Blog of the Society for Menstrual Cycle Research
At least according to the newest ad for Kitadol, a menstrual pain reliever sold in Chile.
According to The Viking Network, Viking women retained property and inheritance rights after marriage, plus the right to divorce a husband who mistreated her or their children, insulted her family, or failed to be a good provider. These are considerably greater legal rights than most women had in that era (approximately 800-1050 CE).
I can think of worse metaphors for menstruating women.
[Via Copyranter]
The Pill makes the cover of NY Mag
Rare is the feature on women’s health from a magazine hip to New York City’s nightlife, dining, arts and entertainment. Within the past two months alone the magazine featured articles on the Julie Taymor Spiderman play, Jimmy Fallon and John Stewart. Not what one might consider provoking and thoughtful. Yet this week’s issue arrived with a juicy six page article titled Waking Up From the Pill that asks readers to consider the side effects of hormonal birth control.
The author begins her journey at a 50th anniversary celebration for the Pill, hosted by a pharmaceutical company, for “a couple-hundred bejeweled women in gowns” who toast to the Pill’s gift of reproductive freedom for women. But author Vanessa Grigoriadis notes a stunning social side effect of hormonal birth control – that women are waiting to conceive, particularly women in New York who “have shifted their attempts at conception back about ten years. And the experience of trying to get pregnant at that age amounts to a new stage in women’s lives, a kind of second adolescence.” She adds that this period is marked by anxiety and obsessions.
Interestingly, Grigoriadis elides information on the Pill’s physical side effects like increased risk of blood clots, strokes, decreased sexual drive and the like, and focuses only on the social side effects. Perhaps fearing a lawsuit, her language strongly connects infertility solely to durational use of the Pill that lingers beyond a woman’s natural reproductive age. “The Pill didn’t create the field of infertility medicine, but it turned it into an enormous industry. Inadvertently, indirectly, infertility has become the Pill’s primary side effect.” Be sure to read on.
15 Dangerous Drugs Big Pharma Shoves Down Our Throats
Alternet recently posted a list of the drugs most likely to make you sick. Writer Martha Rosenberg’s ’15 Dangerous Drugs Big Pharma Shoves Down Our Throats’ contained some startling choices.
Yaz is there, described as a “too good to be true” birth control pill that purported to do away with acne, bloating and PMS but ended up causing the deaths of many young women from blood clots and gall bladder disease. Interestingly, she points out that although the pharmaceutical company Bayer has seen a sales slump of late this has been attributed to the appearance of a generic, cheaper version of the pill, and not women’s suspicion of its side effects. This is a testament to the power of the company’s aggressive marketing campaign, and the pull of Yaz’s promise. I have written at length on my blog, Sweetening the Pill, about the impact Yaz had on my health – from the UTIs to the paranoia – but still when I saw Bayer would be releasing a rebranded version of the drug – Beyaz, with added vitamin B – I still felt tempted to try it. My life has been entirely transformed since ditching the Pill after ten years and looking back I can see very clearly how Yaz destroyed my body and mind, but I am still a woman living in a Pill-pushing culture just trying to avoid the self-doubt I’m sold on every day.
The birth control pill was the first drug created for and prescribed to healthy people. Its release was a catalyst for the industry, showing that although pills for sick people could make a profit, pills for healthy people could make millions. The Pill had a massive potential market of fertile women, and soon became a cure-all for any ailment seen as specific to them. This paved the way for another medicine on Alternet’s list – Lipitor – the heart-attack preventer drug, on which Martha Rosenberg writes:
“”My older patients literally do without food so that they can buy these medicines that make them sicker, feel bad, and do nothing to improve life,” says an ophthalmologist web poster from Tennessee. “There is no scientific basis for treating older folks with $300+/month meds that have serious side-effects and largely unknown multiple drug interactions.” What kinds of side effects? All statins can cause muscle breakdown but combining them with antibiotics, protease inhibitors drugs and anti-fungals increases your risks. In fact, Crestor is so highly linked to muscle breakdown it is double dissed: Public Citizen calls it a Do Not Use and the FDA’s David Graham named it one of the five most dangerous drugs before Congress.”
Lipitor is the best-selling drug in the world because its market is huge – healthy people holding any risk of heart attack, or just holding the fear of a heart attack are the demographic. Whereas the Pill is confined to female parameters, Lipitor also hooks men. Those behind the Pill had to first convince women that stopping ovulation is okay, then that menstruation is at best bothersome and unattractive, and at worst dangerous. Lipitor had a lost less work to do.
An Oklahoma City news program prepared this investigation about health risks of Bayer’s best-selling birth control pill, YAZ, with dramatic personal stories. The video cannot be embedded here, but you can watch it and read the news story here.
Previous commentary and reporting about YAZ at re:Cycling: The Next YAZ, What’s Up with YAZ?, and The Future of YAZ. For more about YAZ, see the reporting of our friend, Holly Grigg-Spall, at Sweetening the Pill.
