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Perspective

Can a pill bring sexy back?

Questioning a film, its feminism, and the FDA.

By Alyssa Giacobbe
March 20, 2011

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At the start of the new documentary Orgasm Inc., we meet Charletta, a sixtysomething woman who says she cannot reach orgasm. Well, she takes that back: She can. Just not at the same time as her husband. Not like they do in the movies. “Not like normal women,” she insists. She’s so convinced something’s wrong that she joins a clinical trial for the Orgasmatron – an electrical device implanted in the spine to induce climax. climax.

Produced over 10 years by Vermont filmmaker Liz Canner, Orgasm Inc. is an indictment of the medicalization of female sexuality and the quest to develop and market medical solutions for a class of disorder called female sexual dysfunction, or FSD. The film targets, for instance, an alarming, though ultimately flawed, study cited by drug companies claiming that as many as 43 percent of American women suffer from FSD – a ready-made pharmaceutical market if ever there was one.

Canner uses Charletta and others as evidence of the ridiculous – even dangerous – lengths women have gone to feel “normal.” She argues that FSD doesn’t exist, at least not in the physiological sense, but rather was manufactured by “Big Pharma” to convince us we have a problem that only its pricey drugs and technologies can fix. It’s not our bodies failing us, Canner says, but a culture that “has been perverted to place the drive for profit above our health.” She maintains that most cases of sexual difficulty are rooted in psychology and therefore not curable with a little pink pill or other technologies. In the case of Charletta, for example, she had the ineffective Orgasmatron removed. The solution for her was seemingly as simple as telling her that she was, in fact, normal.

Orgasm Inc., which premieres locally at the Coolidge Corner Theatre on Thursday, is already being hailed as a sort of modern feminist manifesto, and indeed the film is a much-needed denunciation of the designer vagina era, which brought women everything from “vajazzling” to labiaplasty. But the film’s suggestion that sexual difficulty is “all in our heads” – and that women are particularly susceptible to buying the lies that Big Pharma is selling – strikes me as limiting at best, vaguely antifeminist at worst.

Many doctors specializing in female sexuality argue that women are indeed candidates for FSD drugs. “The pharmaceutical industry did not create distressing sexual problems for women,” says Dr. Jan Shifren, director of the Vincent Menopause Program at Massachusetts General Hospital. She says the percentage of women who experience such difficulties hovers around 12. Not Big Pharma’s 43, but not insignificant, either. “That doesn’t mean we need to treat women exclusively with pills,” she adds. “The answer is somewhere in between.”

As director of the women’s health center at Beth Israel Deaconess Medical Center, Dr. Jennifer Potter sees plenty of women whose sexual life isn’t what they want it to be. “There are women who clearly have a medical condition,” Potter says. Along with “lifestyle interventions” such as enhancing communication, many existing drugs can help, she says. But as long as medical treatment remains something films and feminists, to say nothing of the Food and Drug Administration, seem to oppose, the drugs will stay largely inaccessible to those who need them. Doctors who seek to medicate women in sexual distress are forced to prescribe off-label; the female patient typically has to pay out of pocket. Sexually dissatisfied men, however, are covered by insurance.

Potter says that a key aspect of sexual difficulty is a deficit of education about female sexuality (the poor clitoris, after all, rarely gets any play in high school health class). But the inequities only start there. “As a society, we have a lot of lack of clarity about the OK-ness of celebrating sexuality in women,” says Potter. “We wonder if it’s OK to [medically] intervene. But we’ve certainly intervened for men.”

At one point in Orgasm Inc., opponents of Intrinsa, a libido-pumping testosterone patch for women banned by the FDA but approved in Europe, argue that it’s not necessarily the drugs that are so objectionable; it’s the accompanying marketing and advertising. But that very same barrage has helped drag female sexual discontent out from under the bedcovers and into the cultural discourse.

Awareness isn’t a bad thing.

“The upside to the pharmacologicalization of sexuality is that a lot more women are talking about their problems with their friends and with their health care providers,” says Shifren. Maybe it’s not all in our heads, after all.

Alyssa Giacobbe is a writer and editor in Newburyport. Send comments to magazine@globe.com.

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