1. The ‘Pinking’ of Viagra Culture: Drug Industry Efforts to Create and Repackage Sex Drugs for Women
Hartley, Ch. 23, pp

2. Female sexual dysfunction
With the success Viagra-like drugs for men, women's sexual problems have become medicalized just as men's were – defined and understood as a largely physiologically based set of conditions called female sexual dysfunction (FSD)

3. 2 main strategies of drug industry
a search for a Pink Viagra to treat the "disease" of FSD, shifting from products to treat arousal problems to those targeted at desire problems
the increasing promotion and normalization of off-label uses of men's sex drugs for women

4. Inflated epidemiology and the institutionalization of FSD
In pursuing these strategies, the pharmaceutical industry has relied on inflated epidemiology and the institutionalization of FSD

5. Inflated epidemiology:
Widespread dissemination of disease prevalence estimates, namely the '43-31' study, which found that more than 4 out of 10 women (43%) have sexual problems, a rate of dysfunction higher than that of men (31%)
Even the author of the original study himself has gone on record saying the findings were misappropriated to promote the medicalization of sexual problems

6. The institutionalization of FSD
FSD has become institutionalized in academic circles. Key events in institutionalization process:
Development of systems of disease classification amenable to medical approaches
Creation of a legitimized infrastructure for disseminating supporting research and education
Formation of an attendant professional organization
Establishment of an appropriate medical specialty

7. Institutionalization
Widely used term in social theory to denote the process of making something (e.g., a concept, social role, particular values or norms, or modes of behavior) become embedded within an organization, social system, or society as an established custom or norm within that system

8. Strategy I: Securing FDA Approval for a Women's Sex Drug
At least 7 drug companies are developing testosterone products for women
When Viagra trials for women failed, there was a shift in the definition of FSD, from an arousal problem to a desire problem

9. Strategy II: Off-label Prescribing of Men's Sex Drugs to Women
While none of the existing ED drugs have been sufficiently tested and proven for use in women, increasingly women are given off-label prescriptions for them and now approximately 1/5 of all the prescriptions of testosterone products approved for men are actually written (off-label) for women
Off-label prescribing is now seen as a way to circumvent the (time-consuming and expensive) FDA-approval process altogether in some cases

10. The Bermans: a case study in the commercialization of FSD
Sisters, Laura Berman, PhD (sex therapist) and Jennifer Berman, MD (urologist)
Used crossover appeal to leave academia for profit-driven commercial sectors
Built a multimedia company specializing in women's health, particularly in the treatment of FSD
Offer "quality care in a spa-like high-end environment“ that is expensive and usually not covered by health insurance
Claim approach combines strengths of psychotherapy with benefits of medication, but ultimately give preference to biomedical perspective

11. Nutraceuticals
Currently the only FSD products widely advertised are those from the OTC herbal/botanical/dietary supplement market that do not fall within the FDA's jurisdiction
Two most visible products are Avlimil and Zestra - the marketing platforms for both products attempt to make them seem like prescription drugs