In 1998, the U.S. Food and Drug Administration approved the male sex drug marketed as Viagra. In its first week on the market, almost 40,000 prescriptions were written. Now men have six drugs available for sexual issues. Sixteen years and billions of dollars in research and development later, there are still no drugs available for the estimated 14 million U.S. women who struggle with a low sex drive. Multiple medications have made it to research trials, but none have ended up on pharmacy shelves. In her incisive, insightful investigation, “Pleasure in a Pill?” Virginia Sole-Smith looks at the complicated history behind this oversight. Why have these drugs languished for years? Is it, as some critics have claimed, sexism on the part of the FDA? Or is female sexuality too complex to be treated by medication alone? The story brings an issue to the cultural forefront that isn’t discussed in the media–or, in fact, in many intimate relationships. With in-depth reporting about the machinations of the pharmaceutical industry– aiming to pressure Big Pharma and the FDA to reexamine their clinical trials and approval processes–and artful storytelling about the drug research trial participants, Sole-Smith clearly points to the need for more sexual health options for women. She also gives us an inside look at the different forces on the front lines working to equalize women’s sexuality in the medical and pharmaceutical industries. Although the piece is an investigative look at why women don’t have parity in the sexual health field–and suggests that some women would be better off with medications at their disposal–the most pressing takeaway from “Pleasure in a Pill?” is that medication might not be the answer for every woman, or even most women. Women who struggle with their sex drives find themselves between a rock and a hard place. In long-term relationships, sexual availability is expected, yet many women feel stymied by the cultural expectations placed on them around sex. The drug industry is aware of this conundrum and capitalizes on it, co-opting feminist rhetoric in its campaign for a female Viagra equivalent. If such a drug can be successfully made–and right now it’s far from clear that one can–it has the potential to dramatically shift how women navigate sexual relationships. But Sole-Smith’s reporting shows that there are no silver bullets: perhaps the best thing we can do for women is to reexamine the complexities of female sexuality and decrease the numerous taboos surrounding it.
