The Shocking Double Standard in Women's Sexual Health Medicine

A pharmaceutical entrepreneur's battle reveals how medical bias leaves 43% of women without treatment options that men take for granted.

Key Takeaways

• Men have 26 FDA-approved sexual dysfunction treatments while women had zero until 2015
• 43% of women experience sexual dysfunction compared to 31% of men, yet receive less medical attention
• Brain imaging studies prove female sexual dysfunction has biological, not just psychological, causes
• Insurance companies require women to fail marriage counseling before covering sexual dysfunction medication
• Addyi (flibanserin) took six years for FDA approval while Viagra received fast-track status in six months
• Women weren't required in clinical trials until 1993, creating massive research gaps in female health
• The medical establishment still treats women as "psychological beings" rather than biological ones
• Opportunistic companies exploit the treatment gap by selling unproven, unstudied compound medications
• Cultural discomfort with female sexuality prevents awareness of existing treatments like Addyi

The Tale of Two Sexes in Sexual Medicine

Cindy Eckert stood at a crossroads that would define her life's mission. Working in male sexual health, she witnessed the pharmaceutical landscape's stunning inequity firsthand. Men struggling with sexual dysfunction could choose from 26 different medical treatments. Women facing the same issues had exactly zero options.

• The prevalence data painted an even starker picture - 43% of women experience some form of sexual dysfunction according to the Journal of American Medical Association, compared to 31% of men, yet the treatment disparity remained absolute.
• Eckert's "aha moment" arrived at a sexual medicine society meeting where researchers presented brain scan imaging of women with hypoactive sexual desire disorder (HSDD) - the medical term for persistently low sex drive causing distress.
• The side-by-side brain scans showed dramatically different activation patterns between women with and without HSDD when exposed to sexual stimuli, providing undeniable biological evidence of the condition.
• "It was so obvious in that moment and yet we'd gotten away with up until that moment saying well we can't see it so it must not be real it's just psychology," Eckert explained, describing how the imaging revealed actual hardware differences in brain function.
• Women consistently described their experience as "the switch went out" - they loved their partners but simply never thought about sex anymore, despite wanting to regain that connection.
• The neurological reality showed these women's brains operating "with your foot on the brake" - literally not activating with sexual cues due to disrupted neurotransmitter function in the brain's reward center.

The Biological Truth Behind Female Sexual Dysfunction

Medical science recognizes four distinct types of female sexual dysfunction, each with biological underpinnings that contradict the historical dismissal of women's sexual health as purely psychological. The conditions include orgasmic disorder, sexual interest arousal disorder, genito-pelvic pain penetration disorder, and substance medication-induced sexual dysfunction.

• Flibanserin emerged from German research as an antidepressant that produced an unexpected side effect - instead of the typical sexual dysfunction caused by most mood medications, it actually improved sexual function in clinical trials.
• The compound works by targeting key neurotransmitters in the brain's reward center, essentially "disinhibiting" rather than further suppressing sexual response like traditional antidepressants do.
• Dr. Irwin Goldstein, the principal investigator on Viagra's pivotal trial, led research on flibanserin, bringing serious scientific credibility to the women's sexual health space.
• Clinical trials demonstrated that women taking flibanserin experienced increased sexual desire, more satisfying sexual encounters, and reduced distress about their condition - meeting all FDA-required endpoints for effectiveness.
• Beyond sexual function, patients reported additional benefits including weight loss, improved sleep, and enhanced overall drive and motivation, suggesting broader neurochemical effects.
• The medication targets specific brain receptors (5HT1A and 5HT2A) that regulate the neurotransmitter balance affecting sexual desire, providing a clear biological mechanism of action.

Regulatory Resistance and the Fight for Approval

The path to FDA approval revealed systemic bias in how medical authorities evaluate treatments for women versus men. While Viagra received fast-track approval in six months for addressing "an important unmet medical need," Addyi faced six years of regulatory scrutiny.

• The core debate centered on an absurd premise: "how much sex is enough for women to deserve to have it" - a question that would never be asked about male sexual dysfunction treatments.
• FDA approval required proving women had more desire for sex, more satisfying sexual experiences, and less distress about their condition - all of which the clinical trials demonstrated conclusively.
• Critics questioned whether there was "any benefit to women having more sex," treating female pleasure as subjective rather than recognizing the medical validity of sexual dysfunction.
• Eckert's trials included three times more patients than Viagra's initial studies, yet faced exponentially more resistance and skepticism from regulatory bodies.
• The approval process exposed how deeply embedded cultural discomfort with female sexuality influences even scientific and medical decision-making.
• "We had proven it against all the endpoints that the FDA required," Eckert noted, yet the discussion remained mired in whether women deserved treatment rather than whether the treatment worked.

