Photo by Stacy Lynn Baum and used under a CC BY-NC-ND 2.0 licence.

While debate has been raging about women’s access to birth control and employers’ coverage of contraception, I’ve mostly been unable to write about it. Strange, I know. But every time I heard some ridiculous thing out of woman-hating Rick Santorum or Rush Limbaugh, I was really just too full of sputtering rage to coherently post. After several quick arguments with other folks online, though, below are responses to some common arguments I’ve heard. For more in-depth discussion, I highly recommend any recent clips from The Rachel Maddow Show, where it has been very well handled.

But you can live without birth control.
There are many items of covered medical care people can “survive” without having – orthopedic surgeries for painful injuries or disabilities, vasectomies, prenatal care. People can “survive” without many types of preventive medicine (including birth control) and even cancer treatment – for a while. What is appropriate for insurers to cover has never been based on “what you can’t live without,” and it’s a pretty poor standard to have.

Women who don’t want to get pregnant should just not have sex.
This is extremely hostile to women, and to the male partners of heterosexually-partnered women. It assumes that the sole purpose of sex is procreation, any time is the right time for a child, and as many children as possible are welcome. There may be some religious sects who technically support this belief, but we know that even among Catholic women, rates of birth control use are very high. For most people, it’s unreasonable to suggest that they never have sex if they’re not willing to be pregnant all the time or at any time. This perspective also puts women in the constant, stereotypical position of being the ones to fend off sexual advances, rather than supporting the idea that a man and a woman can be equal partners who both desire sex and make responsible choices about preventing unintended consequences. It denies women the agency of having their own desire, and puts them squarely in “aspirin between the knees” territory. Let’s be clear. Humans have sex, women can seek and enjoy sex, and women have purposes other than making babies.

Women who don’t want to get pregnant could just have a hysterectomy – those are probably covered.
Hysterectomies of course are not an equivalent to contraception, as they permanently prevent pregnancy, rather than allowing a woman to best time pregnancy to her own economic and health situation. It also ignores the non-contraceptive medical uses of birth control drugs, as well as historical inequities that inform which women get to choose hysterectomy and which women have had hysterectomy forced upon them.

Pregnancy is not a disease. So it’s not medical care to prevent it.
No, pregnancy itself is not “a disease” – neither is birth. But pregnancy can and does injure and even kill women. Pregnant women can require frequent medical care, and may encounter any number of complications over the course of pregnancy, from morning sickness so severe it requires hospitalization to eclampsia. So while pregnancy itself is not a “disease,” it is a medically vulnerable state for women that can necessitate frequent medical attention and can indeed result in disease and death.

Churches shouldn’t have to cover birth control.
Churches were not going to have to cover birth control. Period. Religiously affiliated institutions like Catholic churches and hospitals were going to have to cover it, but were given a generous out in which employees would be covered but the employers would not have to be the ones providing that coverage. These are institutions which in many states are already required to provide birth control coverage, and many individual institutions across the country do so in the absence of any requirement. Why? Because these employers need to attract talent, and they can’t or won’t get that talent purely from the pool of professionals who adhere to their own institutional religious affiliations (and even most Catholic women in the U.S. use birth control anyway). Catholic hospitals for example may hire doctors and nurses from any or no faith, because they need qualified people to provide the services that make them money and keep the doors open. They also recognize that providing employees with easy, cheap access to contraception is much cheaper than paying to cover pregnancies and a lifetime of medical coverage for numerous children and their mothers.

No employer should have to provide coverage for things they’re morally opposed to.
I have the slightest bit of sympathy for this perspective, but suspect it’s an extremely slippery slope. With absolutely no requirements for coverage, employers could stop covering lots of different things for economic reasons and claim moral objections. Employees would also be at the mercy of mergers and acquisitions. Imagine finding your company bought by another that would no longer cover blood transfusions, health care for LGBT individuals, any care related to any outcome of premarital sex, psychiatric drugs, or other common therapies. Of course, if employers started gutting already reduced service/higher cost insurance coverage based on their “moral objections,” we might actually start to see more widespread public support for movement away from employer-based coverage to a federal/universal model, so just chew on that.

Women who want to use birth control are just wanting to be irresponsible.
In a country in which half of all pregnancies are unintended, the active choice to prevent pregnancy until it is medically and financially viable is an extremely responsible choice. It actually represents a woman assessing her current situation and thinking explicitly about whether it is appropriate for her to be pregnant and potentially become a parent at this time. Unintended pregnancies also are associated with worse outcomes such as from delays in accessing prenatal care, quitting smoking, or resolving other health issues, the possibility of upsetting women’s ability to earn an income to support their existing families, and other economic, health, and social adverse effects. Many women have health conditions which make it very important to prevent or time pregnancy, and access to birth control makes it possible for them to be the most responsible for their own bodies and the bodies of potential offspring.

Also, the tip off that what we’re really talking about is controlling women’s abilities to make their own choices and to have sex without pregnancy, it’s extremely rare to hear an argument that grocery and drug stores should stop selling condoms, or that men should not have such easy access to condoms, because it just enables them to be irresponsible. Rush Limbaugh is not going to come out saying that men just want easy access to condoms because they’re sluts, I guarantee it – because he and his ilk don’t think *men* should just not have sex if they don’t want to get someone pregnant.

