Sex sells — whether it's
a Hollywood movie or the latest aphrodisiac. But is the
hype surrounding an experimental testosterone patch for
female hypoactive sexual desire warranted? "A case study
in misleading media coverage" is how the British Medical
Journal describes the advertising for the treatment
that's about to be fast-tracked for FDA approval.
BONDAGE
AND InNUENDO
The developer of the patch, Proctor & Gamble, is
being accused of orchestrating a campaign of endorsements
by experts with financial ties to the company in an
effort to influence the FDA. Procter & Gamble's
global program manager for the patch, Ms Andrea Klemes,
wrote to the International Society for the Study of
Women's Sexual Health urging them to testify at an upcoming
FDA meeting. "I think a letter would be appropriate
in this case," she wrote. "Please note the time sensitivity
of this matter as the FDA closes agenda registration
on November 17." Proctor & Gamble was a 'gold level'
sponsor of the society's recent annual conference in
Atlanta, which included some enthusiastic presentations
of the patch.
It's hardly uncommon these days
for pharmaceutical companies to seek endorsements from
physicians, but Proctor & Gamble has also raised
hackles by generating mainstream media coverage of their
claims for the patch. All this when the data has never
been published in a peer-reviewed journal.
Several media sources have quoted
company reports of a 74% increase in sexual activity.
But the available abstracts show that this figure relates
to an increase in "satisfying sexual activity," rather
than absolute activity. Moreover, in most of the trial
subjects, this worked out to about one extra sexual
episode per month.
Some specialists aren't convinced
that hypoactive sexual desire disorder even exists.
Dr Rosemary Basson, professor of obstetrics and gynecology
at the University of British Columbia questions whether
the disorder is a physiological condition, rather than
a primarily psychological one.
At a postgraduate review in family
medicine at Vancouver, she commented on a study of transdermal
testosterone replacement in women with a previous bilateral
oophorectomy. "[The patch] showed benefit only in the
subgroup of women who were both older and achieved high-normal
[as opposed to mid-normal] premenopausal testosterone
levels," argues Dr Basson. She also cautions that weight
gain, clitoral enlargement, facial hair and increased
cholesterol are side effects that can occur with this
therapy.
EMPTY
PROMISES
Few topics make for easier pop science stories than
aphrodisiacs. Headlines such as "Women can patch up
sex woes" practically write themselves. But the story
goes flat if the treatment doesn't work, or is only
applicable to a very few people. In fact, the patch
is aimed at postmenopausal women who've had their ovaries
removed, but newspaper articles suggest it can rev up
the sex life of any woman who has ever said "not tonight,
dear."
For instance, a September article
in the Chicago Sun-Times, "Not in the mood? Now
there's a patch," claimed that the drug was designed
to treat "low libido," a problem allegedly experienced
by "30% of women."
Dr Basson argues that we should
move away from a model in which the absence or rarity
of desire in women constitutes a disorder. By doing
so, she said, "we allow the development of a model that
appears to accurately reflect women's sexual experiences,
especially when they have been with the same partner
for many years."
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