Why don’t more journalists question the 40% female sexual dysfunction estimate?

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The crescendo of news in anticipation of an FDA advisory committee’s consideration of the drug flibanserin for hypoactive sexual desire disorder or HSDD is crazy.

And few stories question the oft-cited estimate that up to 40% of women may have this problem. Why don’t they cite the source? Why don’t they explain how flimsy the evidence is for that market-boosting projection?

NBC’s chief medical editor, Dr. Nancy Snyderman, didn’t challenge it in her nightly news story last night.

[2017 Update: This NBC video is no longer available]

And while she did include a sound bite with a gynecologist skeptical about the drug, Dr. Nancy concluded:
“All eyes are on FDA on Friday as to whether women will have to continue to wait.”

Well, let’s slow down a bit. Not all eyes are unblinkingly fixated on their computer screens awaiting that FDA advisory panel’s recommendation. First, their vote doesn’t determine the FDA’s final decision. So there will be at least one more wave of news about this drug. And many of the eyes that are so trained on the news have been whipped into a frenzy by the news itself.

But the phrase “whether women will have to continue to wait” is really loaded. How many are really waiting for a drug to improve their sex life? How many are tired of having yet another antidepressant prescribed for a “female problem”? Many alleged problems of women all end up in the same place: with an antidepressant prescription.

CNN.com published a story that didn’t challenge a sexual medicine doc’s statements that: “HSDD is a horrible tragedy in women” and that this drug would be “the beginning of an era” for women, and that having a safe and effective drugs is a “unique and historic opportunity for women in the U.S. and for the FDA.”

Horrible tragedy?
Beginning of an era?
Unique and historic opportunity?

CNN didn’t challenge any of those statements.

Sex, Lies and Pharmaceuticals.jpg Let’s step outside the realm of crazy American hype and peek at what Australian journalist Ray Moynihan wrote:

“In trials on women in the US, compared to placebo, flibanserin offered women an extra 0.7 “satisfying sexual events” per month. In the trials on European women, flibanserin simply failed to beat the dummy pill. With data like that, the drug is going to need all the marketing help it can get.”

That’s data, not drama. Journalism, not disease-mongering promotion of a drug.

Moynihan is co-author of a forthcoming book, “Sex, Lies and Pharmaceuticals: How Drug Companies Plan to Profit from Female Sexual Dysfunction.”

I predict: if and when the FDA rejects this drug, there will be many stories talking about how unfairly women are being treated and how this is rationing.

I, too, may then take an antidepressant. Consider the evidence.

Addendum: As another sign of how unquestioning some news organizations are, on Twitter, @MSNBC_health retweeted this:

RT @SexBrainBody: 3 times as many women are aware of erectile dysfunction (66%) than they are of female sexual dysfunction (20%) http://znl.me/BYH-Q6 #SXBB

FYI: @SexBrainBody, and the URL have “content developed with the support of a sponsorship from Boehringer Ingelheim Pharmaceuticals, Inc.” – which is the maker of flibanserin. Gee, could the rest of us get free advertising from MSNBC that easily?


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Comments (8)

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Gary Schwitzer

June 17, 2010 at 4:43 pm

Duff Wilson of the New York Times had one of the better stories on flibanserin.
“There is also debate over how widespread hypoactive sexual desire disorder actually is among women. The medical literature, including articles in the prestigious New England Journal of Medicine, indicate numbers above 10 percent, but such studies have been financed by drug companies.
Critics say Boehringer’s market campaign exaggerates the prevalence of the condition and could create anxiety among women, making them think they have a condition that requires medical treatment.
“This is really a classic case of disease branding,” said Dr. Adriane Fugh-Berman, an associate professor at Georgetown University’s medical school who researches drug marketing and has studied the campaign. “The messages are aimed at medicalizing normal conditions, and also preying on the insecurity of both the clinician and the patient.”


June 17, 2010 at 5:33 pm

Hi Gary,
It could be that the groundswell of coverage on this topic is due to the basic editorial motivation that sex sells, whether its a story about Viagra for men or HSDD in women. Even though most news outlets are regurgitating the same information with little analysis, it makes for a sensational story with an emotional human interest angle for women.
Reading Dr. Goldstein’s comments from the CNN story, I’d venture to guess he was well trained on Boehringer’s key points in favor of its product in anticipation of the advisory committee. It’ll be interesting to see how the FDA reacts to its advisory committee’s recommendations and if those same key phrases work into Boehringer’s press releases following.


June 17, 2010 at 7:24 pm

I would like to add this if I could. HRT is an area where women get excited and that has to do with a study with Premarin vs FDA approved bio identical hormone replacement. Did you know we have been struggling for a real number crunch there for years?
The womens Viagra issue kind of takes the back seat to that as the Women’s Health Initiative did not separate the 2 with their numbers and rolled them all into one as far as the cancer causing statistics.
Drug companies don’t make a lot of money from the bio identical drugs, but as humans, we would really like numbers on the big question on how bio identical drugs compare to Premarin. (approved by the FDA and not custom treatments).
I did an interview with Dr. Erika Schwartz last year we talked about this a lot and it is one of the best read posts on my blog:) So maybe in view of pending numbers like this, we are not too worried about the FDA and female Viagra. I asked a friend of mine who is a CSO in a related area and “he” was also not very concerned either and didn’t feel there was enough evidence here to substantiate.
So I guess in short, HRT is of more interest and importance than the Viagra for women issue so perhaps it’s just a matter of priorities with health for women and what we care about the most:)

Nancy Metcalf

June 19, 2010 at 9:25 am

I realize this is a bit off-topic, but as the daughter, wife, and mother of conservatory-trained musicians, I do appreciate your correct use of the word “crescendo.”
It drives me and my husband nuts every time we see the phrase “reached a crescendo,” because by definition, a crescendo can’t “reach” anything. In music notation, it instructs the performers to gradually increase the volume of their playing or singing — until they reach a degree of loudness that is noted, separately, on the score, such as forte or fortissimo (f or ff). In other words, a crescendo is a journey, not a destination.