Yes, the hormone therapies prescribed for women in perimenopause and beyond have already been suspect. Especially after the initial Women’s Health Initiative (WHI) trial results in 2002 (but even before that), researchers documented the health risks associated with the use of hormones during menopause, especially combination hormone therapies (therapies including estrogen plus progesterone, such as Prempro). SMCR’s Jerilynn Prior has done plenty of work on this as has SMCR’s Paula Derry, and WHI researchers and spokespeople have had to come out about many of the health risks as well. Now, this week, we find out that not only is there an increased risk of breast cancer for women who use these hormone therapies but that, according to a New York Times article published on Tuesday, “Women who took hormones and developed breast cancer were more likely to have cancerous lymph nodes, a sign of more advanced disease, and were more likely to die from the disease than were breast cancer patients who had never taken hormones.” According to this New York Times article, this report is the first to reveal WHI death rates.
After the dust settled from the original WHI reports about the risks of hormone therapies, researchers and doctors often made claims that it was still okay for women to be on hormone therapies for an extended period of time. Instances of death (instead of just disease/illness) are now causing some researchers and doctors to come forward and say that it is no longer safe for women to be on hormone therapies for this amount of time. Dr. Chleblowski, an author of the latest study about women’s mortality, is quoted in the New York Times article as saying that women should not stay on Prempro for more than a year or two.
Bottom line, these drugs are dangerous for women. The older we get, the more we realize that illness, disease, and death are a normal part of life. I find myself realizing this more and more each day as I watch people around me get sick, die, or have to deal with the loss of loved ones. But illness, disease, and death caused by prescriptions and indirectly by doctor’s care (what is often termed iatrogenic illness or death) is just not okay – especially when more caution could be used. Sure, it’s happened all throughout history. Plenty of people died so we could have Aspirin, Viagra, epidurals, Coumadin, birth control pills, safe abortions, hysterectomies, and pacemakers, just to name a few. But, as a doctor quoted in the New York Times article says, “The fallback is that doctors and patients should be deciding this on a one-to-one basis, weighing risks and benefits,” [but] “How do you do that when you don’t know what the risks are?”
We know that doctors are left in a precarious position, as are female patients, as they contemplate the use of hormone therapies….but what these articles and reports aren’t saying outright is that it is probably better NOT to use these drugs unless we absolutely have to. I was listening to Detroit’s NPR station driving home from work yesterday and heard even Dr. Susan Hendrix, a Detroit-based WHI researcher and doctor say, “maybe we can now just laugh at hot flashes,” instead of rely on combination hormone therapies to help us. At least that’s what she was inferring. We don’t completely understand all of the risks of combination hormone therapies but we know they include possible cancer and death, and delayed diagnosis of cancer as well (which means further death). Since yesterday was “Love Your Body Day,” I think perhaps we need to love our bodies more by remembering that some of the signs and symptoms we experience (such as hot flashes and irregular bleeding in menopause, no matter how hard to deal with) are not life-threatening, are completely normal, and can be dealt with without drugs — because the alternative is not so benign. Why should women continue to worry about whether they’ll die by Prempro? It seems WHI results are beginning to get even clearer, and I’ll be interested to see whether rates of prescription decrease after this last report. I also wonder what the makers of Hot Flash Havoc might think of this.
Nearly a year ago, we shared news of FDA approval of tranexamic acid tablets as treatment for heavy menstrual bleeding. Today we learned of successful clinical trials of the drug this purpose: The current issue of Obstetrics & Gynecology includes the results of a double-blind placebo-controlled study of tranexcmic acid tablets, in which the drug “was well tolerated and significantly improved both menstrual blood loss and health-related quality of life in women with heavy menstrual bleeding.”
Some of you may recall that in my book, Capitalizing on the Curse, I argued that the addition of PMDD to the DSM-IV and the re-branding of fluoxetine HCI as Sarafem are linked. It was no coincidence that pharmaceutical manufacturer Eli Lilly sought a unique FDA approval for Sarafem as treatment for PMDD just as the patent on Prozac, also composed of fluoxetine HCI, was about to expire. Eli Lilly initially secured the patent for Sarafem until 2007, and it is no longer the only FDA-approved treatment for PMDD.
Lilly must be in need of a new way to keep milking the cash cow. How fortunate that new research suggests that Prozac can relieve garden-variety PMS as well. A neuroscientist at the University of Birmingham presented research last week at the British Science Festival that asserts a 2mg daily dose of fluoxetine in the week before menstruation could alleviate PMS. She tested it for three years on rats. Of course, rats don’t actually experience PMS, so they were “induced to have PMS-like symptoms”.
Every time I read another article about new treatments for PMS, I remember Joan Chrisler’s comments about over-diagnosis of PMS and PMDD (which are both associated with high levels of relationship and family stress): “We’re conditioned to want a pill. Instead of something you might need more, like a nap or a divorce, or the ERA.”
Longtime readers may recall that late last year, the New York Times published an essay about how hard Big Pharma has worked to market menopause as an estrogen deficiency disease. Despite that exposé and others of the well-documented risks and limited benefits of hormone therapy, plus thousands of lawsuits pending over the role of HT in breast cancer, there’s apparently still quite a large potential market for pharmaceutical treatments for menopause (and other women’s health concerns).
