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The couple walks into my office. She is obviously hurt and angry. He has the look of angry confusion. She blurts out her discovery that he uses pornography. She feels as though he's been cheating on

According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product

her. She feels betrayed. She finds the whole thing repulsive. How could he do this to her?

He is ashamed on one level. On another level, it seems the most natural thing in the world. He's always loo

; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.

Examples of combination products may in

ed at bodies. He has always had fantasies, and he can now see pictures and films just like them on the internet. His friends do it. The guys in the locker room talk about it. What's so wrong with it?

lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.

This situation occurs with surprising frequency. Couples are angry and confused about what to do with it all and about what it really means. They feel terribly hurt and misunderstood. They'd like so

here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe

e answers instead of just blaming each other. So, here's some things to consider.

1. Any problem for a couple is a "team" problem. If one person hurts, the "team" has a problem. If one person is ang

d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.

Combination pro

ry, then the "team" has a problem to resolve. It's not a competition where one wins and the other loses. It is about the "team" winning as a whole.

The pornagraphy issue is the same. The couple need

ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc

to find a way that meets the needs of both people, so that the team wins.

2. Men and women have very different training and understanding of sexuality. Women are raised to focus much more on the re

easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi

ational aspects, while men grew up learning to focus on the visual and physical experience, often to the exclusion of relationship.

In a culture that makes use of women's bodies to advertise and sel

nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically

just about everything, women easily come to believe that they are only valued for their physical attractiveness. Many already feel ashamed of their bodies, believing they're supposed to be shaped li

and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ

ke teenage boys. In their most intimate and important relationship they so desire to be loved and accepted for who they are, not what they look like. It comes as a very rude surprise to realize that

ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi

heir man seems to be just like all the others.

Men, take note. When your partner's dream bubble is burst in this fashion, you have to take action, or it is downhill from there.

As described above,

ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.

Following aspects would a

en are trained to feel both guilty about pornography, and to accept it as the norm. They see it as a simple release mechanism, and not as cheating, betraying, or even having any real meaning at all.

dd to the challenges in developing combination products:

Which markets to tap where the combination products can do fairly well?
Which combination prod

hey are drawn to the relationality of their women, but often do not really understand it, let alone understand that pornography can damage it.

3. From a functional standpoint, here's the real proble

cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin

m with pornography: It seduces a man away from emotional intimacy with his partner. This doesn't have to be the case, but it occurs so often that I tend to assume it is happening until proven otherwi

tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen

e.

The seduction is one of easy avoidance. There is no relationship to take care of or nurture. One doesn't have to live with the complaints or even the mistaken dreams of the fantasy figures. Worse

t?

As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel

still, the images are ever changing, ever titilating. Life at home with the same woman, the same old positions, and the same old timing can seem rather mundane.

The problem with pornography is that

ping new procedures for reviewing their safety, efficacy and quality.

Professional from academic institutions, pharmaceutical industries, health care indust

en do not learn to develop the ability to be highly stimulated by deep emotional intimacy with their one, special partner.

A successful team helps both partners learn to be intensely intimate with o

y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products

ne another, and then intensely stimulated sexually. Pornagraphy offers the stimulation while avoiding the real reward of intimate closeness in the relationship.

So, how do such couples handle this d

.

As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de

lemma? At their best they use it as a vehicle to move them to an ever deeper level of contact with each other. They move past blaming and misunderstanding to acceptance of the other's gender and trai

elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.

Companies that provide selfless information through particip

ing. They come up with behavior that works for both of them and that they can both agree to and live with.

Ultimately, it can be a journey of emotional intimacy that ends up being one huge "turn on.

tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products

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