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What ‘In the know’ magazine doesn’t know about female sexual problems

December 3rd, 2006

Dr Petra

Yesterday I picked up a copy of new women’s magazine ‘In the know’, mainly because I was drawn to a feature on female sex problems advertised on the front cover.

There are several areas where women can experience sexual difficulties including pain during or after sex, problems with penetration, difficulties in reaching orgasm and lack of desire. Most attention is given currently in research and media coverage to the latter category.

Scientific evidence suggests there are several key causes of women’s sexual problems:
* Concerns over body image
* A lack of sex education or knowledge how your body works
* Not knowing what turns you on, or the inability to share what does turn you on with a partner
* Psychological or physical health problems (including sexually transmitted infections)
* Past or present sexual abuse or domestic violence
* A partner who has a sexual problem
* A partner who does not know how to turn you on effectively
* Relationship difficulties including arguments or jealousy
* Being overworked and lacking support from family and/or partner
* Having a young family (particularly if there’s little support provided to care for them)
* Concerns over fertility, problems with contraception use
* Lack of privacy to relax enough for sex
* Poverty and related issues of limited access to healthcare
* Focusing on vaginal sex instead of wider sexual activities, particularly clitoral stimulation

So since ‘In the know’ were covering sexual problems as part of their ‘Health in Focus’ pages you would expect to see all these issues covered. Unfortunately not. Instead they described sexual problems and their treatments in a very specific and mostly inaccurate way.

It all started with the cover of the magazine with the headline on the front cover promising ‘Get a healthier sex life! Are you ready for the female Viagra?’ Now this is misleading for a start since female Viagra is never going to happen – trials of the product were discontinued because the drug did not work in women as it did for men.

The main feature continues to slide downhill from the outset with the statement ‘with the first skin patch for a flagging libido due to be launched we reveal which treatments and therapies can spice up bedtime’. Ah yes, the famous Intrinsa patch which isn’t on the market yet, does not have FDA approval, and is only for post-menopausal women who probably need to be on HRT in order to use the patch at the same time (which in itself is a health concern for long-term use).

This doesn’t stop the majority of the ‘In the know’ feature acting as an advert for the pharmaceutical industry with promises of patches and hormones (particularly testosterone) to spice up our sex lives. So obviously they didn’t find the most contemporary research from the Journal of the American Medical Association that showed testosterone and low libido are not so closely linked in women. Worse still ‘In the know’ incorrectly and unethically recommend the Intrinsa patch for women who aren’t post-menopausal.

More errors arise when the feature states there are ‘so many pharmaceutical treatments…available’ for men. This isn’t true. There are a small number of drugs for erectile dysfunction and that’s it. The majority of male sexual problems do not have treatments at this time.

The feature tells us ‘when Viagra – the drug for male impotence – was first launched in 1999, many women with low libidos secretly hoped and wondered if a version for them would ever be created’. This shows a misunderstanding of Viagra itself that is a specific drug designed for men who consistently have chronic problems with getting and keeping an erection for sex. It’s not, as this statement and the headline advertising this feature implies, an aphrodisiac.

Because this isn’t a very good piece of sex reporting it was bound to happen, and ‘In the know’ don’t let us down, they misunderstand and misquote data on female sexual dysfunction by telling the reader ‘more than 43% of women will suffer from female sexual dysfunction at some point in their lives’. Really? Nearly half of the world’s female global population will have a medical sexual problem in their lifetime? No.
This is an oft-quoted and incorrect interpretation of research, that you can basically use as a diagnostic for a journalist who hasn’t done their homework or doesn’t know what they’re talking about.

Next we’re treated to the statement ‘for those whose men just won’t take a manners makeover – science and naturopaths have stepped into the breech’. So perhaps they missed all the research showing if you have relationship difficulties or an unhelpful partner no amount of changes with toys, products and gadgets will help you? Reputable scientists are not recommending drugs where there are other social, emotional or physical causes of sex problems. The only ones who are suggesting otherwise are in the pay of pharmaceutical companies.