To find out exactly how to mine that market, you can purchase the research report titled Women’s Health Therapeutics Market to 2016 – High Unmet Need will Drive the Uptake of Novel Drugs in Menopause and Osteoporosis from GBI Research. The report promises the following:
- Analysis of the women’s health market in the leading geographies of the world, which include the US, the UK, Germany, France, Italy, Spain and Japan.
- Market characterization of the women’s health market, including market size, annual cost of therapy, sales volume and treatment usage patterns.
- Key drivers and barriers that have a significant impact on the market.
This will better allow you to “align your product portfolio to the markets with high growth potential” and “develop market-entry and market expansion strategies by identifying the leading therapeutic segments and geographic markets poised for strong growth”. Not to mention the ability to “reinforce R&D pipelines by identifying new target mechanisms which can produce first-in-class molecules with more efficiency and better safety”.
It all looks very useful. Too bad I don’t have an extra $3500 in my back pocket.
It’s been two weeks since Chris Hitchcock and I returned from San Diego’s recent Endocrine Society meetings. We are feeling incredibly happy with the success of our protracted, intense commitments to a controlled trial of oral micronized progesterone (marketed in the USA and Canada as Prometrium®) for night sweats and hot flushes/flashes. At the Endocrine Society we presented the first-ever trial showing that the molecularly identical progesterone by mouth is effective treatment for vasomotor symptoms (VMS = hot flushes/flashes and night sweats)(1). We were also invited to present our data at an Endocrine Society-sponsored press conference.
Why did a scientific study require so much from us? First, this trial started in 2003 as the initial scientific venture of the newly founded Centre for Menstrual Cycle and Ovulation Research–thus CeMCOR’s reputation became tied to this trial. Second, despite concerted efforts, we were never able to obtain peer reviewed funding for this study—we successfully supported it with individual private donations. Finally, because of the “estrogen myth” and its corollary negatives about progesterone, I wanted to gain additional accurate information about how Prometrium® works in women’s cardiovascular system from this same study. For that reason we decided to enroll only very healthy women who were within 1-10 years since their final flow—they had to be non-smokers, without obesity, diabetes, or high blood pressure, and further to have normal measured waist circumference, blood pressure, cholesterol, and fasting blood sugar levels. Therefore many women were interested but few were eligible.
Late last fall when we broke to code on this study, we were ecstatic to discover that our trial was highly successful. After only three months’ therapy with Prometrium® (300 mg at bedtime daily) the 127 (of 133 randomized) women’s vasomotor symptoms score (VMS Score, combination of number of flushes times their intensity during the day and during sleep) was decreased by about 60% on progesterone compared to less than 30% decrease on placebo.
In early June we learned the answer to another important question: Does progesterone effectively treat intense VMS? The answer is yes! Although less than half all the treatment-seeking women in our study met the FDA’s criteria for more than 50 moderate-intense VMS/week, the 30 women who did who were randomized to Prometrium® showed significantly more improvement in hot flushes than did women on placebo.
What were the reactions to this news? Some local doctors said they already knew that progesterone was good for VMS! Others people were curious, or skeptical but many realized the importance of providing women with an effective alternative to estrogen for VMS. Other reactions were predictable—many questions about whether this couldn’t really be explained, somehow, by estrogen (Prometrium® is converted into estrogen—not!). And there were several questions about side effects and alleged serious health risks from progesterone (wrongly attributed because of confusion of progesterone with synthetic progestins). Happily I was able to respond that participants had no serious negative effects—more placebo-treated than Prometrium®-treated women dropped out before completion. And it is likely that in estrogen-treated women progesterone decreases breast cancer risk rather than increasing it as medroxyprogesterone does (2). Because of Prometrium®’s significant sleep benefit (3), some women who entered the trial sleep-deprived experienced short-lived morning drowsiness. But the estrogen myth-related mood, bloating, weight gain, migraine headaches, and breast tenderness did not occur.
An epic journey for me, Chris, and CeMCOR ends in triumph. Now that the dust has settled, I am so grateful that CeMCOR’s many researchers over the last six years dedicated themselves to a world class trial, that local donors made the trial possible, and that the Prometrium® and placebo were provided by Schering Canada (for the first two years) and subsequently by the world-wide manufacturer, Besins Healthcare of Belgium.
Art by Flickr user Buhny | CC 2.0
A new study published in the Journal of Obstetrics and Gynecology has found that adolescents are usually able to tolerate the Mirena® IUD rather well. The mean age of girls in this British study was 15.3 years, and they were prescribed the Mirena® for painful and/or heavy periods that did not respond to oral medications. 93.4% of girls in the study (45 young women) reported “significant improvement” within four months. The researchers conclude “that Mirena is a well tolerated and effective alternative for heavy periods±dysmenorrhoea in adolescents who do not respond to oral therapy.”
So will this finding make it easier for young women to obtain an IUD if they’d like it for birth control, now that there is evidence that it is well tolerated?
