Fix for low sex drive puts reporters in a bad patch
Authors: Ray Moynihan
Journal: BMJ (2004)

As the debate over the safety of new anti-arthritis drugs rolls around the world, the gap between marketing messages and scientific truths becomes clearer by the day. The estimated toll of heart attacks associated with Merck's rofecoxib (Vioxx) mounts; questions about other COX 2 inhibitors arise; and the drug companies and regulators are rightly being criticised and investigated. Now is a good time for rigorous scrutiny of the media's role in initially boosting this new class of anti-arthritis drugs: the record will show that many reporters seemed simply to reproduce the marketing hype in their stories.

Yet even while this debacle continues, another case study in misleading media coverage around the world is fast emerging: many of the articles about the experimental testosterone patch for women look more like marketing fiction than rigorous journalism. In their search for sexy stories some media outlets are exaggerating the benefits of the patch, inflating the potential pool of patients, playing down well established harms, and ignoring important conflicts of interest. None of the key clinical trials of Procter & Gamble's testosterone patch has been published in peer reviewed journals, yet for a year or more excited media reports have sung the praises of the latest panacea for women's “low sex drive.” Next week, despite a virtual worldwide absence of independent public scrutiny of the scientific data, a panel of advisers to the US Food and Drug Administration will decide whether or not to recommend this drug's approval.​approval.




Figure 1






In May the BBC ran a story with the headline “Patch `boosts women's sex drive,'” which can still be found on its website. The second line says a trial among women who had had hysterectomies found that the patch caused a “74 per cent increase in satisfying sex.” A professor at George Washington University describes a “tremendous medical need” to help women with low sexual desire, and a University of Central Lancashire professor declares the patch “exciting news.” The BBC story made no mention of side effects or conflicts of interest.

That BBC story was based on marketing material sent out two days earlier by Procter & Gamble and its Manhattan based media advisers Hill & Knowlton—one of the world's most prolific public relations firms—and it was timed to coincide with a conference presentation in Philadelphia. Hill & Knowlton helped distribute a video news release and a press release, featuring as its first line the testosterone patch's miraculous ability to produce a “74 per cent increase” in sex.

At this stage we don't know exactly what that “74 per cent increase” actually means, because the complete data of the trial remain unpublished, and it is unclear what was being measured. What we do know, however, is that this figure describes the relative increase in the amount of “satisfying sexual activity” for women rather than the absolute increase. In absolute terms the benefits of the drug look much less impressive. Several abstracts seem to show that wearing the testosterone patch for six months increases satisfying sexual activity for women by just one “episode” or less a month, compared with a placebo

Along with exaggerating the benefits of drugs, it is not uncommon for the media to inflate the estimated numbers of people affected by medical conditions. Although Procter & Gamble is currently seeking approval to market the testosterone patch for only a limited number of post-menopausal women who have had their ovaries removed, some media stories are already endorsing the drug for a much larger population. An article in the Chicago Sun-Times in September, “Not in the mood? Now there's a patch,” claimed that the drug was designed to treat the widespread problem of “low libido” allegedly experienced by “30 per cent of women.” Like the BBC the Sun-Times made no mention of trial data indicating that the patch added, on average, just one, or less, satisfying sexual episode a month, for surgically menopausal women. The article did, however, list some of the potential side effects of testosterone: “weight gain, clitoral enlargement, increased facial hair, and high cholesterol.”

One of the poorest examples comes from the New Scientist, a media outlet describing itself as “The world's no. 1 science and technology news service.” This story, which was based on a conference presentation in Texas last year, did not give any absolute figures, did not mention any harms, and did not show that the main expert quoted was flown in from Australia by Procter & Gamble. As it turns out, the key trials of the patch have all been funded by the company, several key “thought leaders” in the field, including some trial investigators, have financial ties to the company, at least one of the investigators is a company employee, and the measurement scales used in the trials were also funded and designed with input from Procter & Gamble.

Given the strong evidence that studies funded by drug companies tend to find more favourable results than independent studies, together with the increasingly common scandals over drug safety and conflicts of interest and the fact that key data on the patch have not yet been peer reviewed and published, the excited media stories tell us much more about standards of journalism rather than the latest remedy for a lack of interest in sex.

Procter & Gamble declined requests for interview.