Intended for healthcare professionals

Rapid response to:

Education And Debate

The marketing of a disease: female sexual dysfunction

BMJ 2005; 330 doi: (Published 20 January 2005) Cite this as: BMJ 2005;330:192

Rapid Response:

Re: It is not only Big Pharma that says that female sexual dysfunction exists

Ketan may wish to re-read some of the papers cited in his letter.

Many researchers assessing sexual functioning are concerned about the
way in which female sexual dysfunction is being constructed.

Measuring dysfunction doesn't mean that researchers don't have
concerns about how female sexual dysfunction is being overmedicalised, at
the expense of social and cultural factors affecting men and women.

Estimates that women's sexual dysfunction levels are in the region of
40% have also been criticised, given women may report what a
questionnaire study defines as a 'dysfunction', but they don't report
being unhappy with their relationships.

In our paper (Nazareth, Boynton and King) which Ketan sites, we said:
"Much less is known about sexual difficulties in women, and criticism has
recently been expressed about the involvement of the pharmaceutical
industry in "building the science of female sexual dysfunction."20
Although the results of a British population study of women accord with
our findings,21 a woman centred definition of sexual problems has recently
been preferred to concepts of sickness and health.19 20 The word
dysfunction implies a state of "disease" that needs rectification. Our
data indicate, however, that sexual dysfunction cannot be considered as
one generic problem. Dyspareunia, vaginismus, reduced arousal, and
aversion to sexual contact were uncommon problems and were associated with
other psychological and physical difficulties. Women with these ICD-10
diagnoses were also much more likely to have consulted their general
practitioners about sexual matters than women who received a single
diagnosis of lack or loss of sexual desire. This suggests that many people
do not regard lack or loss of sexual desire as a serious difficulty".

Overmedicalising women's sexual functioning, ignoring other factors,
and specifically quoting high levels of female sexual dysfunction out of
context, is not helping women, or their partners.

Competing interests:
I have completed research on sexual functioning.

Competing interests: No competing interests

25 January 2005
Petra M Boynton
Non clinical lecturer in international health care research
University College London