Orgasm Inc Premieres in 11 U.S. Cities

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Filmmaker Liz Canner, who took a job editing erotic videos for a cream to enhance orgasms, got a voyeur's view of how desperately the pharmaceutical industry wants to find the female equivalent of Viagra.

Now, her documentary, "Orgasm Inc.," which takes viewers behind the scenes in that quest, premieres in theaters in 11 U.S. cities -- New York and Chicago on Feb. 11, and in Los Angeles and San Francisco in April, as well as seven other cities, including Ottawa.

It all began in 2002, when Canner took a job with the California-based pharmaceutical company Vivus, which was using her videos to show to women in early clinical trials for a new orgasm drug called Alista.

The timing couldn't have been better: http://www.pfizer.com/home/?source=google&HBX_PK=s_pfizer&HBX_OU=50&o=41962183|218826469|0" target="external">Pfizer had come out with Viagra for men in the late 1990s, and Vivus was scrambling to find a female equivalent. As Canner intercut ocean scenes with descriptions of the clitoris, she began to wonder if company executives were testing a female sex drug for which they didn't yet have a disease.

Soon, she said she realized her employer -- and perhaps the pharmaceutical industry at large -- might be selling women a potentially dangerous product. So Canner switched gears, and with the permission of Vivus, began her own project.

In Orgasm Inc.," her first feature documentary, Canner explores the creation of female sexual dysfunction and the billions of dollars the pharmaceutical companies have poured into promoting drugs to healthy women.

"I didn't intend to make an expose, I was tired of making these kinds of films," Canner told ABCNews.com when the film garnered buzz last year. "I expected one thing and I found something else. I could keep to my original idea or be honest."

Instead, director and producer Canner took a serious, but sometimes comical look at the medicalization of women's sexuality -- from the invention of the Dr. Stuart Meloy's "

orgasmatron" for on-demand climax to cosmetic vaginal reconstruction -- all in the name of some new kind of normalcy.

As the film opens, Canner introduces Charletta, a middle-aged woman who, incredibly, has agreed to have electrode wires inserted in her spine to help her achieve an orgasm. She hopes Meloy's orgasmatron device will help her end the "the war inside my head."

"Not only am I not normal, I am diseased," says Charletta.

Going under the knife in her elusive quest for sexual satisfaction underscores Canner's mantra that the medical world is tampering with women's health, creating a culture of pill-popping without regard to side effects, all the while contributing to higher health care costs.

Canner argues that most of women's sex problems arise from bad relationships, sex abuse, lack of sex education and working too much. Who says, she asks, that there is a normal number of times a week a woman should have sexual thoughts or an orgasm?

"There is very little physiologically that affects a woman's sex drive," she said. "They are making a culture where women feel discontent and think they have a disorder when they don't."

Study Finds 42 Percent of Women Have Sexual Dysfunction

Meanwhile, Vivus executives turned their attention to women's physiology and an untapped market in need of a cure.

"We are on a race to see who can be first to market," Darby Stephens, their manager of clinical research, tells Canner. "We've come up with the drug, now we have to come up with the disease."

Canner was shocked to learn that a 1999 survey claimed 43 percent of all women suffered from a broad, poorly defined condition, female sexual dysfunction (FSD).

"I had read lots of books and historians of female orgasms and none had mentioned FSD," said Canner. "Where did it come from? It made me uneasy and confused."

And when she asked those who worked at Vivus where the term came from, even founder Virgil Place said on camera, "I don't know."

"A few years later I went back and looked at the footage and realized the discomfort at Vivus among people who worked there," she said. "They didn't want to answer my question."

Vivus took a hit when http://www.viagra.com/viagra-common-questions.aspxL" target="external"> Viagra, known generically as sildenafil citrate, hit the market in 1998. Sales of its own male sexual dysfunction drug Muse dropped from $130 million to $59 million in the first year and continued to decline.

