Low Female Sexual Desire, the FDA and Big Pharma

Low sexual desire, pink viagra, big pharmaLow female sexual desire has been in the news for weeks—months. The issue is complex, involving women who genuinely have little or low sexual desire, the pharmaceutical companies who claim to ‘have a pill for that’, and the FDA. I attended the recent FDA hearing on female sexual dysfunction via webinar in October.

I want to tread lightly here and be sensitive to the legitimate challenges many women are experiencing around sex and desire. This article is not about the women—it is about our culture and those who seek to profit from creating a new disease, conveniently associated with a pill developed to fix that disease.

I want to share a few thoughts about the webinar I listened in on. First of all, I was approached by public relations firms about the webinar. Edelman, reached out with information on low female sexual desire and invited me to attend a seminar and the webinar. I am assuming this flurry of attention was due to my writing a less than positive review of the topic, specifically the drug Flibanserin being developed by Sprout Pharmaceuticals.

I noticed a couple of things as I listened in:

  • The vast majority of the women speaking/attending seem to have been sponsored by Veritas, a PR company (?) through a grant from Sprout Pharmaceuticals to transport all these women to the FDA hearing. Each speaker was required to disclose any affiliations that might indicate a conflict of interest. Sprout Pharmaceuticals is the drug manufacturer seeking approval for its drug, Flibanserin, which is supposed to ‘fix’ low sexual desire.
  • A big focus on having orgasms and satisfying their husbands (attendees term, not mine).
  • Many of the women’s statements contained enough similar phrases for me to assume they were coached.
  • And, many of these women expressed genuine sadness or anger around their inability to feel sexual desire. The issues are legitimate, the pharmaceutical intervention and manipulation less so.

 

One of the scripted comments I heard on the webinar and is prominent in most of the articles pushing for FDA approval was the statement that men have 26 drugs for sexual desire—and women have none. That number must include the various generic versions of the 3 major erection-producing drugs, Cialis, Viagra and Levitra. It’s a clever maneuver. But totally irrelevant. The ED drugs don’t fix sexual desire-they help make erections possible—stronger and longer lasting.  Desire and physical arousal is still required for a man to get an erection. Women don’t have a similar genital issue or solution—unless we want a drug that sends more blood flow to the clitoris.

Sexual desire, a lack of interest, no wish to initiate, inability to orgasm, and numbness—none of these things can be fixed with a pill for low sexual desire. And any television ad, medical professional, or paid blogger who tells you otherwise is acting on behalf of the massively profitable drug industry in the United States. This is about money. This is about conditioning women to think of their complex physiological, emotional, and relationship issues as something that can be eradicated by pharmaceuticals–just like the push to medicalize menopause, a condition women have experienced since the beginning of time.   In 2013 HRT drugs for women in menopause brought in almost $3 billion alone. Don’t kid yourself that this is all a benevolent push by the pharmaceutical guys and the medical doctors and researchers. This wonder pill, Flibanserin, was developed to coincide with the creation of a new disease, Female Sexual Dysfunction. Make a product-create a need for that product. Marketing.

I like what Margery Gass, the executive director of the North American Menopause Society has to say about the female sexual libido, “…[She] sees things differently. Of the 30 to 40 percent of women who complain of low libido, the solution is often not medical, she says, explaining that the issue may owe to an unhealthy relationship or a simple discrepancy in sex drive. “A lot of things are just turnoffs to people that they don’t want to admit to – they think I should love this person anyway. We know that women’s on-and-off switch for sex and sexual desire is more complicated than men’s … Women typically want aspects of the relationship to be good on many levels before they have much desire towards that person,” she says, noting that this is “not always the case for men.”

Emily Nagoski talks about nonPharma treatments in her article, What Works to Increase Women’s Sexual Desire, an excellent article that speaks to the medicalizing of women’s low sexual desire.

A conversation about approving a new medication for low female sexual desire needs to address these topics:

  • Most doctors are reluctant to discuss sex with their female patients.
  • We don’t have proper sex education at any age–leaving women uncertain about their bodies, their anatomy and their desire.
  • Intercourse is the primary vehicle for sex in this country. Most women cannot orgasm through intercourse alone.
  • Women are not encouraged to talk about sex, to express joy or desire. Shame is often heaped on women who openly embrace sex.
  • The complexity of female genitalia as compared to the male penis.

 

I struggled with the writing of this article. There is much that is wrong about the hold the pharmaceutical industry has on us. This is a delicate topic—this distress women feel at a loss of sexual desire. I just don’t think a pill is the answer. As I noted above there are many things to be considered in discussing low sexual desire—none of which would put cash in the pockets of pharmaceutical companies. It’s not in their best interest to encourage alternative means to solving the low female sexual desire issue.