Insurance Barriers and Medical Gaslighting

Even after FDA approval, accessing treatment reveals additional layers of systemic discrimination that would be unthinkable for male sexual dysfunction. Insurance companies created unprecedented barriers that expose how little value the healthcare system places on women's sexual health.

• Insurance providers require women to fail marriage counseling before covering Addyi, treating a biological medical condition as a relationship problem requiring psychological intervention first.
• The medication costs approximately $20 per month when covered by insurance, but hundreds of dollars without coverage - creating financial barriers that particularly impact women.
• No male patient seeking erectile dysfunction medication faces requirements to attempt counseling or therapy before accessing pharmaceutical treatment, highlighting the double standard in approach.
• This "prior authorization" requirement effectively puts insurance companies in the position of determining women's worthiness for medical treatment based on relationship factors rather than medical need.
• The New England Journal of Medicine published articles acknowledging the importance of addressing female sexual dysfunction while simultaneously recommending psychology-first approaches that ignore biological treatment options.
• Medical professionals often remain unaware of available treatments, with survey data showing less than 5% of doctors have heard of Addyi despite treating a condition affecting millions of women.

The Broader Pattern of Medical Bias

Female sexual dysfunction represents just one example of pervasive discrimination throughout women's healthcare. The same psychological dismissal pattern appears across multiple medical conditions affecting women disproportionately.

• Women weren't required to be included in clinical research until 1993, creating massive knowledge gaps about how medications and treatments affect female physiology differently than male.
• Studies show women experiencing heart attack symptoms wait seven minutes longer in emergency rooms because medical staff assume they might be "freaking out" rather than having a genuine medical emergency.
• Conditions like PCOS and fibromyalgia follow similar patterns - women visit doctors an average of 13 times before receiving proper diagnosis and treatment.
• The historical medical diagnosis of "hysteria" was only removed from psychiatric manuals in 1980, yet the underlying belief that women are primarily emotional rather than biological beings persists.
• Ambien provides another example - the sleep medication wasn't properly studied in women, leading to dangerous dosing that caused accidents due to different metabolism rates in female patients.
• "Even Hippocrates believed that the womb traveled throughout the body causing hysteria," illustrating how ancient misconceptions about female biology continue influencing modern medical practice.

Fighting Back Against Predatory Solutions

The treatment gap created by medical bias opens opportunities for predatory companies to exploit desperate women with unproven, potentially dangerous products. This exploitation further undermines legitimate medical research and treatment development.

• Silicon Valley entrepreneurs recently launched "new prescription medications for female sexual dysfunction" that were actually untested combinations of existing drugs with zero clinical studies in women.
• These compounded medications carry all the risks of their individual components plus unknown interaction effects, yet companies market them with claims like "nobody who's taken it has had any side effects."
• The supplement and wellness industry specifically targets women with products carrying disclaimer text stating "these claims have not been evaluated" - a lower standard than any FDA-approved medication.
• Women have been culturally conditioned to prefer "natural" alternatives over proven medicines, creating vulnerability to marketing that exploits distrust of pharmaceutical solutions.
• This predatory cycle reinforces medical dismissal by making women appear to prefer unproven treatments, when actually they've been systematically denied access to evidence-based options.
• "At best I think it's robbing or misleading women... at worst it's harming them," Eckert warned about companies combining medications never meant to be used together.

The Path Forward for Women's Healthcare Advocacy

Real change requires systemic shifts in how medical professionals, insurance companies, and society approach women's health concerns. The solution lies in demanding evidence-based conversations that begin with biological rather than psychological assumptions.

• Healthcare providers must lead conversations with women using the premise that they are biological beings deserving the same medical consideration as men, then layer in psychological and lifestyle factors as appropriate.
• Medical education needs updating to include questions on women's wellness exams that provoke evidence-based discussions rather than dismissive responses like suggesting "bubble baths" for medical conditions.
• Women themselves must advocate more forcefully for biological explanations and treatments, pushing back against automatic psychological attributions of their symptoms.
• The 10-year truth horizon applies to most advances in women's health - it takes a decade for medical breakthroughs to overcome cultural resistance and become standard care.
• Social media platforms and advertising standards must eliminate double standards that allow promotion of male sexual health treatments while restricting female-focused medical information.
• Investment in women's health innovation requires champions who understand both the medical needs and the cultural barriers preventing solutions from reaching patients who need them.

Cindy Eckert's journey from pharmaceutical executive to women's health advocate illuminates how deeply embedded medical bias affects millions of women's lives. The path to equality requires recognizing that women deserve the same evidence-based medical treatment options available to men - nothing more, but certainly nothing less.