Film & Television · Sex & Sexuality

“Orgasm Inc.:” Libido Meets Pharma at a Theater Near You

Orgasm Inc.: The Strange Science of Female Pleasure is a documentary written and directed by Liz Canner. The film is playing in New York and Chicago this week, and will soon be making its way to movie houses, film festivals, and college campuses around the country.

Just about every advance review has praised this filmmaker for exposing the pharmaceutical industry’s interest in finding a drug for female sexual dysfunction and for her reminder that doctors do participate in clinical trials of all drugs once the FDA has given permission for these trials to take place from a safety perspective.

This film came from nine years of work after Canner had been hired by a pharmaceutical firm, Vivus, that had almost made it in the world of erectile dysfunction drugs. Canner was asked to create a body of pornography that could be viewed by subjects to measure their response to drugs that might increase their sexual response. She obtained permission from this strange group at Vivus to film their attempt to find the “Holy Grail” of a cream, patch, pill or instrument that would reliably increase sexual desire in women.

Dr. Suzanne Roth, Genito-sensory Analyzer at the Berman Center, Chicago

The pharmaceutical industry and the doctors who participated in the clinical trials in prospective drugs for enhancing female sexual desire are pitted against a psychologist who is a specialist in sex therapy, Leonore Tiefer, who has created an organization that opposes the use of drugs in the treatment of sexual desire and opposes the use of the term ‘female sexual dysfunction.’ There is drama at the FDA when the good therapist and her supporters rail against the bad pharmaceutical industry, and all of the members of the FDA panel vote against the latest product created to improve the female libido.

The film did demonstrate that education by health care workers about sexual norms could solve much anxiety for women and enhance their sexual pleasure. It did not devote enough edu-time to describe clearly the many issues involved in female sexual function; that would have been useful.

Female sexual function is complicated, after all. There is the relationship issue, the genital atrophy and pain issue, the general emotional and physical health issue, the day to day stressors that do take over the lives of many women with just too much on their plates to consider dessert.

We know that many women need arousal in some form before they experience desire to engage in sexual activity. This well-documented description of female sexual function came from years of observation and study by scientists and doctors.

Orgasm Inc. has a sexy title, but its titillation and energy end there. This was a dull documentary—the type created for soldiers in WWII about the dangers of sexually transmitted diseases.

And now, from across the movie aisle, a second opinion on the film from clinical psychologist and fellow WVFC Medical Advisory Board Member Cecilia Ford.


Female Sexual Dysfunction: A Problem Worth Solving

by Cecilia Ford

Orgasm Inc. is devoted to showing that the pharmaceutical industry is pushing the idea that women’s sexual problem’s are symptoms of a “disease,” and that disease can be cured by a pharmaceutical product like Viagra. If only—and this turns out to be a big problem—they could find one that works.

The fact that this is proving so difficult underscores one of the main issues about female sexual dysfunction, or FSD—the study of which is still, not surprisingly, in it’s infancy compared to that of male dysfunction. Women’s sexuality is very different from men’s, and the causes of dysfunction are less often solely physical.

Nevertheless, FSD is a widespread problem, and it would be a mistake to suggest, as this film does, that big business has somehow imposed it on women. There’s no question that in recent years, pharmaceutical companies have attempted to “transform average difficulties into diseases that need medicine…(and) that there’s a lot of money to be made in telling people that they are sick,” as the filmmakers assert. But it would be a great disservice to ignore the millions of women who have difficulty achieving orgasm, or who suffer from lack of desire, vaginal dryness, etc.

Just because these conditions are widespread,  may not be treatable pharmacologically, or might be reasonably seen as part of a medical disease syndrome does not mean that they do not cause suffering. In fact, vaginal dryness after menopause is normal, but many women find it interferes with  “normal” intercourse and give up trying because of the pain it causes.

As a clinician, what I’ve found over the years, and have learned through training in sex therapy, is that almost everybody thinks that for sex to be done “the right way” or the “best way,” it must be natural and normal, spontaneous and mutual, orgasmic and frequent (or at least as frequent as is normal—and by the way, doctor, how often is that?).

In order words, everyone thinks they are not quite measuring up in some way.

Women’s sexuality is more complex, fluid, fragile, and at the same time hearty than men’s. Tiresias, the blind prophet of ancient Thebes who, in the course of a very long life, had been both man and woman, was asked which was better. He replied that being a woman was much more satisfying. But women are not at all like men: we do not become aroused in the same way or by the same things. Climax is very different for women—before, during, and after. Indeed, it was only in the 1960s that sex researchers began to explore the two different types of orgasms, and it took many more years after that for psychoanalysts to accept clitoral orgasm as a “legitimate” expression of mature female sexuality.

In a landmark study, researcher Rosemary Basson, surveying women who rated their sex lives as “good,” discovered that the sequence of sexual desire and arousal follows a unique pattern for women. She found that in the very early stages of a relationship, a woman’s pattern may mimic a man’s to a certain extent (desire and arousal leading to initiating a sexual encounter). And while some women remain this way, many women do not.

A great number of women in stable, happy sexual relationships do not enter into sexual encounters feeling desire. They may do so for a variety of other reasons, such as the wish to be close to their partner. It is only after they begin to be intimate with the partner that arousal and desire enter into the picture. As one patient put it to me: “I am responsive but not desirous.” This woman had a wonderful sex life. But she thought there was something strange in that she didn’t feel spontaneously attracted to her husband as she used to.

Finding out about the Basson study was a great relief for this woman. She discovered that making the effort to engage in sex paid off. In other words, waiting for spontaneous desire to strike may not be a good strategy. But that doesn’t mean there’s something wrong .

On the other hand, there are many women whose sexual problems could definitely benefit from diagnosis and intervention. The film suggests that the problem has been overblown. And while that may be true, women shouldn’t give up trying to get the most they can out of sex. There is probably no magic bullet, but as my patient would say, it’s worth the effort.

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