Thursday, October 2, 2008

If My Penis Hurt...

Sometimes I think the exact same thing as the blogger in the sidebar: "If my penis hurt, there would be a pill!" As the blogger says in a post, there's no way that chronic penis pain would be relegated to mystery causes and treated with a shrug.

Is it true? Not sure. However, if we compare vulvodynia to the closest men's condition I can think of -- erectile dysfunction -- here's what we get:

Google
ED: about 8,720,000 hits
VV: about 158,000 hits (1/55th of ED's)

Medication
ED: Viagra, Cialis, Levitra, at least
VV: none FDA-approved; crossover meds from other conditions

Rate of Occurrence
ED: increasing with age; Cialis says 50% or more of men 40-70 experience it
VV: 15% or more of women, any age

Causes
ED:
age, lifestyle choices (obesity, high blood pressure, smoking, alcohol or drug abuse), injury, hormones, medications, medical conditions like prostate problems and diabetes
VV: no one knows (but it sure ain't age or lifestyle choice)

Duration
ED: as long as a guy wants to have sex?
VV: all day every day, indefinitely

Effects
ED:
can't have sex
VV: can't have sex, wear certain clothes, walk or pee without pain, sit for long periods of time, ride a bike, etc., etc.

I'm getting snippy. I know it's obvious to all of us that chronic pain trumps a malfunctioning penis any day of the week. It's almost petty to make these points. But if it's so obvious, why the hell isn't there a pill?!

The usual answer: money. The more plausible answer: awareness plus money.

Money: 1 in 6 women will experience vulvodynia in her lifetime. That sounds like ka-ching to me.

Awareness: I visited at least 7 doctors before one mentioned vulvodynia, and that included a urologist, a gynecologist, and a midwife, people who should've been taught about a condition that 15% of their patients will have. The ignorance of the disease in the medical community is unbelievable. They can't advocate for better treatment if they don't know it exists -- this 1-in-6, roll-of-a-standard-die disease.

Money again: Vulvodynia doesn't lend itself to disease-mongering, as this article puts it, like erectile dysfunction does. Pfizer took a drug made for ED resulting from more serious medical conditions and marketed it as a confidence pill for an occasionally shy weewee. They were so successful at it that the text box I'm typing in knows I've spelled "Viagra" correctly. It doesn't recognize "vulvodynia."

Such success is impossible for a drug marketed toward vulvar pain. The revenue cap is at 15% of the female population. The way Pfizer sells it, every grown man is a potential Viagra customer.

Still, bipolar disorder affects around 1% of the population, and there are several FDA-approved meds for it. Assuming a vulvar-pain med drew the same percentage of sufferers a bipolar med drew, that's 7.5 times the customers (if half of those with bipolar disorder are men and children on bipolar meds are negligible). Money might not be a factor at all.

Back to the original question: if my penis hurt, would there be a pill? Would chronic penis pain overcome the awareness hurdle? I'm still not sure, but I think there might be an answer here: ten years after the FDA approved Viagra for erectile dysfunction, there is still no drug that addresses female sexual dysfunction.

P.S. Do you think this would appear in an article on erectile dysfunction? "At each stage of your life, you experience changes in sexual desire, arousal and satisfaction. Accepting these changes and exploring new aspects of your sexuality during times of transition contribute to positive sexual experiences" (source: CNN).

Edit: I did my analysis above assuming that all women with vulvodynia have it simultaneously. They do not. Vulvodynia can come and go, or it can last a lifetime. Bipolar disorder, once diagnosed, is around forever, and presumably those patients would be on medication from there on out. (I've gone on and off and am currently off, so it's not always true.) But my point still stands!

2 comments:

  1. Viagra, the FDA (Food and Drugs Administration) approved anti-impotence drug is composed of specific inactive ingredients such as anhydrous dibasic calcium phosphate, microcrystalline cellulose, magnesium stearate et al and altogether the medicine contains sildenafil as the chief component. But the erectile dysfunction medicine viagra would yield effective results only when taken in accordance with the instructions of the doctor.

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