Saturday, July 28, 2007

Seasonique TV Ad

I just saw the the new Seasonique TV ad. Very disappointing.

I admit I didn't get the concept of the Logical vs. Emotional side witty, mirror-mirror-on-the-wall (or maybe Alice-in-Wonderland?) interplay at all. Whether or not to take the Pill is a logical decision, but when considering the Pill's mechanism of action, risks/benefits profile, your emotional side comes into play. Really? Anyhow, maybe it's just a case of de gustibus and all that.

The main reason I found the Seasonique TV ad disappointing is.... Well, watch the ad and see if you can guess:

Not only do they go on and on about "the period" in the ad, but even the doctor tells you that "There's no medical need to have a monthly period on the Pill. Lots of women are having 4 periods a year."

That's incorrect. There's no medical need to have a monthly withdrawal bleed on the Pill, not a monthly period. [As you recall, women taking the Pill do not have menstrual periods at all.] What the ad doctor is actually saying is that there's no medical need for you to induce a monthly bleed while on the Pill. Big difference between you actively manipulating the hormone dosages in the Pill and you passively having a monthly menstrual period.

I realize that a TV ad is expensive, the time is limited, and the ad's function is to convey a marketing message not to educate. But that's no excuse to misinform.

It's like there's this implicit assumption out there that we mustn't trouble potential Pill users with too much information. And that really annoys me. Explain the difference between a period and withdrawal bleeding and watch the confusion cause women's heads to explode. Tell women they don't actually have periods while on the Pill and avert your eyes while the shock of the revelation paralyzes them into grotesque poses.

To see the Seasonique ad adhere to such a silly assumption by disseminating misinformation in such a matter-of-fact manner was really disappointing. Not to mention discouraging. It's not enough I have to debunk The New York Times, now I have to correct the drug manufacturers as well. At what point do I just admit defeat and give up on trying to get accurate information out to women?

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Friday, July 27, 2007

Former Kansas Attorney General Phill Kline Steals Patient Charts

Remember former Kansas state Attorney General Phill Kline? You know, Phill "I Want Access to Your Complete, Unedited Medical Records If You're A Female Patient" Kline, the one who 2004 subpoenaed the records of 90 women and girls who in 2003 underwent late-term abortions at Comprehensive Health or Women's Health Care Services in Wichita, Kan., saying there is probable cause that each record contains evidence of a felony.

Take a look at this timeline I've put together (via) and tell me you're not perturbed by the fact that in Kansas any deranged person can, and apparently does, have access to patient charts.

2004 - Kline subpoenas patient records.

February 2006 - State Supreme Court rules Kline can seek access to the records but not before he presents his reasons for seeking the subpoenas to District Court Judge Richard Anderson.

November 2006 - Judge Anderson turns over patient charts to Kline's office.

November 2006 - Paul Morrison, Johnson County district attorney, defeats Kline and becomes the new Kansas Attorney General.

January 5, 2007 - Kline forwards copies of patient charts to the Johnson County district attorney's office.

January 8, 2007 - Kline leaves the state attorney general's office for the Johnson County district attorney's office where he replaces Morrison as the new district attorney.

June 2007 - After finding no evidence of any criminal wrongdoing by the clinic, Kansas Attorney General Paul Morrison ends the investigation of Comprehensive Health.

June 2007 - Morrison also informs Comprehensive Health that Kline, the Johnson County district attorney, retains copies of the patient charts and he finally tells the clinic about Kline forwarding copies of the charts to the Johnson County district attorney's office on Jan. 5.

June 6, 2007 - The clinic files a petition with the state Supreme Court for a writ of mandamus* against Kline.

June 22, 2007 - State Supreme Court tells Kline he has until July 12 to respond.

*I'm guessing here, but I suspect the writ of mandamus has to do with directing Kline to return the stolen patient charts to the clinic.

If you live in Kansas and have any updates on this sorry saga (is Kline's July 12th response available?), please share.

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Texas Board of Education President Says Access To Information No Good

Texas law requires school districts to emphasize abstinence in sex education classes. Texas also had the nation's highest birth rate among teenagers ages 15 to 19 in 2004 [63 births per 1,000 teens vs. 41 births per 1,000 teens average rate nationally].

