The quest continues for a female orgasm drug. Since Viagra came on the market in 1998, companies have been racing to produce an equivalent for women, with little success.
For the treatment of female sexual dysfunction, a hotly debated term that involves everything from lack of desire to an inability to reach orgasm, only Intrinsa, a testosterone patch made by Procter & Gamble, has been approved - and that's only in the European Union, and just for women who have had radical hysterectomies and are taking estrogen.
The pink Viagra appears as elusive as its desired goal: the female orgasm.
In a study published this month, researchers at the Medical College of Georgia revealed that several male impotence drugs can engorge blood vessels in the genitals of female rats, but only briefly. Sexual function is indeed a more complex matter in the female, said R. Clinton Webb, study author and chair of the school's physiology department.
Casting a glance over the past decade of research is filmmaker Liz Canner, whose movie Orgasm Inc. airs next week at the Hot Docs documentary festival in Toronto.
Ms. Canner explores whether female sexual dysfunction is a legitimate disease, or one conjured up by pharmaceutical companies looking to profit from normal sexual hiccups.
She interviews squirming marketing executives from pharmaceutical giant Vivus Inc.; a man who fruitlessly patents the Orgasmatron (a device inserted into the spine), and a vintage-vibrator collector who points out this isn't the first time the medical world has been perplexed by female desire or the lack of it: The 19th century gave the world "female hysteria," which doctors treated with massages and vibrators.
Ahead of her May 2 world premiere, Ms. Canner spoke with The Globe and Mail about the hunt for a female Viagra.
Why have scientists not been able to invent this thing?
I'm dubious about whether they'll find anything that works that well. Even Viagra doesn't cause orgasms in men. It causes erections.
You started this film nine years ago, when you were hired by Vivus to edit pornography that they were going to use in research to develop a Viagra equivalent for women. How did you get hired?
They needed someone to edit film, and I was doing editing along with documentary work.
Could they not foresee that the access you gained, as a documentary filmmaker, might be problematic for them?
I don't know. I didn't originally set out to make a critical documentary. I was really curious about the science. I was a little concerned when I saw that 43 per cent of women had sexual dysfunction. If so many women had it, why didn't I know about it? [Pharmaceutical companies, researchers and even Oprah have touted that statistic, which emerged from a 1999 study that was later revealed to be penned by a researcher with financial ties to Pfizer, Procter & Gamble, Merck and Eli Lilly.] I don't want to say that there isn't some disorder that some women may have, but the majority don't have a disease. I think that's clear. The Federal Drug Administration has said that female sexual dysfunction is a developing disorder. This is why the race is on.
Many of these clinical trials use questionnaires to gauge female arousal, since it's not as obvious as an erection.
It's complicated with something as subjective as sexuality. Vivus had trouble with their clinical trials. For a while, they weren't sure what the endpoint would be. Is the endpoint sexual satisfaction, or is it orgasm? It's not like an erection, where you could actually measure something. They've been dependent on diaries.
One of the women in your film, Charletta, undergoes surgery to have this Orgasmatron device installed in her spine. It doesn't work, and then it turns out Charletta actually has no trouble climaxing, but wants it to happen during sex with her husband. She's ecstatic when you tell her most women don't climax through intercourse. How much of this is a lack of education?
That was something that was really shocking to me while I was making the film: the lack of sexual knowledge. We're constantly bombarded with images of sex and the message that you have orgasms every time, but when you start to peel back the layers, one learns that 70 per cent of women don't have orgasms without direct clitoral stimulation. [This according to sex researcher Shere Hite's milestone 1976 survey of female sexuality, The Hite Report.]
Part of our problem is that women, and men as well, are not really given comprehensive sex education. The clitoris is not often taught in sex education when they do genital anatomy. Doctors don't have the time to have in-depth conversations with people about their sexual lives, their relationships, their past history and their knowledge.
It appears that men happily accepted Viagra into their lives. Why is there such a backlash against similar drugs for women among the doctors and therapists, (male and female), in your film?
With men, it's been a functional issue, and certainly as men age or have prostate cancer that can affect their erections. With women, it's much more complex and they're looking at a much wider variety of drugs. They're looking at things like testosterone that affect your desire. There's no talk of making desire drugs for men. Women are also more skeptical, partly because of what happened with estrogen. Menopause became something that we needed medical intervention for. Now we know from the World Health Organization's study of estrogen that hormones are not necessarily something you want to play with, and testosterone is very clearly linked to breast cancer.
Where is the quest for female orgasm heading now?
There is no medical study that says women need to have five orgasms a month, and if they don't they have a disorder. To their credit, [the FDA] went back and looked at the criteria for female sexual dysfunction and said the woman has to be distressed about her sexual function.
Twelve companies have dropped out of the race, but there are still companies pushing. According to its website, Vivus is developing a testosterone spray. There's a company called BioSante that's developing a testosterone spray as well. There's a German company [Boehringer Ingelheim] that's developing a pill that's supposed to increase desire.
But genital surgeries are what's taken off the most as I've worked on this film. There's tightening, revirginizing, collagen g-spot enhancements and clitoral hood removal. The American College of Obstetricians and Gynecologists issued a warning about these surgeries. A woman that I interviewed had [labial and clitoral hood reduction] surgery done with a scalpel. Her suture burst and it was a horrible, bloody experience.