Nobody has a right to birth control.
Well, sure, if you don’t think healthcare is a human necessity and right (a point on which I disagree). What we’ve really been arguing about over the last few weeks, though, is not so much about whether healthcare is a fundamental right, or whether all the specific pieces of usually un/covered healthcare is a right, but about birth control specifically. The politicians and pundits have not been arguing over healthcare as a right generally, but specifically about women’s ability to time and prevent pregnancies, and their ability to have sex without high risk of having a pregnancy *just because some groups of men think women should not be able to have sex without risking pregnancy.* Note that we have not been arguing over whether gestational diabetes screening, HIV testing, domestic violence screening, or lactation support are “rights” – and these are all other services the Institute of Medicine said should be covered as preventive care for women under healthcare reform. Why’s that? Because this debate was never about what care people have a “right” to – it was always about who gets to have a say over women’s control over their own bodies and reproduction.

Filed under: Access, Rights, & Choice, Contraception, Drugs, Government, Women’s Health

First, some recent posts at Our Bodies Our Blog:

Pink Ribbons, Inc. – A Closer Look at Breast Cancer Marketing – I’m really looking forward to seeing this film, especially after all the recent Komen/Planned Parenthood controversy. It’s going to show in several U.S. cities at various events this spring. Pink Ribbons, Inc. people, if you’re reading this, you totally want to hook me up with the showing at the Nashville Film Festival.

Christine also covered Komen and Planned Parenthood and stupid, sexist “barstool sports,” and Judy has something on Planned Parenthood and the Catholic bishops.

Finally, Good Vibrations selected Our Bodies Ourselves as one organization it’s supporting during February and March. If you buy something from their website or in stores, select OBOS during checkout to make a donation that goes entirely to the organization. Go on and buy yourself a Valentine’s present. Or, hey, buy me something, since I don’t otherwise have a tip jar.

Now, onto to other things:

Judy Stone has a great guest post at the Scientific American blogs, Molecules to Medicine: Plan B: The Tradition of Politics at the FDA. Stone ultimately looks at Kathleen Sebelius’s decision to override the FDA’s approval of over-the-counter access to Plan B, but also provides a review of past political decisions and appointees at the FDA, and U.S. government interference in sexual health care and information generally.

Soraya L. Chemaly has something at The Feminist Wire in response to that ridiculous recent piece in the New York Times about girls and “hysteria.”

Flanagan closes with the particularly ironic advice that what girls need is “protection from the most corrosive cultural forces that seek to exploit her when she is least able to resist.”…What girls really need is not to be characterized as inherently mad or inclined to the irrational.

Nick Baumann at Mother Jones writes about The Republican War on Contraception:

…in the past six months, social conservatives have widened their offensive, and their new target is clear: Not satisfied with making it harder to obtain legal abortions, they want to limit access to birth control, too.

I’m pretty sure a lot of women have seen this coming for a while.

I don’t agree with absolutely everything in Nicholas Kristoff’s NY Times piece, “Beyond Pelvic Politics,” but let me just highlight this:

A 2009 study looked at sexually active American women of modest means, ages 18 to 34, whose economic circumstances had deteriorated. Three-quarters said that they could not afford a baby then. Yet 30 percent had put off a gynecological or family-planning visit to save money. More horrifying, of those using the pill, one-quarter said that they economized by not taking it every day.

and this:

If we have to choose between bishops’ sensibilities and women’s health, our national priority must be the female half of our population.

Rachel Maddow has a piece on the birth control nonsense as well.

Nationally, Ohio Rep. Jim Jordan has introduced a national forced ultrasound bill, which I think I’ll start calling a “forced vaginal insertion of an object” bill. We should require all members of Congress to participate in a simulation display of a transvaginal ultrasound, although I’d be kind of afraid of their reactions.

A national forced 24-hour waiting period for abortion has also been introduced, this one by South Carolina’s Jeff Duncan.

Neither of these things is based on medical evidence; both are purely for the purpose of making it more difficult for women to obtain safe, legal, timely abortions. Dr. Jen Gunter talks about what happens to women exposed to inexpert abortion attempts when safe and legal isn’t an option.

And in Tennessee, Planned Parenthood has sued the state, which previously awarded the organization grants for STI and HIV prevention, but in December yanked the funding without providing an explanation, or an alternative route for those services. One of the affected Memphis sites was reportedly the only place around to get HIV testing done after daytime work hours. Pressed on the issue, Tennessee Governor Bill Haslam refused to provide any real explanation of the decision, saying, “The commissioner felt like there were other people who could provide that service just as well.” There was no explanation about why, if that were the case, those others didn’t get the grant during the competitive process last year, and as far as I know, none of those other “just as well” services have actually been awarded the funding.

Mary at Hoyden About Town has a cool post on soliciting research participants, with a lot of good points on what should be communicated to potential study participants and what researchers owe them for their participation.

And completely unrelated to anything, I cannot stop looking at these underwater dogs.

