Female sexual dysfunction, a condition in which women experience low libido and feel sexually unsatisfied, is partly the brainchild of drug companies who helped create and hype the condition, according to the author of a new book.

Ray Moynihan, journalist and lecturer at the University of Newcastle in Australia, argues that drug industry employees have worked with paid opinion leaders to help develop the idea that dysfunction is a disease. They have run surveys to portray it as widespread, and helped design diagnostic tools to persuade women that their sexual difficulties deserve a medical label and treatment.

However, critics say while there is little evidence that medications for female sexual dysfunction actually work, it is still a real disorder.

Women who have struggled to overcome the psychological and cultural barriers to requesting help with their sexual difficulties will not welcome the argument that they are to be "left alone," said Dr. Sandy Goldbeck-Wood, a specialist in psychosexual medicine at Ipswich Hospital in the United Kingdom.

An article about Moynihan's book, "Sex, Lies and Pharmaceuticals" (Greystone Books), appears this week in the British Medical Journal, along with an accompanying commentary by Goldbeck-Wood.

A false impression

In the BMJ article, Moynihan quoted a drug company employee as saying her company was interested in "expediting the development of a disease," and he revealed that companies are funding surveys to portray sexual problems as widespread, as well as creating tools to assess women for "hypoactive sexual desire disorder."

Many of the researchers involved in these activities were drug company employees, or had financial ties to the industry, Moynihan wrote. Meanwhile, scientific studies conducted without industry funding were questioning whether a widespread disorder of low desire really existed, he said.

The industry is also taking a leading role in "educating" both professionals and the public about this condition, he said.

Moynihan cited a Pfizer-funded course designed for doctors across the United States, which claimed up to 63 percent of women had sexual dysfunction , and that testosterone and sildenafil (Viagra) may be helpful in treating them, along with behavioral therapy.

He said that drug companies have worked to create the impression that there is massive "unmet need for treatment," and have more drugs in their pipelines to market as treatments for the condition.

"Perhaps it's time to reassess the way in which the medical establishment defines common conditions and recommends how to treat them," he suggested.

Skepticism

"Faced with a woman in tears whose libido has disappeared and who is terrified of losing her partner, doctors can feel immense pressure to provide an immediate, effective solution," Goldbeck-Wood wrote in her commentary.

She said Moynihan's research clarifies both the conflicts of interest at work and the relative paucity of good-quality evidence for drugs that treat women's sexual problems. However, she argued: "his argument that female sexual dysfunction is an illness constructed by pathologising doctors under the influence of drug companies will fail to convince clinicians who see women with sexual dysfunction, or their patients."

The problem, Goldbeck-Wood said, is one of oversimplification, and she believes more studies are needed that reflect the complexity of sexual life. "It's time to invest in more research into the most realistic, respectful and evidence based treatments, rather than narrow biological ones founded on poor evidence."