J Med Ethics doi:10.1136/medethics-2014-102596
  • Viewpoint

Hypoactive sexual desire disorder: inventing a disease to sell low libido

  1. Adriane Fugh-Berman2
  1. 1University of California, San Diego, California, USA
  2. 2Department of Pharmacology and Physiology, Georgetown University Medical Center, Washington DC, USA
  1. Correspondence to Dr Adriane Fugh-Berman, Department of Pharmacology and Physiology, Georgetown University Medical Center, 3900 Reservoir Rd. N.W., Med-Dent SE 402, Washington DC 20007, USA; ajf29{at}
  • Received 24 November 2014
  • Revised 22 May 2015
  • Accepted 2 June 2015
  • Published Online First 29 June 2015


Condition branding is a marketing technique in which companies develop conditions concurrently with developing drugs; examples include gastro-oesophageal reflux disease, premenstrual dysphoric disorder, social anxiety disorder, erectile dysfunction and hypoactive sexual desire disorder. Although it is illegal for pharmaceutical companies to market drugs prior to regulatory approval, there are no restrictions on marketing diseases, and industry seeks to establish a disease state in the minds of clinicians years before an expected drug launch. Continuing medical education (CME) courses are an important part of promotion prior to drug approval and have become a key marketing tool for increasing clinician receptivity to new products. We systematically identified 14 free, internet-based, industry-funded, accredited CME modules on hypoactive sexual desire disorder in women which came out before a new drug, flibanserin, was being considered for regulatory approval in the USA. Common themes in these modules included the following: (1) Hypoactive sexual desire disorder is common, underdiagnosed and can have a profound effect on quality of life. (2) Women may not be aware that they are sick or distressed. (3) Simple questionnaires can assist clinicians in diagnosing the disorder. (4) It is problematic that there are medicines available to treat sexual problems for men but not women. In fact, there is no scientifically established norm for sexual activity, feelings or desire, and there is no evidence that hypoactive sexual desire disorder is a medical condition. Hypoactive sexual desire disorder is a typical example of a condition that was sponsored by industry to prepare the market for a specific treatment.

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