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THE ‘PINKING’ OF
VIAGRA CULTURE:
DRUG INDUSTRY
EFFORTS TO CREATE
AND REPACKAGE SEX
DRUGS FOR WOMEN
Hartley, Ch. 23, pp. 287-296
FEMALE SEXUAL DYSFUNCTION
 With the success Viagra-like drugs for men, women's sexual
problems have become medicalized just as men's were – defined
and understood as a largely physiologically based set of
conditions called female sexual dysfunction (FSD)
2 MAIN STRATEGIES OF DRUG
INDUSTRY
1.
a search for a Pink Viagra to treat the "disease" of FSD,
shifting from products to treat arousal problems to those
targeted at desire problems
2.
the increasing promotion and normalization of off-label
uses of men's sex drugs for women
INFLATED EPIDEMIOLOGY AND
THE INSTITUTIONALIZATION OF FSD
 In pursuing these strategies, the pharmaceutical industry has
relied on inflated epidemiology and the institutionalization of
FSD
INFLATED EPIDEMIOLOGY:
Widespread dissemination of disease prevalence estimates,
namely the '43-31' study, which found that more than 4
out of 10 women (43%) have sexual problems, a rate of
dysfunction higher than that of men (31%)
 Even the author of the original study himself has gone on
record saying the findings were misappropriated to
promote the medicalization of sexual problems

THE INSTITUTIONALIZATION OF FSD

FSD has become institutionalized in academic circles. Key
events in institutionalization process:
1.
Development of systems of disease classification amenable to
medical approaches
2.
Creation of a legitimized infrastructure for disseminating
supporting research and education
3.
Formation of an attendant professional organization
4.
Establishment of an appropriate medical specialty
INSTITUTIONALIZATION
 Widely used term in social theory to denote the process of
making something (e.g., a concept, social role, particular
values or norms, or modes of behavior) become embedded
within an organization, social system, or society as an
established custom or norm within that system
STRATEGY I: SECURING FDA APPROVAL
FOR A WOMEN'S SEX DRUG
 At least 7 drug companies are developing testosterone
products for women
 When Viagra trials for women failed, there was a shift in the
definition of FSD, from an arousal problem to a desire
problem
STRATEGY II: OFF-LABEL PRESCRIBING OF
MEN'S SEX DRUGS TO WOMEN
 While none of the existing ED drugs have been sufficiently
tested and proven for use in women, increasingly women
are given off-label prescriptions for them and now
approximately 1/5 of all the prescriptions of testosterone
products approved for men are actually written (off-label)
for women
 Off-label prescribing is now seen as a way to circumvent the
(time-consuming and expensive) FDA-approval process
altogether in some cases
THE BERMANS: A CASE STUDY IN THE
COMMERCIALIZATION OF FSD
 Sisters, Laura Berman, PhD (sex therapist) and Jennifer
Berman, MD (urologist)
 Used crossover appeal to leave academia for profit-driven
commercial sectors
 Built a multimedia company specializing in women's health,
particularly in the treatment of FSD
 Offer "quality care in a spa-like high-end environment“ that is
expensive and usually not covered by health insurance
 Claim approach combines strengths of psychotherapy with benefits
of medication, but ultimately give preference to biomedical
perspective
NUTRACEUTICALS
 Currently the only FSD products widely advertised are
those from the OTC herbal/botanical/dietary supplement
market that do not fall within the FDA's jurisdiction
 Two most visible products are Avlimil and Zestra - the
marketing platforms for both products attempt to make them
seem like prescription drugs