Female Sexual Dysfunction: A Case Study of Disease Mongering and Activist Resistance

Tiefer highlights key steps in the "creation" of a new diagnosis, female sexual dysfunction, and of the campaign to challenge its reductionist approach to women's sexual problems

Timeline of Events Beginning in 1999 of Activism, Which Came to Be Called the “Campaign for a New View of Women's Sexual Problems”

<p>(Figure: Rusty Howson)</p

Timeline for the Promotion of FSD from 1997 to Present

<p>AUA, American Urological Association; CME, Continuing Medical Education; JAMA, Journal of the American Medical Association (Figure: Rusty Howson)</p

Missed Opportunities in the Patient-Focused Drug Development Public Meeting and Scientific Workshop on Female Sexual Dysfunction Held at the FDA, October 2014

There were numerous missed opportunities at the October 2014 U.S. Food and Drug Administration (FDA) meeting on female sexual dysfunction (FSD). They included opportunities to hear from a diverse range of patients and to engage in evidence-based discussions of unmet medical needs, diagnostic instruments, trial end points, and inclusion criteria for clinical trials. Contributions of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) nomenclature, based on extensive research, were dismissed in favor of language favoring a seemingly clear but scientifically unsupportable distinction between women's sexual desire and arousal. Numerous participants, including patients recruited by their physicians, acknowledged travel expenses paid for by interested pharmaceutical companies. Conflicts of interest were manifold. The meeting did not advance the FDA's understanding of women's sexual distress and represents a setback for our fiel