As I read and researched I found many articles speaking to this topic—all in a similar vein. It’s hard to share the opposite point of view when many of those voices have a monetary connection to the pharmaceutical companies—it taints their point of view, in my opinion. So, I’m not going to share those.

 

After listening in on the FDA hearing I’m less convinced that low sexual desire is a medical disease that needs a pill. What I heard there, and from my readers/clients, is dissatisfaction, faulty communications and a penetrative, intercourse driven approach to sex. I didn’t get a sense that the conversation was about helping women learn to develop their own personal desire or work to strengthen relationships. When desire is equated with having an orgasm or satisfying a man we’re talking about societal and relationship issues, not a disease. When we talk about pleasure as being only about orgasm we’ve reduced sex in its most narrow definition–anything less is a failure and that notion alone is enough to bring about stress, anxiety and avoidance.

There really isn’t a pill to fix everything that ails us, even if the wealthy, greedy pharmaceutical companies want us to believe there is.

 

 

Q&A: Single with a STD

 

sexuality, STD, STI, herpes,Dating with Herpes

Walker, I am 63 and about to be single again. I have had herpes since I was 25 and always told my partners. I am terrified that no one will want to be with me. Do you know the attitudes of seniors towards herpes. I haven’t had symptoms since I had the shingles vaccine, an ironic coincidence.

Thanks….Annis

This is an great question, particularly as I’ve just starting writing for My LabBOX, an at-home testing kit business and the American Sexual Health Association (ASHA). Both of these groups are working to inform men and women about sexually transmitted diseases, safety and sexual health. During Sexual Health Awareness Month the ASHA talked about various initiatives, one of which is Boomer Sexual Health. Annis’s (not her real name) question involves STDs among boomers and reflects the normal trepidation most single people feel upon reentering the dating game.

Annis has always taken a proactive approach to her STD by informing potential partners–and has found partners who understood how to manage the risks, as a couple, in order to have a safe, sexy relationship. As she approaches being single and dating again she has concerns about how an older individual might feel about herpes.

I love what the ASHA says about this:

In the grand scheme of things, genital herpes is an inconvenience for most couples—nothing more than that. Keep this fact in mind and keep your language positive. Your attitude will also have a lot of influence on how the news is received. If you are positive and upbeat, it’s more likely your partner will adopt the same attitude. Try not to let the anticipation of a possible negative reaction affect the delivery of your message.

Annis, I would like to think that many older adults are having open conversations about STI/STDs and taking the necessary steps to protect each other. Awareness and the right mix of caution and precautions (condoms, medications, abstaining during flair ups) can create safer conditions for having sex.  The new partner who automatically dismisses you due to the herpes isn’t the right person for you. He or she would be making a decision based on fear and prejudice rather than working to build trust and intimacy.

Some statistics:

  • It is estimated that as many as one in five Americans have genital herpes, a lifelong (but manageable) infection, yet up to 90 percent of those with herpes are unaware they have it.
  • With more than 50 million adults in the US with genital herpes and up to 776,000 new infections each year, some estimates suggest that by 2025 up to 40% of all men and half of all women could be infected.   (ASHA)

 

The dating game isn’t easy at any stage and sharing your herpes status might make things tough. I’m not sure that singles in their 60s are any less knowledgeable or tolerant of STDs than younger individuals. There is a strong likelihood that some of the single people you will meet also have a sexually transmitted infection.

I recommend that you wait to disclose your personal information until the first date, or maybe the second. Give yourself enough time to see if you want to go farther with this person and then have the conversation. As you have probably done in the past, be prepared with resources for partners and a willingness to answer questions. There’s no point in telling him/her before you know if you want to continue dating this person—but don’t wait so long that it looks like you were hiding something.

Timing can be a touchy situation—you might want to talk about STDs as part of the larger conversation about sex. Will you both get tested? How long to wait before having sex? You will want to talk about your wants and needs and other aspects of a sexual relationship that are important to you. Take time to listen to the other person’s concerns as well. If the reaction is negative, you can walk away knowing that you did the right thing, acting with honesty and integrity.

Best to you as you navigate the dating world again.