When asked about the possibility that Texas' emphasis on abstinence in sex education contributes to the state's relatively high numbers, Don McLeroy, president of the State Board of Education, had this to say:

"The idea that just giving them a lot of information is going to solve it, I think, is kind of naive," he said. "Certainly, it's more of a societal problem than it is a school problem."

When the president of the State Board of Education tells you access to information isn't all that's cracked up to, you naive sorts better take note.

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Thursday, July 26, 2007

Seven Heart Transplant Patients Offed In China

Or so says AFP. According to its article Seven killed in China heart transplants:

SHANGHAI (AFP) - Seven people have died in recent years after receiving unapproved German-made artificial hearts at a Chinese hospital, state press reported Thursday.

The Shanghai Eastern Hospital conducted at least nine artificial heart transplants between 2001 and 2005, the Beijing News said, quoting city government officials.

Seven of those patients died and an eighth was left brain-dead, it said. The ninth was said to be alive but in poor health.

The hospital is being sued by the family of one of the patients, Zhou Yiqing, who died in 2005 at age 13 -- a year after receiving the artificial heart.

Seven patients died. One, a 13 yo boy, died one year post-transplant. The article provides no other details about the case, nor any information on the other six deaths.

So how do we know these patients were killed, and who, or what, exactly killed them? The Chinese doctors, the devices, the Germans? Or maybe it was a swarm of locust.

Have the standards for health reporting sunken so low that an accusation of killing patients no longer requires any supporting evidence?


Tuesday, July 24, 2007

News From Around The World

Bulgaria celebrates the return (finally!) of the six healthcare workers sentenced to death in Libya for allegedly infecting children with HIV.

Papua New Guinea combats AIDS by torturing womenwitches.

Norwegian Princess, a physical therapist, to teach angelic method of treatment.


The Community Based Abstinence "Education" Business Plan

Forget the entrepreneurial acumen of the underpants gnomes. The Community Based Abstinence "Education" (CBAE) government welfare piggies can teach us all a thing or two about business. Behold:

Step 1. Formalize the ideology behind your multimillion-dollar scheme.

Shoring up marriage was Robert Rector’s vision a decade ago. A fellow at the Heritage Foundation, Mr. Rector wrote the first bill that legally defined abstinence education, and got it attached as a stowaway to the 1996 welfare overhaul, backed with $50 million for the states. A later Congress, irked at states’ finding loopholes in the original intent, designated a second pool of abstinence money in 2001, now the lifeblood of the movement.

Mr. Rector says viewing abstinence primarily through the lens of public health distracted the focus from marriage. "Once you understand that that’s the principal issue," he said, "you understand that handing out condoms to a 17-year-old is utterly irrelevant."

Step 1a. Encourage use of visual aids when propagandizing scheme.

"You have to look at why sex was created," Eric Love, the director of the East Texas Abstinence Program, which runs Virginity Rules, said one day, the sounds of Christian contemporary music humming faintly in his Longview office. "Sex was designed to bond two people together."

To make the point, Mr. Love grabbed a tape dispenser and snapped off two fresh pieces. He slapped them to his filing cabinet and the floor; they trapped dirt, lint, a small metal bolt. "Now when it comes time for them to get married, the marriage pulls apart so easily," he said, trying to unite the grimy strips. "Why? Because they gave the stickiness away."

2. Don't concern yourself with scientific accuracy, public health, or beneficial results.

Much of the data cited in support of the efficacy of abstinence programs are from surveys taken immediately before and after a program. These commonly find an increase in intentions to stay abstinent, but do not necessarily mean that a year later, high on emotion, teenagers will follow the script.

Most studies so far have found no significant impact on behavior, and the few that do see only modest changes. In April, Mathematica Policy Research released a report that was nine years and $8 million in the making. Scientists followed middle school children enrolled in four separate abstinence programs for about five years, and found no difference in the age of first intercourse between them and their peers.

3. Factor in the given that Democrats will vigorously support your government welfare scheme, and then some more ($28 million more than requested and counting).

Those who thought abstinence education financing would decline swiftly under a Democratic watch were wrong: On July 11, the full House extended state grants through September — a reprieve at the edge of expiration. That same day, the House Appropriations Committee increased spending, a political move to make the proposed Health and Human Services budget more appealing to Republicans, said Representative David R. Obey, Democrat of Wisconsin, the committee chairman.

4. Count on news outlets to spread your propaganda.

The long decline in sexual activity among U.S. teenagers, hailed as one of the nation's most important social and public health successes, appears to have stalled.