Both drugs worked by allowing the smooth muscles of the penis to relax so that the organ can be filled with enough blood to sustain an erection. But Pfizer's little blue pill had a more comfortable mode of delivery. Muse, a suppository, was inserted into the tip of a penis with a plastic applicator.

Vivus's quest to duplicate Viagra with the female cream Alista for women failed, according to Canner, "because women don't care if they are engorged."

"Viagra doesn't give orgasms, only an erection," she said. "Drugs that do the same thing on women's bodies don't make us any more sexually satisfied."

Vivus said it has "discontinued development" of products for female sexual health, now focusing on drugs for obesity, sleep apnea, diabetes and male sexual health. CFO Timothy Morris declined an interview with ABCNews.com last year.

"Liz Canner's, 'Orgasm, Inc.' was filmed more than nine years ago, is out of date and does not accurately capture the core focus of Vivus," he said in a prepared statement.

The documentary also follows Proctor and Gamble's failed attempt to get U.S. Food and Drug Administration approval for its testosterone patch Intrinsa in 2004. Women's health advocates dismantled the product after finding links to breast cancer.

"Who doesn't want something that increases their desire, but doesn't hurt them?" said Canner. "We all want a drug that puts us in nirvana, but it's so easy for healthy women to end up taking drugs that can kill them."

But Sheryl Kingsberg, chief of the division of behavioral medicine in the department of obstetrics and gynecology at Case Western Reserve School of Medicine, says it is a "disservice" to women to deny them access to medications that might help them.

Antidepressant for Low Sex Drive

"My concern is clearly there is a side to the documentary that is biased and it's unfortunate for women," said Kingsberg. "We would not want to pathologize every woman with a sexual problem."

"We all wax and wane and dismiss the fact that women do struggle with sex problems and are very much in distress by it," she said. "They should not be marginalized or dismissed and not get treatment."

Kingsberg is a "external"> medical expert for the German pharmaceutical giant Boehringer, which sought FDA approval for its drug Flibanserin last June.

The drug was designed to treat hypoactive sexual dysfunction disorder (HSDD), which was included in the American Psychiatric Association's diagnostic manual in 2002, defining it as a persistent lack of desire that specifically causes anxiety.

The FDA rejected Flibanserin, saying it did not significantly increase women's desire and had significant side effects, including dizziness and depression.

Kingsberg argues that direct-to-consumer advertising has "opened to doors for sex" to be considered "healthy and appropriate."

"Women are smart. It's hard enough for anybody to comply with a medical regimen," she said. "If the drug isn't helpful, someone is not going to take it," she said. "It has to be effective."

But critics say when the FDA relaxed the rules on television marketing, the creation of new disease soared. The United States is the only country in the world, except New Zealand, that allows direct to consumer advertising.

"It's not a matter of rights for women, it's a matter of hijacked science," said Leonore Tiefer, associate clinical professor of psychiatry at both New York University and Albert Einstein schools of medicine, who has a private sex therapy practice.

Tiefer, who currently leads the New View Campaign to fight "disease mongering," was part of the documentary as she fought Proctor and Gamble's bid to market Intrinsa.

"I had an epiphany," she said. "When Viagra came out, I was working in a urology department and I knew about men and the penis and five minutes after it was approved, they were saying, 'Where is Viagra for women?' Wait a minute, there are loose screws. Women are not clamoring the men are. This is an attempt to create a market."

Even Viagra is not as successful as its company publicizes, according to Tiefer.

"Drugs are never that great," she said. "There's always problems."

A ban on direct to consumer advertising, more government regulation of the pharmaceutical industry and more "sexual literacy" among Americans is needed, according to Tiefer.

"The whole society is set up to stimulate men who are ready to go on a moment's notice," she said. "Women's sex lives are more profoundly affected by social and interpersonal contexts."

As for Charletta, she eventually discovered she could achieve orgasm, but not after undergoing surgery for the push-botton orgasmatron.

That medical odyssey ended in disappointment: The device failed to give her climactic joy, only a twitch in her left leg.

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