANTS - THE UP, AND THE DOWN
Have decades of drug use obscured the origin of the problem? In his
expose "Prozac Backlash," Joseph Glenmullen (2000) [7] recounts that "the
first potent antidepressants of the modern era were cocaine elixirs,
introduced in the late 1800s". They were "prescribed for everything from
depression to shyness, just as the Prozac group are today." Glenmullen
elaborates, "Freud wrote three famous 'cocaine papers' advocating the
drug's use. Since cocaine elixirs, we have had numerous amphetamines,
bromides, barbiturates, narcotics, and tranquilizers, all hailed as
miracle cures until their dangerous side effects emerged" (p. 12).
Beyond describing side effects of Prosac type drugs that characterize
brain damage, Glenmullen challenges the accuracy of data on side effects
presented by pharmaceutical companies -- "While systematic studies have
shown that 60% of patients on serotonin boosters suffer from severe sexual
side effects, Eli Lilly's official figure is just 2-5%"
(p. 22). (Eli Lilly is the manufacturer of Zoloft,
Paxil, and Luvox.)
Dr. Glenmullen cautions, "Future generations
may well look back on the last 150 years as a frightening
human experiment" (p. 24). In 1998 more than 60 million prescriptions for
serotonin booster type antidepressant drugs were written (p. 15).[7]
Newsweek reported the prescription rate was up to 200 million in 2002. [2]
Sex researchers and health providers must now consider that a morbid
syndrome that has been touched off by drug treatment for classic symptoms
of female sexual dissatisfaction.
PHARMACEUTICAL ENGINEERING - A TOXIC SYNDROME?
Historically marriage had been the prescription
for female sex-related problems, but Freud's coauthor Joseph Breuer (1893)
[8] noted that "the great majority of severe neuroses in women have their
origin in the marriage bed"
(p. 246). From that standpoint the following syndrome is evident:
(a) Originally, the most common female neuroses were
caused by the failure of intercourse to provide orgasm
for women (resulting in an incomplete response for men as well). As
stated by Freud (1925), "The symptoms [such as depression]...must be
regarded as direct toxic consequences of disturbed sexual chemical
processes" related to intercourse (p. 26) [5].
(b) Currently, the Prozac type drugs used to treat depression cause
loss of sexual desire.
(c) The loss of sexual desire from antidepressants
has provoked research for new drug solutions, such as
a female-type Viagra to increase sexual arousal. But,
at best, drug induced arousal will enable couples to recommence the sex
act in the same archetypal manner
that has caused depression and other sex-related problems historically.
Finally, in this syndrome the biological regulatory mechanisms of the body
are no longer functioning normally -- pharmaceutical engineering replaces
natural body function.
FREUD'S VISION - "A SPECIFIC...ACTIVITY"
The research finding of a natural physical
alignment that makes female orgasm possible in coitus
--and has resulted in high frequency of simultaneous orgasm--has been
replicated by studies (Pierce, 2000)[9] reporting success in the treatment
of hypoactive sexual desire, a common problem that has dumbfounded sex
therapists [10]. Research on the technique and anatomy of "coital
alignment" (Eichel, et al., 1988) [11] was motivated by
a visionary part of Freud's theorizing that was largely ignored in his
lifetime.
In describing the ideal of coital orgasm, Freud (1894) [12] alluded
to "a SPECIFIC or ADEQUATE ACTIVITY" consisting of "a complicated spinal
reflex act resulting
in relief of the tension at [the] nerve-endings...and in
all the preparatory psychical processes necessary to induce this reflex"
(italics Freud). Freud stressed that the entire process "must absolutely
be carried into operation" (pp. 97-98). He concluded, "[I]n essentials
this formula is applicable also to women..."(p. 98). That formula appears
to be dependent on the specifics of coital alignment, a basic positioning
and the coordination of sexual movement [13]. It requires that men and
women relate. No pharmaceutical treatmentcan substitute for
the human interaction that is necessary.
1. Moynihan R. The making of a disease: female sexual dysfunction.
BMJ 2003; 326:45-47.
2. Veith I. Four Thousand years of hysteria, Chapter 1
in Horowitz M (Ed.). Hysterical personality. New York: Jason Aronson,
1977.
3. Deveny K. No sex, please, we're married: Are stress, kids and
work killing romance? We're not in the mood. Newsweek (USA), 2003 June
30; 40-46.
4. Maines R P. The technology of orgasm: "Hysteria," the vibrator,
and women's sexual satisfaction. Baltimore/London: Johns Hopkins
University Press, 1999.
5. Freud S. An autobiographical study (1925). New York: W.W.
Norton, 1952.
6. Dickman G. "A role for sexologists: Helping manage medication-
induced sexual dysfunctions associated with treatment of depression.
Contemporary Sexuality 2003;
37: i-viii.
7. Glenmullen J. Prozac backlash. New York: Simon & Schuster,
2000.
8. Breuer J and Freud S (Trans. Strachey J). Studies on Hysteria
(1893-1895). New York: Basic Books, 1957.
9. Schover SR, Leiblum SR. Commentary: The stagnation of sex
therapy. J Psychology & Human Sexuality 1994; 6:5-30.
