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Sex, Lies and Pharmaceuticals – Book Review

By Ray Moynihan and Barbara Mintzes.

As the topic of excessive pharma power slowly comes out into the light, or perhaps out of the bright lights of the parties being thrown by the brilliantly strategized pharmaceutical industry, Ray Moynihan takes on this battle once again, this time with something a little sexier.

Our author has in the past addressed the subjectof pharma interference beyond medicinal red lines in books and numerous reports. He now turns his attention to the hot subject of female sexual dysfunction (FSD) and it couldn’t have been timelier. It is as if publication was scheduled to coincide with the announcement of the fall of the third potential next-huge-thing in drugs – Boehringer-Ingelheim’s attempt at the Pink Viagra, Flibanserin.

Sex, Lies and Pharmaceuticals posits that FSD is different to other diseases and disorders that the pharmas have taken on, because it is a series of conditions that although defined in the DSM (Diagnostic and Statistical Manual of Mental Disorders), it is not well accepted in the sexual health field as accurate or well-established.

He makes a good point that FSD is an easy target for the kind of public confusion that sends perfectly healthy people running to their physicians and demanding help. He also brings hard findings from many of the foremost academics and therapists dealing with this issue, to back up his argument. Sure, some of the voices heard are considered to be radicals, but then blowing the whistle on a well-entrenched boys club is always considered marginal behaviour, perhaps even anarchist, at first.

The book covers the “discovery” and responses to the reality of lowered sexual desire in women, reviewing much of the historical roots and contemporary responses to it. This comes across as excessively detailed and simplistic to anyone already in the field of sexual health, but reads like a full course on the subject for anyone without a specific background (perhaps drawn to the book by the sexy title).

On the other hand, the discussion of the drug companies’ behaviour has all been said before. They treat viagra and hormonal therapy drugs just as they do others that have been long in the pipeline and now promice huge profit for the taking. The wining and dining of doctors, the company-funded speakers at company-sponsored medical conferences, sponsoring bio-medical research for drug regulation, the direct to public advertising of prescription drugs where it is legal and indirect (illegal) advertising where is is not allowed – all these and more are known methods of spending a small fortune to make a big one.

So much of the nature of this enormous industry is known and ever more exposed, but Moyhihan adds a few interesting chapters on exactly how the industry is stepping into a new slot. Since hypoactive (low) sexual desire in females is not quite understood, and hotly debated, pharmas are attaching themselves to established academics who are then together devising the questionnaires and other research tools by which this “new” condition is subsequently being constructed. Anyone miss the conflict of interest?

Clearly, the subject material is heavy and sometimes rather technical, but Moynihan is a skilled medical journalist and he manages to string his sentences into highly readable pages. His argument feels like it spirals in and out, with each consecutive chapter deepening his argument but also repeating many of the previously mentioned facts and conclusions. This way he manages to introduce a good representation of the A-list researchers and therapists in pro- and anti-pharma work, and even leaves the reader feeling like they have an intimate knowledge of said personalities and their motivations.

I am really glad that this book has been written. It takes on a vital issue that needs to be published and debated, the more the better. It adds a disclaimer here and there about the fact that sponsored research is not always bad research and drug-funded doctors can be just as good as doctors who have never received any services or support (if there are any). However, it fails to sound one voice, at least.

There is a great deal of advocacy been done to inform and empower women and men about healthy sexuality (in this case) through NGOs without pro-drug agendas. Much of the important grassroots and professional work can only realistically be undertaken because organizations are receiving funding from pharmaceutical or medical device companies. Many of them work with absolute integrity despite their pharma connections.

Just as the book calls for medical people to show full transparency regarding their links with pharmas and other for-profit companies, so groups and organizations should not be dismissed for taking money to do their thing; instead, this should be better tolerated with the condition that all ties and interests be widely stated.

Features

    • Written by a health journalist and academic researcher
    • Follows up on previous works critiquing the pharmaceutical industry
    • Provides thorough background on female sexual dysfunction
    • Explains heath measurement tools
    • Introduces most of the leading professionals in the field
    • Includes personal accounts of industry workers, sponsorship recipients and sponsorship rejectors
    • Simplifies the technical concepts to make the topic accessible to laypersons
    • Completely up-to-date

 

Publisher

Allen & Unwin, 2010

Dinah Rates      


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