[note: I modified the title after I realized a possible mis-reading of it]

Filed under: Abortion, Access, Rights, & Choice, Cancer, Contraception, Drugs, Government, HIV/AIDS, Infectious Diseases, Laws, Legislation, & Courts, News Round-Ups, Sex & Sex Education

Pfizer is recalling certain packs of oral contraceptives (the pill). From the FDA:

Pfizer Inc. announced today that it has voluntarily recalled 14 lots of Lo/Ovral®-28 (norgestrel and ethinyl estradiol) Tablets and 14 lots of Norgestrel and Ethinyl Estradiol Tablets (generic) for customers in the U.S. market. An investigation by Pfizer found that some blister packs may contain an inexact count of inert or active ingredient tablets and that the tablets may be out of sequence. The cause was identified and corrected immediately.

What this means is that you could be getting placebo pills on days when you’re supposed to be getting real hormones, and this could mean you’re at risk of getting pregnant. Women with the affected pills should use non-hormonal, barrier methods (like condoms) starting now. You’re also asked to return the pack to your pharmacy.

See the full list of affected pills.

Filed under: Contraception, Drugs

Pfizer is recalling certain packs of oral contraceptives (the pill). From the FDA:

Pfizer Inc. announced today that it has voluntarily recalled 14 lots of Lo/Ovral®-28 (norgestrel and ethinyl estradiol) Tablets and 14 lots of Norgestrel and Ethinyl Estradiol Tablets (generic) for customers in the U.S. market. An investigation by Pfizer found that some blister packs may contain an inexact count of inert or active ingredient tablets and that the tablets may be out of sequence. The cause was identified and corrected immediately.

What this means is that you could be getting placebo pills on days when you’re supposed to be getting real hormones, and this could mean you’re at risk of getting pregnant. Women with the affected pills should use non-hormonal, barrier methods (like condoms) starting now. You’re also asked to return the pack to your pharmacy.

See the full list of affected pills.

Filed under: Contraception, Drugs

[Originally posted at Our Bodies Our Blog. Speaking of, did you know the OBOS 40th anniversary edition book is one of Library Journal's Best Books for 2011 in the consumer health category?]

This week, Health and Human Services head Kathleen Sebelius interfered with the FDA’s decision that emergency contraception could safely be made available over the counter (OTC) without a prescription to women and girls of all ages.

The drug is already available without a prescription for women 17 and older, after years of political wrangling. Advocates have worked to ensure OTC access because emergency contraception is most effective when used as soon as possible, and time, distance, money, and privacy can be serious barriers to getting a prescription and obtaining the drug in time to prevent pregnancy.

The FDA’s Center for Drug Evaluation and Research (CDER) had completed a review of the issue and concluded that Plan B One-Step emergency contraception should be available OTC to younger women, which Commissioner Margaret Hamburg explains:

Based on the information submitted to the agency, CDER determined that the product was safe and effective in adolescent females, that adolescent females understood the product was not for routine use, and that the product would not protect them against sexually transmitted diseases. Additionally, the data supported a finding that adolescent females could use Plan B One-Step properly without the intervention of a healthcare provider…CDER experts, including obstetrician/gynecologists and pediatricians, reviewed the totality of the data and agreed that it met the regulatory standard for a nonprescription drug and that Plan B One-Step should be approved for all females of child-bearing potential.

That’s when Sebelius stepped in and blocked the findings of CDER from taking effect. In her letter [PDF] overruling the FDA’s findings, Sebelius objected that “The label comprehension and actual use studies submitted to the FDA do not include data on all ages for which the drug would be approved and available over-the-counter.”

That data is not available for the vast majority of over-the-counter drugs on sale to all age groups without a prescription. Many OTC drugs (like acetominophen and aspirin) can have serious, even fatal, effects if taken inappropriately because of deliberate misuse or misunderstanding the label and instructions. You will not find data on safety and label comprehension for every possible age group for these medicines, yet they are readily available OTC in adult doses to consumers of any age.

Former FDA official Susan Wood – who resigned after a previous round of political interference in emergency contraception – agrees:

“They don’t do this for pain medication, headache medication, cold medication,” she said. “That’s not part of how we assess products. Are we going to go and now do this with all products, or are contraceptives once again being singled out for this special treatment and this extra standard when we’re talking about a very safe and very effective product that can really help women?”

Change.org has a petition up urging Sebelius not to let politics trump science, and objecting to the HHS leader’s focus on very young girls who may access the drug:

The fact that the HHS and the Secretary are focusing on this extremely young age group is bizarre. Less than 1% of 11 year olds are sexually active, where over half of adolescents have had sex before their 17th birthday.

This decision is illogical and unfounded. Physicians around the country agree that Plan B is incredibly safe and effective for all ages, helping to decrease the number of unintended pregnancies.

Further reading:
This NPR coverage provides a succinct timeline and political explanation of the controversy over accessibility of emergency contraception.

Statement from Physicians for Reproductive Choice and Health stating that the Obama administration’s “put[ting] politics before science and responsible health policy…is appalling.”

Heather Corinna at Scarleteen urges young people to speak up in protest of this action.

Jodi Jacobson at RH Reality Check, who reminds us that the previous administration wasn’t the only one playing political games with reproductive rights:

…no amount of proof it seems can make up for the fact that, despite all the evidence, even President Obama and Secretary Sebelius appear to think young women are too stupid to make their own decisions or that they are just chum to be thrown to the religious right in an election year. As the saying goes, with friends like these, who needs the far right?

Added: Email the White House directly.

.