 

Additional Articles and Resources:

image: Hotblack at Morguefiles

Male Sex Writers- An Interview with Dr. Stephen Snyder

American society always had a double standard when it comes to sex and men.  And, it applies to the world of sex writing as well—though in this case it’s reversed. In real life men have sex when they want and women are not expected to actively seek out sex. In writing we rarely see men openly discussing sexual pleasure or sharing their thoughts and experiences. Why are most of the voices talking about sex women? Is it because we’re just naturally talkative or is it something deeper? sex writers, sex therapist

With this idea in mind I asked Dr. Stephen Snyder to talk about this topic with me. Dr. Snyder is a psychiatrist with a specialty in sex therapy. He practices in New York City and writes for his own blog and on PsychologyToday

Dr. Snyder, why do you think men are reluctant to write about their sexuality and thoughts on sex?  You suggest that one reason might be how we view men–as predators.  And, having been raised in the era of “watch out for men…protect yourself…they only want sex…” I understand that rationale.

A really revolutionary article came out in the June 2014 journal Nature Methods—not that I routinely read Nature Methods, but it was big enough news to make The Washington Post, and then on to twitter.

A series of ground-breaking experiments in mice showed that the mere presence of a male OF ANY SPECIES STUDIED—humans, rats, guinea pigs, cats, and dogs, as well as unfamiliar mice—was enough to cause anxiety in laboratory mice.  The researchers showed that this effect was mediated through scent. The scent given off by males of a variety of mammalian species just seemed to make mice more anxious.

Now of course it’s risky to cross species lines, but this study just makes so much intuitive sense.  People naturally feel less threatened by women than by men—both sexually and otherwise. I think this gives female sex writers much more latitude in expressing themselves.  I do find now that I’m approaching sixty years old, though, that women are more relaxed in my presence.  I have female patients whom I’m pretty sure would not have felt comfortable being in treatment with me when I was 35.

 

What if one of the ways to defuse the tension and misunderstanding about men as predators was to encourage men to be more honest about their sexual experiences? Wouldn’t we hear a more balanced view?

Men are often quite insecure sexually.  But it’s different.  As a generalization, women tend to be insecure about their power to attract.  Men worry about their ability to perform.  

 

There are really two kinds of sex writing–the personal exposition and the sex education writing? Agreed? Jon Pressick, the man with the classic pin-up pose writes and curates content on a wide range of sexually related topics. A good portion of his content falls in the category of sex education. In that instance it would seem less threatening for men to write about sex–and yet we don’t see men going there–maybe a few academic types but there isn’t much in between.

It’s more culturally acceptable for women to revel in pleasure, including sexual pleasure.

“Oh my God that sex toy was wonderful.  I came so hard with it.” That sounds great when a woman says it.  

But imagine a man saying it.  It doesn’t sound right.  It sounds icky.

We’re very funny about men experiencing pleasure for its own sake.  And DEFINITELY funny about men masturbating.  Female sex writers these days write endlessly about their masturbation.  Betty Dodson made a video of women masturbating called “Self-Loving Divas.”  No one will ever call a masturbating man a “self-loving diva.”  It just doesn’t happen.  

Men are supposed to work hard, compete, serve, and achieve great things — not revel in the delights of their bodies.

A certain male sex writer once posted an image of himself nude by a roaring fire in a fireplace, holding a glass of wine.  I was impressed. I figured he must be a really evolved human being.  But still it just felt odd.  After all, women are supposed to luxuriate naked in front of fires.  Men are supposed to be out chopping the wood!

It’s fine if as a doctor I write about sex.  That’s an acceptable male role.  It has the connotation of “work.”  But my thoughts on the subject wouldn’t be of much interest to anyone otherwise.  Women are the natural guardians of sexual space.

 

It’s hard for me to agree with the idea that women ‘own’ sex given that so many female writers report being attacked or shamed, called bad names, and taunted for being open about sex. No man is ever put down by his tribe, or our society, for being sexual—in fact it is expected. In a room of 100 women probably less than 10% would say they owned sex–we don’t have that understanding of heterosexual relationships. I think the increase in female sex writing is a positive thing. To talk openly about masturbation when so many women have felt shame about it (as have men) and been unable or unwilling to get in touch with their bodies–this is a healing process. We assume men masturbate. That’s not an assumption we have about women.

You’re right.  A man who wrote openly about sex wouldn’t get “slut-shamed.”  He might just be ignored.

In the sex therapy world, where the majority of the professional community is female, a man is a member of a minority that’s seen as potentially dangerous.  To be accepted in the female-centered world of sex therapy professionals, he must avoid spontaneous expressions of sexual feeling.  His female colleagues don’t have to constrain themselves in this way.  A woman at a sex therapy meeting could say, “yes, that really turns me on,” and that spontaneous expression of sexual feeling might be accepted and even celebrated.  I believe that for a man to admit that something in the moment really turns him on would not be so accepted, and would certainly not be celebrated.

 

You point out that we celebrate female sexuality but not male. I think you are correct and I’m saddened by that. The ability to accept and encourage male expression of sexuality would go a long way towards lessening the idea of men as predators–if “we” can sit with our discomfort long enough to find acceptance. What do you think?

