issue 165 - November 1986
'When women outlive their ovaries'
Advertising slogans like this, used to promote mood-altering drugs,
are hard to ignore. They lace the pages of Canadian medical journals,
for the eyes of prescribing doctors only. Toronto-based health professional
Anne Rochon Ford looks at how sexist advertising influences the
almost exclusively male kingdom of the physician.
The corporate goals of the pharmaceutical industry are the same as any other business: expansion and market control. And slick advertising campaigns are a powerful weapon in their armoury. It is estimated that over $7,000 a year per doctor is spent by the pharmaceutical industry in Canada - $250 million p.a.1 - to convince doctors to buy their products.
Most journals from which doctors get their contemporary medical information are heavily supported by the advertising revenue from pharmaceutical companies. While some publications are subscribed to, most are sent free and unsolicited to doctors by the companies which subsidize them. Obviously it pays the corporations, for they are among the four wealthiest industries in North America today.
But such advertising doesn't simply sell drugs, it also sells a particular view of patients and a particular view of how doctors should treat them. Women come off worst, with advertisements frequently reinforcing negative stereotypes. The most progressive of male doctors cannot help being influenced by the hidden bias which ripples through the copy and visual images.
The effect of the advertising is important because doctors often serve as agents of social control.
'In every society,' writes Ivan Illich, 'medicine, like law and religion, defines what is normal, proper or desirable. Medicine has the authority to label one man's (or woman's) complaint a legitimate illness, to declare a second man (or woman) sick though s/he themselves do not complain, and to refuse a third social recognition of his/her pain.'2 So how much of what doctors learn or have reinforced about women through pharmaceutical advertising contributes to their control function? 'The suggestion is,' notes Elissha Mosher, 'that women should be medically managed with mood-altering drugs when adapting to changes in their lives. The "empty-nest syndrome" and the "irritable post-menopausal woman" are advertising creations developed in timely response to women's conflicts and search for identity and fulfilment in our society.'3
Do doctors prescribe so many psychotropic (mood-altering) drugs for women because doctors themselves are victims of distorted ads for such medicine? The results speak for themselves.
Women are more likely than men to receive a prescription for mood-altering drugs by a ratio of two to one and this increases with age, concluded a study on pharmaceutical drugs in Canada.4 It was also found that symptoms presented by a woman - 'My neck is always tense' - were more likely to elicit from a doctor the response of a drug prescription. The same symptoms presented by a man were more likely to result in the doctor sending him for lab tests or X-rays.5
All too often psychotropic drugs are seen as a solution to a woman's problems. Of course it may be that such problems have little to do with individual sickness and far more to do with broader social issues. In this way women are given mood-altering drugs to suppress the rage and frustration of living with dual roles, inferior status and physical violence. It is not surprising, for example, to find most of the women in battered women's shelters being prescribed mood-altering drugs by their doctors.8
I have researched the portrayal of women in the advertising pages of six Canadian and American medical journals.
A consistent series of images appeared exemplified by the illustrations on this page.
Anne Rochon Ford is the Resource Co-ordinator of Women's Health Care Programs at Women's College Hospital in Toronto.
An extended version of this article first appeared in Healthsharing, Spring 1986.
1 According to Joel Lexchin MD., author of The Real Pushers:A Critical analysis of the Canadian Drug Industry New Star Press. Vancouver, 1984.
2 Medical Nemesis: The Expropriation of Health, Penguin, 1978.
3 Portrayal at women in drug advertising: A medical betrayal, Journal of Drug Issues. Vol. 6, No. 1, 1976.
4 Sex differences in psychotropic drug use, Social Science and Medicine. Vol 12B, pp.179 - 186.
5 Response of physicians to medical complaints in women, Journal of the American Medical Association, Vol.241, No.20. May 18, 1979, p.2l86.
6. Report from Byrony House. transition home for battered women and children in Halifax, Nova Scotia. 1979.
The image of a woman as a nuisance
When we see how frequently ads with this theme appear, we can't help but wonder just who these drugs are for - the woman being prescribed them or those she imposes her moods and crankiness upon? It might be anyone, like the bus driver. Here the language is aimed at trying to make the doctor sympathize not with the woman and her problem, but with the poor, long-suffering bus driver who has put up with her. We're told in the text that she makes life miserable for everyone she comes in contact with, including no doubt the doctor.
The image of a woman as dumb
One of the most effective ways to illustrate that women are dumb is to treat them like children. 'You're looking at a patient who needs as hematinic - chances are 1 out of 3 that she won't take it !' The smaller print reads: 'Many patients fail to comply with the prescribed hematinic dosage regimen. In pregnant women, non-compliance has been as high as 1 out of 3.' Words like 'comply' and co-operation' appear in the text as easily as in manuals for training animals.
The image of a woman's biology being her destiny
According to the stereotyped world of pharmaceutical advertising, one of the worst things about being for women is the menopause, signalling the end of the reproductive years. The implication is that 'something is terribly wrong'. Menopause is referred to as the time 'when women outlive their ovaries'. The advertising language packs a strong punch. 'Oestrogen deficiency' implies there is something lacking with the body. In fact, the female human ovaries are supposed to stop functioning at a certain point in a woman's life cycle. Imagine the outrage from the medical community if pharmaceutical advertising suggested that 'men outlive their testicles', which eventually they do.
The image of women as naggers
Women are complainers, the advertising implies, and the more persuasive the implication, the more convincing is the advertiser's argument for the drug which will silence them. This ad from Ross Laboratories for Isomil infant formula pigeonholes the petulant and over anxious mother. In one investigation of Canadian doctors' attitudes 68 General Practitioner were asked to describe a typical complaining patient to whom they had prescribed mood-modifying drugs. There was no reference to the sex of the person. In their response, 4 per cent of the physicians spontaneously mentioned men as particularly complaining, 24 per cent didn't mention either sex, and 72 per cent referred spontaneously to female patients. How much of this is prejudice - enhanced by pharmaceutical promotion?
The image of a women as unable to cope
References to the inability to cope are everywhere as in 'If she could cope she wouldn't have called.' Emphasis on the woman's powerlessness is a particularly popular theme in the advertisements dealing with drugs for menopausal symptoms. The menopause is referred to in one ad as a time when women simply 'are beside themselves'.
The inability-to-cope theme is one that we are likely to be seeing more of in years to come as increasing numbers of women attempt to juggle both family and a career outside the home. The theme has been used most flagrantly, however, in ads for drugs for the elderly. One ad speaks volumes: 'She doesn't know if she's coming or going.' It is the type of comment one might overhear spoken by family members in semi-hushed tones, but the idea of using it n an advertisement is in dubious taste.