Filed under: Access, Rights, & Choice, Adolescent Health, Contraception, Drugs, Ethics, Government, Women’s Health

A nonprofit research group called Extending the Cure has published a series of maps looking at the major drivers of bacterial resistance to antibiotics.  They demonstrated a troubling growth in the use of some antibiotic classes, and also a more surprising result.

The states with the highest levels of antibiotic overuse are in the Southeastern United States and along the Appalachians.  These states that map to the greatest antibiotic use are also the same states that have the worst health status in the U.S., including the greatest incidence of obesity, asthma, heart disease, heart attack, diabetes and stroke.

Wired Magazine reports:

“… [W]hat if antibiotics cause these other health effects? That lines up with the work of Martin Blaser of New York University, who has proposed that taking antibiotics permanently kills off beneficial bacteria in the gut  — and might therefore be responsible for changes in nutrient absorption and for the rise in obesity and diabetes.”

The Merck corporation has pled guilty to a criminal charge over the marketing and sales of the painkiller Vioxx.  In a negotiated settlement, they agreed to pay $950 million, which includes the resolution of civil cases and federal and state fraud cases.  While doctors can prescribe drugs for any purpose they see fit, drug companies are prohibited from marketing them for uses not approved by the FDA.

Vioxx was pulled off the market in 2004 because evidence showed that it posed a substantial heart risk.

The New York Times reports:

“No person was held liable for Merck’s conduct.  ’It’s just a cost of doing business until a pharmaceutical executive does a perp walk,’ said Erik Gordon, a pharmaceutical analyst”.

A few things that have caught my attention over the last couple of weeks:

Over at Nature, which is *supposed* to be a respectable publication, Ed Rybicki wrote some utter unfunny bullshit in Parallel Processing, in which men hunt, women gather, and HA HA, WOMEN are so good at SHOPPING because they can ACCESS A PARALLEL UNIVERSE. Because of how women and men are just so inherently different in a binary, unknowable-to-men way. LOLLERSKATES. Christie Wilcox over at Scientific American’s Science Sushi has the more mature response.

At another Scientific American blog, Kate Clancy talks about menstrual synchrony and why women might not really synchronize their cycles.

Rock Center has a segment on involuntary sterilization in North Carolina that disproportionately targeted women of color.

Health News Reviews takes a look at media coverage of a study on preventive mastectomy.

The draft research review for Closing the Quality Gap Series: Quality Improvement Interventions to Address Health Disparities is online (free) and open to public comment through Dec 15. (via BHIC)

eeshap at the Crunk Feminist Collective writes about diamonds and conflict, and why care in purchasing is not enough – we must make choices that devalue the diamond in society and therefore reduce diamond mining-related incentives to cruelty.

A clear photographic example of the way products for children reinforce gendered steretypes, in the form of magnetic words for boys and girls. Here, boys get the moon, a wizard, and a dragon, while girls get a diamond, perfume, and make-up. Oh, and bunnies.

Lena Chen has a guide to/review of some sex toys. The separate files for this article are totally unwieldy, but there is some good info therein.

I haven’t spent much time on the site yet, but here is the inevitable OccupyHealthcare. One thing they’re talking about is health information and responsibility for health literacy.

Jill Filipovic talks at the Guardian about the long game for personhood amendments.

The FDA revoked its approval of Avastin for metastatic breast cancer treatment.

Kotex has recalled a whole bunch of tampons.

Filed under: Access, Rights, & Choice, Cancer, Drugs, Miscellaneous, News Round-Ups, Sex & Sex Education

If controversial draft guidelines being considered by Australia’s National Health and Medical Research Council are accepted, Australian parents who don’t medicate children with ADHD could be referred to child protection authorities.

This could lead to a situation similar to that in the U.S., where some states have had to pass legislation to prevent schools and child protection authorities from telling parents they must put their children on drugs.

According to The Australian:

“Controversy has dogged the NHMRC’s ADHD guidelines since Daryl Effron, the original chairman of the committee, resigned because of his association with drug companies that produce ADHD medications.”

The U.S. government has ruled that the drug Avastin should no longer be used to treat advanced breast cancer.  Studies have not shown that it helps breast cancer patients live longer, and it comes with dangerous side effects.

Avastin remains on the market for certain colon, lung, kidney and brain cancers.  A year’s treatment with Avastin can cost $100,000.

Boston.com reports:

“The Avastin saga began in 2008, when an initial study suggested the drug could delay tumor growth for a few months in women whose breast cancer had spread to other parts of the body. Over the objection of its own advisers and to the surprise of cancer groups, FDA gave Avastin conditional approval — it could be sold for such women while manufacturer Genentech tried to prove it really worked.”

Research is showing that the more drugs a man takes, the worse his symptoms of sexual dysfunction are likely to be.  A new study found that men who took multiple medications, whether prescription or over the counter, were more likely to have erectile dysfunction and more likely to have worse problems with it.

Researchers surveyed more than 37,000 men aged 45 to 69.  More than half of the men used at least three drugs.

According to Time Magazine:

“Of all the men in the study, 10,717 — or 29% — reported moderate or severe symptoms of erectile dysfunction. Across age groups, the chance of having ED was higher in men taking more medications … Men who took more pills were also more likely to have increasingly severe symptoms”.

