|
“Men taking iron supplements are warned that taking Viagra may cause them to spin around and point north… Then there was the man who got his Viagra tablet stuck in his throat and suffered from a stiff neck.” Everyone knows the jokes about Pfizer’s little blue erection pill, and indeed, the best-selling drug has entered the realm of popular culture. In everyday mythology, Viagra not only cures impotence, but it turns men into handsome, voracious sexual supermen. In the wake of Viagra’s success, attention has turned to women’s sexual problems. Obviously it takes two to tango, and while Willy may be raring to go, Mavis may not necessarily be ready – or interested. Thus, as part of the race for “female Viagra”, medical, and media, attention has become focused on “female sexual dysfunction” or FSD. FSD is a nebulous description that currently encompasses four main sexual problems: lack of desire, lack of arousal, lack of orgasm, and pain during sex. According to Professor Marita McCabe, a lecturer and psychologist from Deakin University, at least 50% of Australian women experience some form of sexual problem in their lifetime. “It used to be that anorgasmia – or difficulty in experiencing orgasm – was the main complaint. Now I would say that the most common one would be lack of interest in sex; that has been increasing gradually over the last few years.” Clearly, there are a lot of unhappy women out there, but it’s only recently that the medical profession has tried to address FSD in any major way. In the US, the FSD “movement” has been led by a Pfizer-funded urologist called Dr. Irwin Goldstein from Boston University. Dr Goldstein has written countless articles about women’s sexual problems, as well as organised and headed two high-powered conferences on the topic in 1999 and 2000. The first conference, at which half the attendees were “industry” (read: drug company) people, focused heavily on the purely physical problems encountered by women with FSD. One delegate gave a speech entitled: “Psychologic Treatments: Are They Effective and Do We Need Them?”, while others discussed rabbit clitorises, blood flow and labial recovery after cancer. Amidst
all this, Leonore Tiefer, a well-known feminist, clinical psychologist
and author from New York, gave a short speech entitled “The Selling of
FSD.” In it she argued that the drug companies and doctors were
combining to medicalise and simplify what were enormously complex
women’s issues. Tiefer berated doctors for ignoring the ground
breaking work of 70’s feminists in overcoming anorgasmia , and
advocated looking at the whole picture of women’s sexuality, as
opposed to a purely genital one. “Most people, including sex researchers, are afraid to look too closely at the psychology of sexuality,” she said. “We protect ourselves with questionnaires and standardized language… But our desires for expression and affirmation are ultimately unique; our desire for an orgasm, for example, is as often for a feeling of connectedness and vitality as it is for release of pelvic tension.” She also urged them to “be alert to the insidious dangers of commercialization of your research. Sex sells. If you didn't know it before Viagra, you know it now.” Tiefer was something of a “lone voice in the wilderness” at the conference, however she feels she succeeded in making a point. She relishes her work as a watchdog in an increasingly drug-driven field. “Too much of the research about women's sexual problems is funded by drug companies and narrowly conforms to their interests,” she told Salon magazine. “There's just too much emphasis on claiming things are physical and then selling products. The pharmaceutical companies want products they can market, which I distinguish from products that will help women with their sexuality.” But what’s so wrong with a doctor trying to help a woman to have an orgasm. If a pill works, why not just take it? “You make it sound like doctors are just kind-hearted qualified professionals desperately eager to help sexually unhappy women,” she told AWF, “and what could be wrong with that? On the contrary, doctors are largely uninformed about sexuality, unprepared and uncomfortable finding out in any depth or detail why women have sexual problems, and unwilling to provide any help other than prescriptions. Keep in mind no drug is yet proven to be of help to women. Sex therapists and videos and books can teach women to have orgasms, isn't that right? We're mostly talking about women going to doctors for help with lost or absent sexual desire, a much more complex matter, and more likely to be due to relational and sociocultural factors.” In line with this, Tiefer and her feminist colleagues presented “A New View of Women’s Sexual Problems” at the 2000 conference. They advocated viewing FSD in broader terms of women’s dissatisfaction, as opposed to comparing women to a sexual norm (orgasm versus non orgasm). They also suggested dividing sexual problems into four areas. First is the social, cultural, political or economic category. This is where a woman may have sexual problems due to lack of sex education, or cultural differences. The second category looks at relationships, such as whether there is abuse, a lack of communication, or low compatibility. The third takes psychological problems into account, such as child abuse, or lack of self esteem. And finally the fourth category focuses on purely physical problems, such as STDs or circulatory problems. This category can only be applied after all the other factors have been ruled out. This “new view” has been put forward to get doctors thinking about what other factors may be involved in a problem, apart from a purely physical one. The medical profession may be starting to pay attention as it becomes apparent that drugs aren’t the “quick fix” they were supposed to be. In March 1999, the medical journal Urology revealed that 30 post-menopausal women reported no increase in sexual desire after taking Viagra. And the 2000 FSD conference gave more time to those covering the psychological factors behind women’s sexual problems. Professor McCabe believes the search for a “female Viagra” may not be the best approach. “I think that female sexuality is more complex than what would be addressed with a drug. Even if there is a physiological base to some women’s problems, there is undoubtedly a psychological overlay, because the woman will start becoming anxious about whether she’ll become aroused or experience orgasm, she will start feeling not as feminine, start losing confidence in her sexuality and so on. “Female sexuality is a combination of the physical and the psychological component of engagement with the other person, of feeling good about themselves and the situation. Indeed, research has shown that women who present with sexual dysfunction have the same level of physiological arousal as those who are quite functional. The difference is that the dysfunctional women aren’t tuning in to their physical arousal due to their psychological problems.” Professor McCabe says the main treatments for FSD in Australia at present were psychologically based, and that there were no officially sanctioned drug treatments available here. Interestingly, the only “treatment” approved in the US is the Eros-CTD clitoris pump, a smaller version of the Austin-Powers-type Swedish penis enlarger (but they’re really not my bag, baby!). The small suction cup works by creating a vacuum and drawing blood into the clitoris, making it enlarged and sensitive to the touch. It is only available on prescription, and costs almost US$400. Meanwhile, the search for female Viagra goes on. Trials are still being held, and results have not been released to the public. Leonore Tiefer’s crusade continues. AWF asked what she thought was the best method of treating FSD. “’Treating’? How about preventing problems with comprehensive sex education and equal social status and opportunities? Women's knowledge in and pride about their own bodies is a key factor - and is difficult to sustain as you get older. Women
need to feel safety and respect to maintain their initial sexual
attraction, they need to feel the burdens of life are shared (for
example, child care, elder care, and domestic chores), and they need to
feel their partner is interested in them as a human being - that's the
part that's often missing.” Drugs,
Pumps, Herbs: What’s available? Hormone
therapy Sprays,
Creams and Gels “Herbal
Viagra” Wellbutrin
(bupropion hydrochloride) Eros-CTD
Clitoris Pump Apomorphine Caring,
nurturing, supportive partner who knows where the clitoris is This
article first appeared in Australian Women's Forum April 2001
|
|
