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Women's sexual health deserves equal attention
By Laura Berman
22 November 2004
A recent study found that a heart medication reduced the death rate among black patients, while whites saw no benefit. With this finding, the national dialogue exploded. By proving success in an exclusively black population, the drug's maker has virtually guaranteed approval by the Food and Drug Administration. Some medical ethicists say whites were left behind, while others contend there's nothing wrong with race-tailored medication.
No such ripples are felt when similar disparities between men and
women surface — and
that's a shame. The flawed idea that what's true for men is also
true for women is leaving women on the fringes of one of medicine's
most promising new frontiers: sexual health.
Since the FDA approved Pfizer's Viagra
for men in 1998, we have witnessed a revolution in the treatment
of male sexual dysfunction. Six years later, the 43% of American
women who suffer from sexual
dysfunction still lack an FDA-approved medication.
At a time when the medical community is debating race-specific research, it's also time to rethink the way we evaluate female sexual health and give women the medical treatments they require.
Right step for women
Procter & Gamble recently took a positive step with a testosterone patch for women. While testosterone use was approved for men in 1953, doctors have prescribed it off-label for years to help women. In clinical trials, Intrinsa has been proved effective at boosting libido. The FDA has fast-tracked it, and, if successful, it will be the first prescription medication developed to treat women's sexual dysfunction.
Even so, this drug would benefit only about 30% of the women suffering from sexual dysfunction. Yet 90% of men with erectile dysfunction respond successfully to Viagra. Why does this matter? Because the easier path to huge profits for drug companies comes by treating men.
Viagra generates nearly $2 billion in annual sales; Cialis and Levitra add another $1 billion. Experts forecast a $7 billion market by 2007. With such revenue, most pharmaceutical companies consider treatment for women an unworthy risk because it will never match the one-hit-wonder model.
In addition to low sexual desire, women also can have problems with arousal, orgasm and pain. Men can, too. The difference is that men's dysfunction most often comprises physically based problems that respond well to treatment. Women's problems are more complicated, often tethered to emotions as well as physical causes.
What it means to you
Unfortunately, it looks as though health care's male-heavy research model is continuing right into our bedrooms. Several studies, including one by Pfizer, have reported that Viagra is not effective at improving women's sexual function.
One major flaw of these studies, though, is that they lump together women who have emotionally and physically based sexual dysfunction. A study I helped design found that Viagra did produce significant improvements in arousal and satisfaction. The difference: My study screened out emotional causes.
Pharmaceutical companies are taking the most lucrative path in seeking solutions. The FDA, however, serves a broader public purpose and, thus, has no such excuse.
The FDA has compounded the problem of treating female sexual dysfunction by setting male-defined outcome measures for drug treatments. For instance, a drug is considered effective if it produces a statistically significant increase in sexual satisfaction through orgasm. This model works for men, but not for women (where intimacy must be part of the equation).
If the FDA doesn't know how to appropriately gauge the problem, how are women ever going to receive effective treatments?
Women's sexual health may not fit the same model as men's. Knowing that, pharmaceutical firms should target women's problems just as aggressively as men's. And the FDA should adapt to better reflect what's working and what isn't.
Though women may be more complicated, our sexual health deserves as much attention as men's. At the very least, it merits the same debate that race is currently stirring up within the medical community. Gender is as important as race when it comes to what ails us and what, ultimately, will heal us. Let's hope prescriptions everywhere will one day reflect that.
Laura Berman is director of the Berman Center, a women's sexual health facility in Chicago.
source :-http://www.usatoday.com
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