Orgasm Inc.: Search for the Female Viagra

May 17, 2010 — -- Liz Canner, a 42-year-old filmmaker from Vermont, was emotionally exhausted from making the wrenching documentaries that had so far defined her career: police brutality, world poverty and genocide.

"I was getting depressed about the human condition," she said. 'I watched the same violent footage over and over again and started to have nightmares. I thought, 'I've got to do something on pleasure.'"

So in 2002, Canner took a job with the California-based pharmaceutical company Vivus, helping to edit a series of erotic videos that were to be shown to women in early clinical trials of a new "orgasm cream" called Alista.

The timing couldn't have been better:Pfizer had come out with Viagra for men in the late 1990s, and Vivus was scrambling to find the 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, but they didn't yet have a disease.

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

Now, in her first feature documentary, "Orgasm Inc.," Canner explores the creation of female sexual dysfunction and the billions of dollars the pharmaceutical companies have poured into promoting drugs to healthy women. Winning a Visionary Art Award from Dartmouth College, the film has been shown in several countries and premieres in New York City on May 27.

"I didn't intend to make an expose, I was tired of making these kinds of films," Canner said in a telephone interview from Scotland. "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."

Who Says 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 huge hit on profits when 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.

"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 medical expert for the German pharmaceutical giant Boehringer, which will seek FDA approval for its drug Flibanserin on June 18. The drug is 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.

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.

"Flibanserin a brain drug," she said. "They tried the blood flow drug on women and didn't work. The hormone drug didn't work and now they have a brain drug for women that's not going to fly either -- for the same reason, safety and efficacy."

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.

The following drugs are devices could be up for FDA approval next year: LibiGel; a testosterone gel rubbed into the upper arm daily that is supposed to stimulate sex drive; Bremelanotide, a synthetic peptide injected with a syringe before sex; Flibanserin, an antidepressant to boost libido; and the orgasmatron.

Click here to find screenings of Orgasm, Inc., around the country.