A recent study sought to determine whether the use of statin drugs was associated with prostate cancer risk.  The researchers looked at close to 400 prostate cancer patients who had a first-time diagnosis during the period between 2005 and 2008.

They found that use of any statin drug, in any amount, was associated with a significant increase in prostate cancer risk.  In addition, there was an increasing risk that came along with an increasing cumulative dose.

According to the study, as reprinted on the website Green Med Info:

“The results of this case-control study suggest that statins may increase the risk of prostate cancer.”

Some things that caught my attention this week, with bonus “this week in misogyny” content.

I don’t know how many people noticed, and I assume it won’t go anywhere, but Michele Bachmann introduced a forced ultrasound for abortion bill in the House. It’s been sent to the Subcommittee on Health.

The National Campaign to Prevent Teen and Unplanned Pregnancy has launched a new website, Bedsider, about birth control and says it’s intended for women ages 18-29 years. I haven’t looked through it thoroughly, but it includes comparisons of different methods of preventing pregnancy by factors like cost, immediacy, STI prevention, ease of getting and using the method, ease of hiding it from a partner, and degree of mistake-proofed-ness. It is focused through a pregnancy prevention lens, so the site is focused on penis-in-vagina sex, not other forms of sex or prevention. I haven’t reviewed the site thoroughly, but let me know what you think. Some of the language seems a little, uh, teen magazine-y for my tastes and for a target audience that is actually made up of adults, but perhaps it’s my advanced age talking there (early 30s).

Over at OBOS, between C and I we’ve covered Mississippi, personhood, and reproductive justice, and new research on in vitro fertilization and ovarian cancer risks.

The CDC released the final data on 2009 births [PDF] in the United States. It’s full of data on the number of births, birth rates by things about women, like their age and marital status, and rates of cesarean (another all-time high), low birth weight, preterm, and out of hospital births. [hat tip to Jill]

Jaclyn Friedman, who I met briefly at the Our Bodies Ourselves 40th, has a new book out, What You Really, Really Want: The Smart Girl’s Shame-Free Guide to Sex and Safety. I haven’t read it yet, but there’s a Twitter chat happening at 9pm Eastern tonight using the hashtag #shamefreesex.

B points out the ridiculousness of news coverage taking the “vodka-soaked tampon” story seriously. Notably, liquid-soaked tampons expand and are not exactly convenient for insertion. Aside from which, alcohol+mucous membranes would probably hurt. And the likelihood of it being widespread for teenage boys to be inserting said vodka-soaked tampons rectally is just absurdly small. And then there was the follow-up to B’s post, which takes a quick downward spiral in the comments to “if we take your picture without permission but link to you, you should be glad of the traffic”-land.

The FDA released a new statement on Makena, a drug intended to help prevent preterm birth. It has been the subject of controversy because versions of the same ingredient in Makena has been available for pretty cheap through compound pharmacies for a long time. FDA’s approval of Makena with it’s extremely high price, have generated strong reactions and concerns about access. The FDA’s new statement basically says, “The company that makes Makena says those vastly cheaper compound pharmacy products vary in their strength and purity, so we’re going to look into it.”

The agency also approved the first therapy derived from cord blood cells.

Jill at Feministe had a note left in her suitcase by the TSA when she checked what she’s referring to as a “personal item.” A note that read, “get your freak on girl.” Jill follows up that the TSA agent who left that note has been suspended, and Jill responds to the lack of response to the real problem here: “…I get no satisfaction in hearing that someone may be in danger of losing their job over this. I would much prefer a look at why ‘security’ has been used to justify so many intrusions on our civil liberties, rather than fire a person who made a mistake.”

This week, the CDC is running a campaign focused on the smart and appropriate use of antibiotics. Go to the website to learn more about why you don’t always need antibiotics and why it’s bad for all of us to use too many.

Transgender Day of Remembrance is coming up on November 20th.

The Abortioneers ask when to speak up, when to keep your mouth shut, and how to know the difference.

The fact that women prisoners often get shackled during labor is discussed at Smart Bitches, Trashy Books, in an interview with a fiction writer who covered this practice in a book.

Sometime this week, I stumbled across #occupyhealthcare and the accompanying website. The contributors seem to be mostly healthcare providers and adjacents, focused on increasing access to healthcare.

The government has issued a “Leading Health Indicators App Challenge,” soliciting developers to create apps that promote the use of key measures of health (“indicators”) to improve the health of communities.

The Census released new data with the headline, “Half of First-Time Mothers Receive Paid Leave, Census Bureau Reports.” Before you get too excited, “paid” leave included not just official paid maternity leave, but using up your own existing balance of paid sick and/or vacation leave, if you’re fortunate enough to have that. They also noted that women who got some type of paid leave were *more* likely to return to work within 3-5 months, making me wonder if they are often returning to work when they exhaust their reserves of paid sick or other time. Then there’s this limitation: “Given that FMLA and other leave policies in the United States do not allow for leave for more than 12 weeks, it is not entirely surprising that new mothers return to work relatively soon.”

ePatientDave writes about how impossible to understand an “explanation of benefits” document can be and how we’re prevented from stopping errors and reducing costs because of this lack of transparency.

