Marshall

Sexual Medicine, Sexual Bodies and the 'Pharmaceutical Imagination'

Analyzes clinical research on sexual dysfunctions.
Explores the biomedical construction of sexual bodies.
Highlights increased search for biomedical explanations and solutions after Viagra's success.
Discusses shifts in narratives surrounding sexual problems.
Argues for a 'pharmaceutical imagination' that frames narratives about sexual dysfunctions.
Drugs like PDE-5 inhibitors, hormones, and SSRIs are highlighted as actants in sexual health discourse.

Quote by Hippocrates at the entrance of Indiana’s medical school:
- "The nature of the body is the beginning of medical science."
Implies a common understanding of science leading to medical advancements.
Suggests that medical discourses construct rather than discover truths about the body.
Focus on the role of drugs in constructing (hetero)sexual bodies post-Viagra.
Critique of the 'pharmaceutical imagination' guiding sexual medicine.

Medicalization has a political history with early critiques viewing it as a force imposed by professionals.
Recent approaches highlight the complexity of medicalization, focusing on context and agency.
Peter Conrad posits that medicalization is now driven by commercial interests.
Shift from clinical to biomedicalization emphasizes transformation of bodies.
The concept of 'pharmaceutical imagination' analyzes the production of knowledge about sexual function and bodies.
Asserts that the pharmaceutical narrative often overlooks the cultural context of biological issues.

Review of historical changes in the perception of erectile dysfunction (previously seen as psychogenic).
Introduction of Viagra redefined the understanding of impotence (now known as erectile dysfunction).
Highlights a trend towards disease specificity shaped by pharmacological treatments.
Viagra's success has led to broader disease models that now include younger men.
Female sexual dysfunction is framed differently, with efforts to connect it to logical medical treatments.

The pharmaceutical market for sexual dysfunction remains significant.
Off-label prescribing allows for new definitions of existing drugs as treatments for various sexual disorders.
Testosterone and SSRIs play major roles in this market expansion.
Focus on 'androgen deficiency in the aging male' (ADAM) and 'female androgen insufficiency syndrome' (FAIS) as new disease categories.
Off-label usage of testosterone prescriptions is growing despite disagreements on normal levels.

Contrasts previous notions of normal/abnormal with functional/dysfunctional.
This shift links individuals to new standards of sexual function and encourages self-monitoring.
Pharmaceutical interventions are positioned as solutions to create 'functional' bodies.
Emphasizes the necessity for diagnostics and re-evaluation in light of drug effects.

The 'pharmaceutical imagination' frames understanding of sexual problems as biochemical in nature.
Explores how narratives constructed around drugs and sexual dysfunctions interact to reshape individual experiences of sexuality.
Highlights feminist critiques of how this reduces diverse sexual experiences within biomedical contexts.
Calls for continued critical examination of the interplay of drugs and the biomedicalization of sexuality to ensure more nuanced understandings.