On June 4, 2015, an advisory panel to the FDA recommended approval of the drug Flibanserin. The drug, intended to treat hypoactive sexual desire disorder in pre-menopausal women, had been rejected by two previous panels. For the third panel, according to filmmaker Liz Canner, Sprout Pharmaceuticals hired women to attend the public hearing and loudly advocate the drug’s approval. Afterward, the media reported about the new “female Viagra,” which supposedly represented a step toward sexual equality (there are many drugs for male sexual dysfunction, not as many for women.)
Here’s the problem: Flibanserin doesn’t do much, and the side effects are worrisome. Those using the drug have to take it every day, can’t take it in conjunction with antifungal medication, can’t drink any alcohol, and may experience dizziness, fainting, nausea, and insomnia. Car accidents for test patients tripled over the national average. All for the dubious benefit of 8-12 extra sexual events per year. Subjects who received a placebo also reported an increase in sexual events, at a rate of about 50% compared to those taking the drug. “Sexual event” was broadly defined to include manual stimulation and masturbation; orgasm was not required. Those reading the fine print noted that a glass of wine provides similar, if not greater, benefit.
Liz Canner has some experience digging into how pharmaceutical companies develop, test and market sex drugs for women. She was originally hired by a pharmaceutical to edit an erotic film, which the company intended to use in trials for its own drug. Canner thought it might be interesting to document the development of the drug, and she scored on-camera interviews that are astonishing in retrospect. Orgasm Inc., as it turned out, is not a pro-pharmaceutical documentary. Canner documents the project’s evolution without much commentary – she starts as one of the film’s subjects but fades into the background as the narrative develops.
Orgasm Inc. describes how drugs can’t be developed in the United States without an official disease or disorder they’re intended to address. That’s how the all-encompassing “female sexual dysfunction” was established, although its meaning is vague at best. But imagine the effect when news programs flash statistics like “Two out of three women are affected by FSD.” Not only does the official phrase allow drugs to be developed, it also identifies (even creates) a market, which is the first step in marketing.
Canner’s documentary is often funny. The best moment is when she reveals that the erotic film she’d edited caused almost as many positive reactions in the placebo test group. The drug wasn’t working, but they’d proven that “women like porn.” Orgasm, Inc. also has disturbing moments – the second half of the movie is concerned with an activist’s efforts to prevent a testosterone patch from being approved by the FDA. The friendly corporate interviews from the first half are gone, and drug companies are shown as much more villainous – not returning phone calls, preventing a non-pharmaceutical sex therapist from presenting at an industry trade show, and (perhaps) manipulating studies to better position their drugs for approval. The movie’s dramatic climax comes when the drug is defeated, although a postscript showed the same drug went on to be approved and sold in Europe.
I didn’t love Canner’s use of invented video clips to illustrate certain points. Although these are clearly fake (animated drugs running toward a finish line labeled “FDA Approval”; famous artwork figures popping pills) they add no information or clarity, and arguably cheapen the subject. On the other hand, the film’s music is hilarious, often evoking the cheesy sound of porn movie soundtracks.
The Flibanserin recommendation (it has not yet been approved by the FDA), which comes six years after Canner’s film, carries a disheartening message. Corporations are winning. One can imagine frustrated couples reading the news reports: “Honey, look – there’s a drug that might help us.” Most won’t read the fine print. The big winners will be pharmaceutical companies and their shareholders. Here’s a better idea: get a bottle of wine and a decent porn film for couples (they exist.) Start talking honestly about sex (throw away Cosmopolitan and Maxim). And just say no to drugs.