This week in misogyny:
Rick Perry’s “departments I would close” gaffe has received most of the news coverage, but in the same GOP candidate debate, Herman Cain referred to Representative/former Speaker Nancy Pelosi as “Princess Nancy.” He or his team reiterated this remark on Twitter, before offering the fauxpology that he “probably shouldn’t have” made the remark, but “was trying to make a point.” A point that required a gendered diminishing and dismissal of a powerful woman politician, apparently. I guess he thought he had built up too much goodwill with women over the course of his sexual harassment scandal.

Using the #mencallmethings hashtag (which Sady Doyle apparently started), feminist women bloggers took to Twitter to talk about some of the vile things that have been said to them in the course of their writing, including rape and death threats. I contributed a rape threat I received through the comments here because I had the temerity to dislike a rape joke on tv. Just another humorless feminist who deserved threats of violence because of it, right? @metalmujer and others pointed out that the hashtag itself would be better focused on misogyny rather than “men.” Yes, most of the excessively hateful and threatening remarks I’ve been subjected to have been made by men, but the problem is not something about all men, it’s the misogyny these particular men have carried out and a culture that encourages them to do so.

I also keep seeing this image on Facebook intended at a critique of dubstep and its fans. I don’t have an opinion one way or the other about the actual quality of dubstep or its fans over time, but I do know that when the main critique is presented as “it was good when it was a bunch of men standing around, now it sucks and is by/for little girls,” that’s misogyny.

Filed under: Abortion, Abuse, Rape, & Safety, Access, Rights, & Choice, Birth, Contraception, Drugs, Events & Observances, Government, Laws, Legislation, & Courts, Miscellaneous, News Round-Ups, Sex & Sex Education, Web Resources

A recent study examined the effects of statin drugs on the likelihood of exercise-related injury.  The researchers measured myoglobin and creatine kinase levels in subjects who were running the Boston marathon.  Elevated creatine kinase is a sign of damage to muscles.

Subjects being treated with statins, along with a similar number of nonstatin-treated controls, were examined the day before the race, immediately afterwards, and the day following.  The researchers found that the exercise-related increase in creatine kinase 24 hours after exercise was greater in the statin users.

According to the study, as reprinted on the website Green Med Info:

“In conclusion, our results show that statins increase exercise-related muscle injury.”

More than a decade ago, Dr. Yolande Lucire started noticing high rates of hospital admission and suicide among patients treated with antidepressant medications and antipsychotics. Since then, she has gathered evidence that makes it clear that many people being treated with antidepressants can’t metabolize them due to common genetic mutations.

Dr Lucire has been campaigning to introduce ways of minimizing overprescription of antidepressants.

According to Prevent Disease:

“[The enzyme] CYP2D6 (cytochrome P450 2D6) acts on one-fourth of all prescription drugs, including the selective serotonin reuptake inhibitors (SSRI), tricylic antidepressants (TCA), betablockers, opiates, neuroleptics, antiarrhythmics and a variety of toxic plant substances. Up to 15% of the population has a slow acting form of this enzyme and many of these a fast-acting form. Thirty-five percent are carriers of a non-functional CYP2D6 allele, especially elevating the risk of adverse drug reactions when these individuals are taking multiple drugs … This means that potentially up to 1 billion people on the planet cannot metabolize and eliminate the commonly prescribed drugs from their bodies”.

More than a decade ago, Dr. Yolande Lucire started noticing high rates of hospital admission and suicide among patients treated with antidepressant medications and antipsychotics. Since then, she has gathered evidence that makes it clear that many people being treated with antidepressants can’t metabolize them due to common genetic mutations.

Dr Lucire has been campaigning to introduce ways of minimizing overprescription of antidepressants.

According to Prevent Disease:

“[The enzyme] CYP2D6 (cytochrome P450 2D6) acts on one-fourth of all prescription drugs, including the selective serotonin reuptake inhibitors (SSRI), tricylic antidepressants (TCA), betablockers, opiates, neuroleptics, antiarrhythmics and a variety of toxic plant substances. Up to 15% of the population has a slow acting form of this enzyme and many of these a fast-acting form. Thirty-five percent are carriers of a non-functional CYP2D6 allele, especially elevating the risk of adverse drug reactions when these individuals are taking multiple drugs … This means that potentially up to 1 billion people on the planet cannot metabolize and eliminate the commonly prescribed drugs from their bodies”.

The remyelination of lesions in the central nervous system is a crucial element of neural repair following relapses in multiple sclerosis. The process begins with the recruitment and differentiation of oligodendrocyte progenitor cells (OPCs) into myelinating oligodendrocytes. But the statin drug simvastatin (Zocor) disturbs these processes.

A recent study examined animals with induced localized demyelination in the corpus callosum. When simvastatin was injected into the animals during the remyelination period, it caused a decrease in myelin load.

According to the study, as reprinted on the website Green Med Info:

“Our findings suggest that simvastatin inhibits central nervous system remyelination by blocking progenitor differentiation, indicating the need to monitor effects of systemic immunotherapies that can access the central nervous system on brain tissue-repair processes.”

Obesity can be added to the long list of disorders that can be caused by medicine.  Recent research shows that altering your intestinal flora with antibiotics influences appetite-regulating hormones and body mass.

