Phyllis Greenberger

Today’s TBT post ran over two years ago and addressed female dysfunction. Given the FDA’s recent approval of flibanserin, a pill that aims to increase a woman’s desire for sex, we thought it would be helpful to review some of the early conversations on the issue.

A recent article published in partnership with The Investigative Fund and Newsweek questioned the existence of “female dysfunction,” as if to say, who cares about women’s sexual health? If you can’t “see” it, apparently it doesn’t exist. This is one-sided, inaccurate and disparaging of women.

Why is it that when men are impotent it is taken seriously, but when women suffer from sexual dysfunction it is ridiculed and attributed to “Big Pharma’s” attempt to conjure a condition so they can make and sell a drug?  If Pharma is so bad, why do we depend upon them to research and manufacture drugs to prevent and treat cancer?

Why do we hope that one of the companies will be successful in developing a drug to prevent, delay or treat Alzheimer’s disease? Do you give your child an antibiotic when they have strep or do you ignore it? If there is a pandemic whom do we turn to?

Full disclosure, my non-profit organization, the Society of Women’s Health Research (SWHR), credited with changing the face of medicine and the definition of women’s health, receives support from Pharma and our success could not have been possible without it.

Not too long ago, illnesses such as restless leg syndrome, fibromyalgia, chronic fatigue, and PMDD were derided as made-up conditions by “Big Pharma” – until they weren’t. So if a condition is recently recognized and diagnosed, but hasn’t been previously recognized by the medical establishment or the media who covers them, then they don’t exist – until they do.

The Society for Women’s Health Research was established in 1990 to improve the health of women to focus on all conditions that differently, disproportionately or uniquely affect women. Our focus is women’s health. All women’s health includes quality of life, and sexual health is an important part of that.

When it comes to sexual health, for many but not all women, when they reach menopause or later, they may experience vaginal atrophy, also called atrophic vaginitis, a thinning, drying and inflammation of the vaginal wall due to the body having less estrogen. Usually this occurs after menopause but it can develop any time your body’s estrogen production is low; it makes intercourse painful and can interfere with healthy urinary system function. And what happens when your partner is taking Viagra or Cialis, and you are experiencing pain? What effect does that have on your marriage?

Sexual dysfunction is defined as a disturbance in or pain during sexual response, and can present itself in various ways. The problem is more difficult to diagnose and treat in women, due to the intricacy of the female sexual response, and can consist of various physical and psychological components. According to William F. Young, Jr., M.D., M.Sc., President of the Endocrine Society, lack of interest in sex is a real problem for women. In studies, 40 to 60 percent of women will report a sexual problem and the most common is low sex drive.  Has anyone seen the myriad of ads on TV for testosterone to enhance male sexuality? Talk about a double standard.

Side effects are an important concern for women sexual health therapies.  Let’s see what they are in relation to side effects for Cialis, the male erectile dysfunction drug. Osphena’s most common side effects are hot flush, vaginal discharge, muscle spasms, excessive sweating. As with all side effects, some or none may appear.

Side effects for Cialis are headache, indigestion, back pain muscle ache, nasal congestion, flushing, and limb pain. Cialis side effects also include blindness.

It is amazing that no matter how much new research comes out from the Women’s Health Initiative (WHI) concerning the risks and benefits of hormone therapy, the media consistently gets it wrong.  The notion that hormone therapy was discredited a decade ago is inaccurate and not current with the research.

The WHI asked one question and one question only: did hormone therapy prevent heart disease in older women? The answer was NO.  But when the research has been re-examined, which it has, the key variable is timing. Younger women in premenopause or perimenopause actually experience a protective effect on heart disease, and the incidence of breast cancer seems to decline with estrogen alone. The jury is still out on whether combined estrogen progesterone increases breast cancer.

We know it does not increase mortality. Recent papers in both the Journal of Women’s Health, reporting on a scientific roundtable convened by the Society for Women’s Health Research, to reexamine the WHI as well as new research since the WHI to afford women the information they need to make decisions, as well as along with the Journal of the International Menopause Society (IMS) determined that the benefits outweighed the risk.

Let’s not forget that the combined therapy used in the WHI is no longer used. The dose is now much smaller and there are a number of other hormone therapies and different methods of delivery. Still much research is needed and many questions are unanswered, but the original panic apparently was unsubstantiated.

We must stop being blind to women’s sexual health conditions. They are just as important as men’s sexual health, and remember, it takes two to tango.

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