The marketing of a disease: female sexual dysfunction
The marketing of a disease: female sexual dysfunction
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DOI：
10.1136/bmj.330.7484.192
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发表时间：
2005-01-22
影响因子：
--
通讯作者：
Moynihan, R
中科院分区：
文献类型：
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作者：
Moynihan, R
罗伯特·威尔逊（Robert Wilson）的畅销书《永远的女性》（Feminine Forever）帮助说服了现代世界，更年期是一种激素缺乏的“疾病”，可以通过激素替代治疗。这本书1966年的封面承诺，“每个女人，无论她的年龄，都可以安全地过着一辈子完全性生活，”威尔逊赞助商出售的荷尔蒙成为畅销书。40年后，长期激素替代疗法被揭露为弊大于利，药品销售崩溃，威尔逊的论文被正确地嘲笑为企业赞助的疾病传播。在这种过度医疗化的阴影下，制药业试图向女性出售下一个有利可图的“疾病”，女性性功能障碍，却遇到了意想不到的阻力。热情的支持者声称这种情况影响了43%的美国女性，但在其定义和患病率方面存在广泛且日益增长的科学分歧。此外，实验性药物对妇女性困难的有意义的好处是值得怀疑的，那些赞同高度流行的医疗条件概念的专家的经济利益冲突是广泛的。2004年12月，美国食品和药物管理局的顾问拒绝了普罗克特和甘布尔的试验性睾丸激素贴片，这使这些争议成为焦点。5
Robert Wilson's bestselling book Feminine Forever helped persuade the modern world that the menopause was a “disease” of hormone deficiency, to be cured with hormone replacement. 1 The book's 1966 front cover promised,“Every woman no matter what her age, can safely live a fully-sexed life for her entire life,” and the hormones sold by Wilson's sponsor duly became best sellers. Forty years later, long term hormone replacement has been exposed as doing more harm than good, drug sales have collapsed, and Wilson's thesis is rightly ridiculed as corporate sponsored disease mongering. 2 3In the shadows of this overmedicalisation, the pharmaceutical industry is meeting unexpected resistance to its attempts to sell women the next big profitable “disease,” female sexual dysfunction. This condition is claimed by enthusiastic proponents to affect 43% of American women, 4 yet widespread and growing scientific disagreement exists over both its definition and prevalence. In addition, the meaningful benefits of experimental drugs for women's sexual difficulties are questionable, and the financial conflicts of interest of experts who endorse the notion of a highly prevalent medical condition are extensive. These controversies have been brought into focus by the rejection of Proctor and Gamble's experimental testosterone patch by advisers to the US Food and Drug Administration in December 2004. 5