The feature moves to list a range of products that will apparently sort out your sex problems. In fact all the products mentioned are only linked to lack of desire. No mention is made about seeking urgent medical attention if you are in pain during or after sex, or if penetration is difficult.

Intrinsa’s mentioned again. Perhaps their press office contacted ‘In the know’about this feature which is certainly great advertising for a product not yet on the shelves.

Then we’re told about using Zyban, but not told this should be used only after consultation with a doctor.

Counselling is recommended, but it isn’t made clear what you need when. Some sex problems affecting women require medical attention, others psychological treatments, some a combination of the two.

Then we’re told about diet. I got hopeful at this point since if you recommend people eat a healthy balanced diet and exercise regularly they may well reduce other health problems that can in turn cause sexual difficulties. Sadly this evidence was overlooked and instead readers were advised to try ‘foods rich in vitamin B6, vitamin E and zinc such as oysters, pumpkin seeds and nuts’. Now this is worrying advice since no instructions about how much of this food to try which means people often assume the more they eat the sexier they will get (untrue). The most basic nutritional advice – that these additions won’t make a difference if your overall diet is poor – is not mentioned.

There’s more to come though, with the reader being told they can get DHEA (dehydroepiandrosterone) over the counter that they can use with Viagra to boost desire. This part of the feature is advocated by Irwin Goldstein who has been criticised for close links to the drugs industry and recommending treatments for women not based on clinical evidence. In the US doctors can prescribe Viagra to women, but most doctors do not do this routinely since the evidence shows the product is not successful for women. In the UK it’s less likely to be prescribed as there’s no evidence supporting its use. If you are going to recommend a treatment it needs to have been tested in a drug trial and the results published in a reputable peer review journal. Searches for trials on the efficacy of Viagra and DHEA reveal very little, try it for yourself using the resources at the end of this blog. It’s not hard to do. Why didn’t ‘In the know’ check this out before recommending a treatment not recognised nor routinely offered to women in the UK?

Finally readers are told about some ‘over the counter remedies’. My particular favourite in this section was the Fireplay lubricant ‘based on Nobel-prize winning research’. Now I searched for this in trials and published papers and couldn’t find it mentioned anywhere, so I’m not entirely clear what part of the Nobel prize winning research this was based on. Of course the website for the product says it’s based on research from 1998 but no links are made to this original work or what specifically it won the Nobel prize for.

Damiana tablets are also recommended with the claim that it is an aphrodisiac backed up by scientists through clinical trials. Now this is also interesting since if you search the literature on this there is some evidence that it works in mice, and in a few small scale studies women have noted an improvement in their sex lives if they’re taking this drug compared to those taking placebo. However all these trials were funded by manufacturers of herbal supplements and therefore aren’t reliable. There are no independent large-scale clinical trials to prove Damiana will boost your sex drive.

At the start of this blog I listed all the causes of female sex problems. Many of these are complex and often women have more than one problem at once. Sex problems in women and men always need tackling holistically. A ‘quick fix’ of patch, supplement, lotion or lubricant used without addressing other factors is bound to fail. That’s why the ‘In the know’ feature is irresponsible journalism. It misquotes evidence, promotes theories and treatments that aren’t evidence based, and sets its readers up to fail.

So how could ‘In the know’ have got a bit more knowledge on sex research?
They could have checked out all the evidence they were citing by using free and reliable search tools such as
Google scholar
Search Medica
PubMed

They could have checked out the credentials of those they were quoting to see if they have any links with the pharmaceutical industry that might have led to biased advice being given.

They could have asked a wider range of sex researchers what the evidence on this area actually is, and whether their suggested ‘remedies’ were widely recognised and scientifically valid.

They should have been particularly sceptical about products not yet on the market and avoided becoming an advertorial for the pharmaceutical industry.

They shouldn’t take at face value claims made by manufacturers or on product websites – all claims should be checked against scientific evidence. Otherwise bogus products could be being promoted within the health pages for a magazine.

I’ll be emailing the editor of the magazine to let them know about this problem piece in the hope they can avoid similar bad reporting in the future. I’ll let you know their response.

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