10. Pierce, A P. The coital alignment technique (CAT):
An overview of studies. J Sex Marital Therapy 2000; 26: 257-268.
11. Eichel EW, Eichel JD, Kule S. The technique of coital orgasm
and its relation to female orgasmic response and simultaneous orgasm. J.
Sex Marital Therapy 1988; 14: 129-141.
12. Freud S. The justification for detaching from neurasthenia a
particular syndrome: Anxiety-neurosis (1894). In Freud S. (Trans. Joan
Riviera) Collected Papers, Volume one. London: Hogarth Press, 1950.
13. Eichel EW. Orgasm the natural way: the coital alignment
technique (CAT). Video, version 1.0, 2001. Previewed at 15th World
Congress of Sexology
(Paris, 2001).
Rapid Response:
Female sexual "disease", depression, and drugs -- A toxic syndrome?
FEMALE SEXUALITY - A TIMELESS PROBLEM
The British Medical Journal (BMJ) expose [1] on
the role of pharmaceutical companies in defining female sexual dysfunction
as a DISEASE has triggered controversy about a problem dating back 4000
years in medical corpus [2]. The fact that common female "neuroses" have
been caused by the failure of intercourse to provide orgasm for women has
been an enigma of gender relating from past to present. The cover story
"No sex, please, we're married"
in a recent issue of Newsweek magazine [3] blames the problem on "stress,
kids, and work." But one married
woman ponders, "[M]aybe, it's all those libido-dimming antidepressants
we're taking." Her question may reflect
a morbid syndrome that has obscured the real problem and created
additional ones. Neither the BMJ nor the Newsweek article addressed the
most timeless problem of female sexuality and new researches that have
been effective
in "treating" the problem.
AN HERSTORIC OVERVIEW
In a landmark book "The Technology of Orgasm" (1999), Rachel P.
Maines documents the problem of female sexual frustration dating back to
400BC with Hippocrates masturbating women for "hysteria." [4] Maines
recounts
that next to fevers, the greatest part of a physician's caseload consisted
of women suffering from lack of sexual satisfaction. Female orgasm
invoked by treatment modalities like hand massage, hydrotherapy, and
electrotherapy was called "paroxysm" so that women's frustration would not
embarrass men; it was more expedient to burn women as witches than to cope
with them as sexual beings. Maines' chapter 1, "The job nobody wanted,"
documents how weary husbands passed the woman's sex problem on to
physicians,
who passed the job on to midwives. The invention of the vibrator was a
major medical innovation that cut the time
of treatment from an hour to 10 minutes - a practical solution, for
physicians.
WHAT DOES A WOMAN WANT?
In his quest to solve the sex-related problem
of female "hysteria," Sigmund Freud (1925) envisioned
the function of coital orgasm as a regulatory mechanism essential for
mental health. He used the term "actual neurosis" to classify common type
of neuroses caused by frustration from typical "failed" intercourse -- a
problem that could not be solved by psychoanalysis (pp. 25-26). [5] The
etiology of failed intercourse--not clear to Freud--is clearly defined by
historian Rachel Maines, a woman: "[P]enetration unaccompanied by direct
stimulation of the clitoris is an...ineffective way to produce orgasm in
women" (Chapter 5, "Revising the androcentric model", p. 115). [4] That
simple description of coitus in the standard missionary position explains
why Freud's patients never succeeded
at the goal of "vaginal" orgasm.
CONFUSING THE SYMPTOM WITH THE CAUSE?
If classic female sex problems--loosely termed "hysteria" and
"frigidity"--were so widely recognized throughout medical history, how is
it possible that in recent decades the sex problems suddenly "disappeared"
from view? A most common symptom of sexual dissatisfaction
for women has always been DEPRESSION. The May 2003 issue
of "Contemporary Sexuality" (Newsletter of the American Association of Sex
Educators, Counselors and Therapists) contains the article "Medication
induced sexual dysfunctions associated with treatment of depression" that
poses a logical question about the relationship between depression and
sexual dysfunction. [6] Author, Gordon Dickman ponders: "Which came
first? Was the client depressed and that resulted…in sexual concerns…?"
Or, he probes, "were they experiencing [sexual problems] and then became
depressed
as a result of that?"
ANTIDEPRESSANTS - THE UP, AND THE DOWN
Have decades of drug use obscured the origin of the problem? In his
expose "Prozac Backlash," Joseph Glenmullen (2000) [7] recounts that "the
first potent antidepressants of the modern era were cocaine elixirs,
introduced in the late 1800s". They were "prescribed for everything from
depression to shyness, just as the Prozac group are today." Glenmullen
elaborates, "Freud wrote three famous 'cocaine papers' advocating the
drug's use. Since cocaine elixirs, we have had numerous amphetamines,
bromides, barbiturates, narcotics, and tranquilizers, all hailed as
miracle cures until their dangerous side effects emerged" (p. 12).