A study found that people treated with antibiotics had a 6-fold increase in the appetite- and fat-increasing hormone ghrelin after meals, a 20 percent increase in levels of the hunger-influencing hormone leptin, and a 5 percent increase in body mass index a year and a half after completing the drug treatment.

According to Primal Wisdom:

“Conventional physicians most commonly prescribe antibiotics for upper respiratory, sinus, or ear infections, despite the fact that most of these events involve viruses or fungi … which are not susceptible to antibiotics … I just say no to pharmaceutical antibiotics.”

Drugmaker GlaxoSmithKline has preliminarily agreed to a $3 billion settlement over the sales and marketing practices of its drugs, including the diabetes treatment Avandia.  Avandia was withdrawn by the European Medicines Agency, and was given restricted marketing by the U.S. Food and Drug Administration, after it was shown to increase the risk of cardiovascular events.

The final settlement is still under negotiation and will be finalized sometime in 2012.

According to PM Live:

“The company said payments could be funded through existing cash resources … Recent changes in the way the company operates include the establishment of a new framework for compliance in the U.S.”

You might not know that the blockbuster Alzheimer’s drug Aricept
(donepezil) has a lot in common with insecticides, chemical weapons and venom.  It is a member of the chemical class known as
acetylcholinesterase inhibitors, which prevent the neurotransmitter acetylcholine
from breaking down.  There’s no proof
that this slows the progression of Alzheimer’s disease, and it comes with a
host of dangerous side effects.

Aricept is a reversible or non-competitive cholinesterase
inhibitor, which means it is not as toxic as reversible competitive or
noncompetitive inhibitors of cholinesterase, which kill insects and humans
through neurotoxic effects. But Aricept’s side effects still include seizures
and bradycardia (arrhythmia) — a well-known side effect of organophosphate
insecticide poisoning.

Green Med Info reports:

“What
is so outrageous about the present situation is that non-patentable,
inexpensive and relatively safe alternatives to intrinsically neurotoxic drugs
like donepezil not only exist, but have been confirmed through clinical
research … The
reality is that there is a vast array
of natural approaches available in the prevention and treatment of Alzheimer’s
disease, some of which have been demonstrated to regress the disease process by
clearing pathological beta-amyloid brain plaque. A 2006 study in the Journal of Alzheimer’s disease reported on this
phenomena with the use of curcuminoids (an extract of Turmeric)”.

Photo used under CC Some Rights Reserved license; by jypsygen

When you have a medicine with an instruction like, “do not take with alcohol?” or “tell your doctor if…,” do you really know why, or how serious the consequences of not following the instruction could be? The drug label and insert are unlikely to offer further detail, but I always wonder just how seriously I need to take those warnings. Knowing why I’m being warned, and how likely and severe problems might be, would go a long way in convincing me to actually follow the instructions.

To use a common example, a new medicine, whether over-the-counter or prescription, that instructs “do not take with alcohol.” I want to know – is it because I might feel stronger effects of the alcohol and need to moderate my drinking? To me, that’s a different issue than, “3 out of 10 patients will have irreversible, severe liver damage.” I might just assume the first, less bad consequence is the real one, and only follow the “do not” instruction until I feel that I know how the combination of the medicine and alcohol affects me. If I knew that a more serious consequence was a reality, I might take the directive more seriously.

I need details. I want to know, “What’s excessive sunlight? How much water is plenty? By ‘take with food,’ do you mean a snack, or a meal? What are the consequences if I ignore this, and how serious are they?”

What if the medicine is short-term (like a week of antibiotics) vs. longer-term (like an antidepressant or birth control)? Sure, you might follow a “do not” instruction for a week, but for months or years? I personally can’t tolerate simply following an instruction without context – it’s a characteristic that has gotten me into more than a little trouble over the years.

Yes, I know – drug labels are already confusing, and adding more information to them as they are designed right now maybe wouldn’t help matters. Perhaps something clear on the insert – the little brochure that comes with your medicine – would be a good alternative. In general, I’m all for redesigning drug labels, packaging, and instructions (especially when more than one medicine is needed) so they are more useful and less confusing. There are some serious issues around language, literacy, and design that might make adding more information problematic, but it’s a worthwhile challenge if it results in people actually having a better understanding of instructions and their relative importance.

And, yes, that’s what pharmacists are for, and perhaps people should ask them these questions more often. So often, though, you have to make a special request to actually talk to a pharmacist, and the question – “Hey, can I ignore this and have a margarita at happy hour?” – might not be one that most people are comfortable asking. It’s also rare to have real privacy when speaking to a pharmacist – those little plastic nowhere-near-a-walls don’t quite do it for me.

The bottom line is that I’m inclined to ignore any instruction that doesn’t come with an explicit rationale and some indicator of how seriously I should take it, and drug labels are one important place where that’s a problem. Anybody else similarly inclined? What would you like to know about the various warnings that come on OTC and prescription drugs?

Filed under: Drugs

A U.S. government report has stated that the number of overdose deaths from powerful painkillers more than tripled over the course of a decade.  CDC Director Thomas Frieden and White House drug czar Gil Kerlikowske called the problem an epidemic.

In 1999, prescription painkillers such as OxyContin, Vicodin and methadone led to the deaths of roughly 4,000 people.  By 2008, that number had jumped to almost 15,000.

