Women Lacking Libido Aren't Sick

Birth of a "pink Viagra" would wrongly medicalize low libido, says Leonore Tiefer.


As companies race to bring a "pink Viagra" to pharmacy shelves, some people are doing everything they can to stop them. At the forefront of this countermovement is Leonore Tiefer, clinical associate professor of psychiatry at the New York University School of Medicine, who in 2000—two years after Viagra's approval—gathered a group of what she calls "like-minded feminists" to form the New View Campaign. Their goal: to educate about the "medicalization of women's sexuality." Their beef with companies developing a Viagra for women: If a female libido drug comes on the market, healthy women who aren't bothered by having a low sex drive may face societal pressure to seek "treatment." U.S. News spoke with Tiefer. Excerpts:

Why did you organize the New View Campaign?

About five minutes after Viagra hit the market, people started asking: "Where is a Viagra for women?" and I had never heard any woman express a desire for such a drug. So I thought someone with credibility had better stand up and say, "Excuse me, the emperor is naked—this is not what women want, and this is not what's in their best interest." I decided I was going to be that person. What do you mean by the "medicalization of women's sexuality"?

Women complain about many sexual problems; among them is a loss of interest in sex, irregular sex, interest in the wrong partner, lots of things. But how do you classify those complaints? What language do you use? These are professional matters that I think have been hijacked by agents of the pharmaceutical industry. In 2006, about 1.4 million off-label prescriptions for testosterone were written for women. Doesn't that suggest women want a libido-boosting drug?

It's hard to know. I mean, doctors prescribe like taxi drivers honk. It's their job. And doctors don't have that much to offer when people come in and complain about their sexual problems, so they give them a prescription. They're not going to sit there for an hour and a half and explain to you their feelings about how your labia are connected to your inability to relax, and how your inability to relax is connected to your loss of desire. What would you encourage such women to think about?

The first thing I would do would be not to consider [low desire] a medical condition. Approach the idea of medical treatment with tremendous hesitancy and caution. Research suggests that to lose desire is normal. I would regard fluctuations in sexual interest not just as normal but as a good thing built into one's feelings about pretty much everything; with the seasons, with age, with changes in a relationship, with changes in health, with changes in work responsibilities. Everything comes and goes. But what about women for whom diminished testosterone might be the culprit?

We don't know that a lack of testosterone is behind the problem. There was a big study in the Journal of the American Medical Association in 2005 that has never been refuted showing that low testosterone may have nothing to do with [low libido]. When a company says, "Oh, but women lose testosterone after menopause," that may well be true, but there are plenty of hot-to-trot women who have zippo testosterone. Now why is that? So you're saying a case of low testosterone doesn't necessarily justify treatment?

Again, it's one of those underlying assumptions that when you're 60, and your physiology is different from when you were 40, it's a problem that you can reverse by somehow replenishing the things being lost. Your whole body is changing; you don't need the things you needed earlier. It's not a problem to have normal physiological changes in your body. If drugs for low desire aren't a good solution, what is?

The only thing you need a solution for is a problem. I hope some women who take a look at their sex lives won't need a solution. But if you do decide you need a solution, there are lots of them: Conversation and communication with a partner; sexual education with a partner; education for yourself about sexual realities and options. If you're not where you want to be, then you might say to yourself, "Maybe there's some more I need to learn about sex, not just putting [tab] A into slot B, but about how imagination fuels desire." The mind leads and the body follows.