Women sex writers go on at length about their sexual feelings. And they appear on their blogs and on twitter in all sorts of suggestive poses.  Male sex writers don’t do that.

 

Why is that? Are women overcompensating and overexposing themselves as they try to ‘catch up’ in a world where men have always been acknowledged as having sexual desire?  And, why is it that we feel so squeamish about men writing about sex when we’ve accepted for centuries that men enjoy sex? Is there another double standard that applies to the written word?

It may be less of a stigma for a man to admit sexual desire, but it would be more of a stigma for a male sex therapy professional to write about desire. As I mentioned above, male desire tends to be seen as uncomfortable and potentially dangerous—unless it’s directed by a particular man towards a particular woman who’s interested in being desired by him—in which case it’s permitted. But only then.  

 

Dr. Snyder and I didn’t reach any conclusions about why there are so few male sex writers or the challenges for men in expressing their sexuality. I’d love to hear your thoughts, particularly my male readers.

Finding My Way-My Journey as a Sex Writer

This is my most recent article for Midlife Boulevard, sharing about my recent award and giving readers a glimpse at why and how I find myself writing about sex.

A Sex Writer’s Personal Journey

Sex writers and educators spend a lot of time thinking about sex, reading and practicing their craft. My journey to becoming a sex writer began with “write what you know”. What I knew was how it felt to be in my 50s, trying to find the sexual me who had gotten lost along the way.

Journey to Sexual Pleasure

Last week Kinkly’s 2014 Top 100 Sex Blogging Superheroes  were announced–I am ranked #5!  A “sex guru for the over-50 set – and an inspiration to the younger sex positive crowd”. I’m pretty pumped and humbled. I want to say that it was all my doing but you helped as well. You gave me material to write about, you gave me support, and when I reached out to ask for your votes you did so. Thank you.

It’s absurd to think that older adults aren’t interested in sex. The needs of women in the menopausal phase of life differ from those of a 25-year-old. There are some age-neutral issues around sexuality, but older women have very specific needs and want to hear from someone who understands their issues. Right?  Blanket statements about who we are as midlife and older women just serve to reduce us. We are unique; we defy categorization. Suffice it to say that not everyone has the same sex drive and that’s absolutely fine. Regardless we should consider our sexual health. In my first article for Midlife Boulevard I shared my definition of sexual health.  And, I will continue to talk about the importance of paying attention to our bodies as we age.

I want to share how I reclaimed my sexuality—it explains why I feel that sex writing and education is so important.

I had marginal sex for a number of years as my marriage deteriorated. In that last pre-divorce year I declared myself “done with sex”. My self-esteem and my sexual self had suffered from those years of Charity Sex. Call it a coping mechanism, or call it keeping the husband happy. I failed to place my own needs ahead of those of my spouse. My unhappiness with the marriage came before the sexual dissatisfaction but they became entwined and even though I made a choice, it wasn’t a smart one. A choice that shut me down bodily and emotionally.

By the time I was separated and ready for an intimate connection I was no longer in tune with my body. I was going through the motions,  even a little self-pleasuring. But I wasn’t feeling desire. I wasn’t turned on in sexual encounters because I had faked it for so long.  I couldn’t reconnect to feelings of sexual pleasure. It was difficult to stay focused on my body when having sex; there was little arousal and even less orgasming. I was doing all the right things—for them—but not for me. It was the difference between having sex and being an active participant in sex.

Good sex requires that we be aware of our needs, our bodies and our sexual preferences. If we don’t know what we need and don’t know how to communicate that how will we get our needs met? Why have sex if there’s no pleasure? Isn’t that akin to disregarding our own personal integrity? That’s what happened to me, upon reflection.

One component of sexual health involves taking ownership of one’s body and sexuality. As I began dating I also began writing about my experiences. Once I began writing about dating and sex I saw a great need for these kinds of articles and conversations.  Midlife individuals were reaching out to me, sharing their stories and asking questions. And a sex writer was born. It started with my own work to regain sexual awareness and desire. Then, about four years ago I began exploring my own capacity for sexual pleasure. I became more in touch with my body which led me to become more engaged with partners. I was finally able to embrace my body and proclaim my sexual needs.

My goal as a sex writer and educator is to help you find the information and resources to maintain and enhance your sexual needs. To help you sharpen your sexual skills in order to develop greater pleasure and intimate connections with partners. Just as in couples sex there is giving and the receiving, as a writer I feel a similar pleasure in knowing you have received something from my words and experiences. Thank you.

This article was originally published on Midlife Boulevard.