Entirely new diseases can be, and have been, invented to extend a manufacturer's patent on a highly profitable drug. Fugh-Berman said Eli Lilly stood to lose a lot of profits once the patent expired on its hugely popular antidepressant Prozac. "So they positioned this new condition, PMDD (Pre-Menstrual Dysphoric Disorder), and then went to physicians and the FDA with their highly paid experts who said PMDD is a tragic disease, and they got approved for Sarafem, the same drug. It's an on-label use for a repackaged drug; they created the disease and then got a drug re-approved that was going off patent."

Just how sly a move was it? "If I as a physician write a prescription for Prozac 20 mg," Fugh-Berman said, "the pharmacist can substitute fluoxetine, the generic. If I write a prescription for Serafem, they can't substitute another drug."

A TEXTBOOK CASE

Dr. Leonore Tiefer, a noted sexologist and associate clinical professor of psychiatry at New York University School of Medicine, said the 1998 approval of Viagra for "erectile dysfunction" -- formerly known as impotence -- created a "sea change" in the field of urology. "It was like being sucked into a very medical model and treatment orientation," she told me.

People immediately started asking about Viagra for women. As it was doing for men, Tiefer said that, as a feminist, writing about women, "I knew what would happen if there was a Viagra for women -- the isolation of the function from the person, the isolation of the genitalia from the rest of the body."

The only way to redefine "what a woman wants" -- and build a case for a drug to "treat" it -- was to turn "it" into a medical condition. Without widespread agreement on its definition, pathophysiology, or clinical manifestations, Female Sexual Dysfunction (FSD) was created. Tiefer called the development of FSD "a textbook case of disease mongering by the pharmaceutical industry and by other agents of medicalization."

With Pfizer's 2011 U.S. Viagra sales pushing $2 billion, and Eli Lilly's Cialis catching up, the booming "enhancement" market suggests that either there has been an extraordinary uptick in male impotence -- or that Pharma has convinced multitudes of men that erectile dysfunction, "E.D." for short, has reached epidemic proportions (40 percent of men are allegedly "at risk"), and drugs are the only solution.

It pains to think of the men who aren't ready when the moment is right as a result of taking Propecia to "treat" another natural effect of aging nearly as widespread among men as occasionally uncooperative equipment: male pattern baldness, or, in medicalese, alopecia.

The fact is you may not need chemical enhancement for the E.D. or the baldness. The best remedy for both may be to reexamine your beliefs about why hair or hardness are so important. A shot of redefined meanings can do wonders to restore normal functioning.