According to Yahoo Health:

“Overall, there were 36,450 fatal overdoses in 2008, including accidental cases and suicides involving illegal drugs like heroin and cocaine along with prescription medicines. About three-quarters of the deaths from prescriptions involved narcotic painkillers.”

A U.S. government report has stated that the number of overdose deaths from powerful painkillers more than tripled over the course of a decade.  CDC Director Thomas Frieden and White House drug czar Gil Kerlikowske called the problem an epidemic.

In 1999, prescription painkillers such as OxyContin, Vicodin and methadone led to the deaths of roughly 4,000 people.  By 2008, that number had jumped to almost 15,000.

According to Yahoo Health:

“Overall, there were 36,450 fatal overdoses in 2008, including accidental cases and suicides involving illegal drugs like heroin and cocaine along with prescription medicines. About three-quarters of the deaths from prescriptions involved narcotic painkillers.”

A U.S. government report has stated that the number of overdose deaths from powerful painkillers more than tripled over the course of a decade.  CDC Director Thomas Frieden and White House drug czar Gil Kerlikowske called the problem an epidemic.

In 1999, prescription painkillers such as OxyContin, Vicodin and methadone led to the deaths of roughly 4,000 people.  By 2008, that number had jumped to almost 15,000.

According to Yahoo Health:

“Overall, there were 36,450 fatal overdoses in 2008, including accidental cases and suicides involving illegal drugs like heroin and cocaine along with prescription medicines. About three-quarters of the deaths from prescriptions involved narcotic painkillers.”

The bacteria in your gut may be controlling your life more
than you ever realized.  Researchers have
recently reported a link between gut bacteria and the development of multiple
sclerosis in mice. Gut bacteria has also previously been linked to obesity,
depression and much more.

In the most recent experiment, researchers studied mice bred
to develop a disease similar to multiple sclerosis.  Those raised in an environment with no
bacteria never developed symptoms. Once typical gut bacteria were introduced, however,
the mice began to show signs of the disease.

Discover News reports:

“If
a healthy gut microbial community proves important for different aspects of our
health, what could we do to encourage the bacteria that would prevent obesity
or disease?  One option might be to take
probiotics, eat a particular diet, or minimize antibiotic use”.

A study sought to characterize the adverse cognitive effects of statin drugs.  The researchers looked at more than 170 patients who self-reported memory or other cognitive problems associated with statin therapy.

The patients completed a survey assessing statin-associated, cognitive-specific adverse drug reaction characteristics, and the time course of symptom onset and recovery.  Three quarters of them experienced cognitive problems determined to be probably or definitely related to statin therapy. And of the patients who stopped statin therapy, ninety percent reported improvement in cognitive problems, sometimes within days of ceasing to use the drugs; in some patients, a diagnosis of dementia or Alzheimer’s disease reportedly was reversed.

According to the study, as reprinted on the website Green Med Info:

“Findings from the survey suggest that cognitive problems associated with statin therapy have variable onset and recovery courses, a clear relation to statin potency, and significant negative impact on quality-of-life.”

A study sought to characterize the adverse cognitive effects of statin drugs.  The researchers looked at more than 170 patients who self-reported memory or other cognitive problems associated with statin therapy.

The patients completed a survey assessing statin-associated, cognitive-specific adverse drug reaction characteristics, and the time course of symptom onset and recovery.  Three quarters of them experienced cognitive problems determined to be probably or definitely related to statin therapy. And of the patients who stopped statin therapy, ninety percent reported improvement in cognitive problems, sometimes within days of ceasing to use the drugs; in some patients, a diagnosis of dementia or Alzheimer’s disease reportedly was reversed.

According to the study, as reprinted on the website Green Med Info:

“Findings from the survey suggest that cognitive problems associated with statin therapy have variable onset and recovery courses, a clear relation to statin potency, and significant negative impact on quality-of-life.”

One major
side-effect of treatment with statin drugs is muscular problems. Such problems
are known to occur much more frequently during and after exercise.

An eight-year
study monitored professional athletes who were being treated with statins
because of familial hypercholesterolaemia. However, only 6 out of the 22 athletes
being examined were able to tolerate at least one member of this family of
drugs.

According to the
study, as reprinted on the website Green Med Info:

“These findings indicate that in top
sports performers only about 20% tolerate statin treatment without
side-effects.”

A good night’s sleep may not sound like the key to passionate sex, but experts say that getting enough sleep is the single most effective aphrodisiac.  It tops the list of CNN’s suggestions for improving your sex life.

The list also included exercise, as a good workout increases dopamine and may boost levels of testosterone.  And the article warns that common antidepressants like Prozac and Paxil may lift your mood, but they can kill your sex drive, as can certain prescription painkillers, antianxiety medications, and even laxatives.

In addition, according to the CNN article:

“You’ve heard it before, but it’s worth saying again: Be patient with your partner and yourself as you work to make things better.”

New data shows that prescriptions for antidepressants have risen nearly 400% since 1988. More than one in ten Americans over the age of twelve now takes an antidepressant.

In fact, the study found that antidepressant prescriptions are more common than depression itself.

According to Time Magazine:

“Perhaps the most concerning finding in the CDC report is that people who take antidepressants are taking them long term. About 60% of people had taken the medications for two years or longer, and 14% had taken antidepressants for more than a decade.”