Beyond describing side effects of Prosac type drugs that characterize
brain damage, Glenmullen challenges the accuracy of data on side effects
presented by pharmaceutical companies -- "While systematic studies have
shown that 60% of patients on serotonin boosters suffer from severe sexual
side effects, Eli Lilly's official figure is just 2-5%"
(p. 22). (Eli Lilly is the manufacturer of Zoloft,
Paxil, and Luvox.)
Dr. Glenmullen cautions, "Future generations
may well look back on the last 150 years as a frightening
human experiment" (p. 24). In 1998 more than 60 million prescriptions for
serotonin booster type antidepressant drugs were written (p. 15).[7]
Newsweek reported the prescription rate was up to 200 million in 2002. [2]
Sex researchers and health providers must now consider that a morbid
syndrome that has been touched off by drug treatment for classic symptoms
of female sexual dissatisfaction.
PHARMACEUTICAL ENGINEERING - A TOXIC SYNDROME?
Historically marriage had been the prescription
for female sex-related problems, but Freud's coauthor Joseph Breuer (1893)
[8] noted that "the great majority of severe neuroses in women have their
origin in the marriage bed"
(p. 246). From that standpoint the following syndrome is evident:
(a) Originally, the most common female neuroses were
caused by the failure of intercourse to provide orgasm
for women (resulting in an incomplete response for men as well). As
stated by Freud (1925), "The symptoms [such as depression]...must be
regarded as direct toxic consequences of disturbed sexual chemical
processes" related to intercourse (p. 26) [5].
(b) Currently, the Prozac type drugs used to treat depression cause
loss of sexual desire.
(c) The loss of sexual desire from antidepressants
has provoked research for new drug solutions, such as
a female-type Viagra to increase sexual arousal. But,
at best, drug induced arousal will enable couples to recommence the sex
act in the same archetypal manner
that has caused depression and other sex-related problems historically.
Finally, in this syndrome the biological regulatory mechanisms of the body
are no longer functioning normally -- pharmaceutical engineering replaces
natural body function.
FREUD'S VISION - "A SPECIFIC...ACTIVITY"
The research finding of a natural physical
alignment that makes female orgasm possible in coitus
--and has resulted in high frequency of simultaneous orgasm--has been
replicated by studies (Pierce, 2000)[9] reporting success in the treatment
of hypoactive sexual desire, a common problem that has dumbfounded sex
therapists [10]. Research on the technique and anatomy of "coital
alignment" (Eichel, et al., 1988) [11] was motivated by
a visionary part of Freud's theorizing that was largely ignored in his
lifetime.
In describing the ideal of coital orgasm, Freud (1894) [12] alluded
to "a SPECIFIC or ADEQUATE ACTIVITY" consisting of "a complicated spinal
reflex act resulting
in relief of the tension at [the] nerve-endings...and in
all the preparatory psychical processes necessary to induce this reflex"
(italics Freud). Freud stressed that the entire process "must absolutely
be carried into operation" (pp. 97-98). He concluded, "[I]n essentials
this formula is applicable also to women..."(p. 98). That formula appears
to be dependent on the specifics of coital alignment, a basic positioning
and the coordination of sexual movement [13]. It requires that men and
women relate. No pharmaceutical treatmentcan substitute for
the human interaction that is necessary.
1. Moynihan R. The making of a disease: female sexual dysfunction.
BMJ 2003; 326:45-47.
2. Veith I. Four Thousand years of hysteria, Chapter 1
in Horowitz M (Ed.). Hysterical personality. New York: Jason Aronson,
1977.
3. Deveny K. No sex, please, we're married: Are stress, kids and
work killing romance? We're not in the mood. Newsweek (USA), 2003 June
30; 40-46.
4. Maines R P. The technology of orgasm: "Hysteria," the vibrator,
and women's sexual satisfaction. Baltimore/London: Johns Hopkins
University Press, 1999.
5. Freud S. An autobiographical study (1925). New York: W.W.
Norton, 1952.
6. Dickman G. "A role for sexologists: Helping manage medication-
induced sexual dysfunctions associated with treatment of depression.
Contemporary Sexuality 2003;
37: i-viii.
7. Glenmullen J. Prozac backlash. New York: Simon & Schuster,
2000.
8. Breuer J and Freud S (Trans. Strachey J). Studies on Hysteria
(1893-1895). New York: Basic Books, 1957.
9. Schover SR, Leiblum SR. Commentary: The stagnation of sex
therapy. J Psychology & Human Sexuality 1994; 6:5-30.
10. Pierce, A P. The coital alignment technique (CAT):
An overview of studies. J Sex Marital Therapy 2000; 26: 257-268.
11. Eichel EW, Eichel JD, Kule S. The technique of coital orgasm
and its relation to female orgasmic response and simultaneous orgasm. J.
Sex Marital Therapy 1988; 14: 129-141.
12. Freud S. The justification for detaching from neurasthenia a
particular syndrome: Anxiety-neurosis (1894). In Freud S. (Trans. Joan
Riviera) Collected Papers, Volume one. London: Hogarth Press, 1950.
13. Eichel EW. Orgasm the natural way: the coital alignment
technique (CAT). Video, version 1.0, 2001. Previewed at 15th World
Congress of Sexology
(Paris, 2001).
Competing interests:
None declared
Competing interests: No competing interests