Viagra for Women?

Flibanserin's cure for the low female libido is far from progressive

Female sexuality has long been an epistemological lacuna. Freud, never at a loss for words about male psychosexual development, deemed woman’s sex a “dark continent”—a subject he could only broach by injecting penis envy with estrogen. Contemporary sexologists seem to fare no better: Women’s experience during penetrative sex, from female orgasm to the ever-elusive G-spot, remains an enigma.

The enduring ambiguities of women’s sexual desire have not, however, deterred big pharma. Despite the lack of consensus on what constitutes female sexual normality, drugmakers, heartened by their latest cash cow, male impotence, are attempting to reincarnate Viagra in female form. From Proctor & Gamble’s testosterone patch, Intrinsa, to BioSante’s LibiGel, an androgen-based skin cream, comes flibanserin, the metaphorical peanut butter to Pfizer’s stiffening jelly. Yet, unlike Viagra, which remedies a mechanical problem by diverting blood from the brain to the penis, flibanserin acts on the female psyche. Initially conceived as an anti-depressant, it corrects the serotonin imbalances now imputed as the etiological agent of women’s low libido. Not in the mood, ladies? The problem, it seems, lies not in your vagina, but in your brain.

Flibanserin purports to treat Hypoactive Sexual Desire Disorder, catchily abbreviated HSDD—though the disease moonlights under a remarkable array of pseudonyms, all equally authoritative and sufficiently vague, from female sexual dysfunction to female sexual arousal disorder. Regardless of the title—syndrome, deviation, perversion—they all make one point emphatically clear: Women thus diagnosed are abnormal. Yet, precisely what norm sufferers of FSD are deviating from, though tacitly assumed, is never made explicit. While male sexual dysfunction centers on the convenient question of erect or soft, female sexual anomalies prove more difficult to quantify. Specified measures include hormone levels, vaginal pH, and clitoral blood flow, yet clinicians remain divided on what the normative standards for these measures are—or, barring that, what they should be.

Compounding the confusion, in 1999, the Journal of the American Medical Association published a study claiming that 43 percent of women suffer from sexual dysfunction, as compared to 31 percent of men. Authored, not surprisingly, by consultants to Pfizer, the statistic voids sexual normality of all substantive meaning: When the in-group is barely the majority, what legitimating function—of certifying, beyond doubt, the healthy and the natural—can it serve?

Now consolidated into a medical field, complete with an annual conference, journal, and professional organization, FSD promotes belief in its own existence through sheer tautology—it says it exists, therefore it does. Officially defined as “inability to experience an orgasm or lack of lubrication, often causing painful intercourse and/or lack of desire/decreased libido,” this neologism seems to apply to any, and every, woman. Here, the center cannot hold because no one knows where to draw the dividing line: Female sexual perversion and function converge to the same amorphous horizon. Grounded in an ineffable understanding of woman’s sexual essence, the normal becomes consubstantial with, even defined by, the abnormal.


The medicalization of female sexual experience is nothing new. Doctors in the 18th century had a heyday with hysteria, a diagnosis reserved exclusively for females and imputed to malign uterine vapors. In retrospect, the absurdity of charging vagrant vaginal fumes with the ability to distend the female brain appears patent—yet, as the New York Times noted, the grounds for FSD may be no more substantial.

Indeed, an article in the 2003 British Medical Journal named FSD “the freshest, clearest example we have” of the corporate-sponsored creation of a disease. In doing so, the piece exposed the conspicuous ties between researchers in the field and pharmaceutical companies still high on Viagra’s success. Thus, although FSD’s online wing claims to be purely informational, providing the tools for women to realize their feminist entitlements to sexual pleasure and multiple orgasms, its goals are far from altruistic. By articulating dysfunction, FSD capitalizes on women’s sexual insecurities, establishing a norm which no woman meets and solidifying a consumer base for forthcoming treatments.

In our culture, where women are enjoined to “get Dirrty” with Christina, female sexuality is decidedly overexposed. Advanced by the male-dominated media industry and reinforced by profit-hungry pharmaceutical companies, the voracious female libido has become normalized, leaving those of us who don’t enjoy a good mudfight in assless chaps feeling like prudes. Hyperbole aside, the problem lies not in talking about women’s sexual experiences, but in stringently classifying them, only to exalt deviance from an ill-defined norm as a pathology in need of remedy.

Abstracting from sexuality’s complex social and relational dynamics, FSD reifies genital function and biomedical cure as the be-all, end-all of satisfying sex. What’s more, by granting medical authorities the power to proscribe and regulate, FSD denies women the agency of sexual self-definition—we are told to “consult a physician,” rather than arrive at our own normative judgments. Against this medicalizing current, control over female sex should return to where it rightfully belongs: women themselves.

Courtney A. Fiske ’11, a Crimson editorial writer, is a social studies concentrator in Lowell House. Her column appears on alternate Tuesdays.