After decreasing steadily and significantly for more than a decade, the percentage of teenagers having intercourse began to plateau in 2001 and has failed to budge since then, despite the intensified focus in recent years on encouraging sexual abstinence, according to new analyses of data from a large federal survey.

The halt in the downward trend coincided with an increase in federal spending on programs focused exclusively on encouraging sexual abstinence until marriage, several experts noted.


The data on teen sexual activity come from the Youth Risk Behavior Survey, a nationally representative survey of about 13,000 students in grades nine through 12 conducted every two years by the federal Centers for Disease Control and Prevention.

The most recent survey data, from 2005, was released last year, but attention focused primarily on the overall change in sexual behavior from 1991 to 2005....That comparison shows a significant drop, from 54 percent to nearly 47 percent, in the proportion of teenagers who said they had ever had sex. The fraction who said they had sex in the past three months fell from 37 percent to 34 percent.

Largely unnoticed was that the percentages for both measures did not change significantly between 2001 and 2005.

As Rachel notes:

I’m not making any statements here about what the baseline rate for teen sex should be. However, I’m guessing that the news outlets who parroted the drop in teen sex were getting press releases from pro-abstinence-only folks (whether .org or .gov) whose funding was up for debate, and rushed to print this "dramatic" news without properly checking their facts. And by "dramatic news," I mean old news that doesn’t mean what you think it means.

Step 5. Leslee Unruh. Just...Leslee Unruh.

"We need to increase abstinence education and give more dollars to abstinence education. It is the healthiest program we have for young people," said Leslee Unruh of the National Abstinence Clearinghouse.

Well done, indeed.

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Sunday, July 22, 2007

The New York Times Bars Facts From Op-Eds

And Karen Houppert's menstrual suppression op-ed is the perfect case study.

Here's how you, too, can strip your article of facts in 5 easy steps:

1. Don't bother to know what Lybrel is or how it works.

[Lybrel] is as effective at preventing pregnancy as the other pills already out there (about 98 percent) but boasts one advantage: Women who take it will never get their periods.

Incorrect. The one advantage Lybrel boasts isn't period suppression.

All [combination] birth control pills, from the first brands that were available in the 1960s to Lybrel have the exact same effect on the menstrual period: Women who take them never get their periods.

The difference between Lybrel and the other pills already out there is that women who take Lybrel will never induce an withdrawal bleeding episode. Lybrel does away with the monthly bleed by eliminating the placebo pills.

I've mentioned this before but one more time, exclusively for New York Times op-ed columnists: the menstrual period and withdrawal bleeding are not one and the same thing.

It's an important distinction to get, otherwise you run the risk of wasting an entire op-ed column attacking the wrong bogeyman. [When it comes to Lybrel, you want to misinform your readers about eliminating monthly withdrawal bleeds, not about menstrual suppression.]

2. Make sure you can't tell the difference between scientific research and opinion and propaganda.

Ms. Houppert goes on and on about the existence of scientific proof, rashes of studies and flurries of research, but when it comes time to be specific all she has to offer are the observations of a British doctor and a propaganda film. Personal opinions, even those of a physician, and government films are not scientific proof of anything to do with the menstrual period.

Ms. Houppert does have one reference to some actual studies (those from Wyeth showing that menstruating women feel less effective at work, take more sick days, don’t exercise and wear dark clothes more often) and a mention that premenstrual syndrome studies appeared in the medical literature in 1953. And still she manages to ignore the scientific method and relies instead on name calling and innuendo to support her assertions.

Studies on how menstruating women feel and what they wear tell menstruating women feel and what they wear. They're not part of the proof that Western civilization...hinges on our ability to wrangle our messy cycles to the ground and stomp ’em out once and for all. Also, describing PMS as an affliction and implying that the date of publication for the early studies on PMS somehow taints their validity, still not a valid method of scientific critique.

One more thing.

Someone cynical might suggest that research highlighting menstruation’s distressing consequences bubbles to the surface every time the public feels anxious over women’s expanding roles.

And someone cynical (oh, who are we kidding? That would be me.) might suggest that nebulously sourced innuendo bubbles to the op-ed pages of The New York Times every time a writer is too too lazy to look up data to support her assertions.

3. Avoid knowing the indications for menstrual suppression.

While [menstrual suppression] may be good news for the 8 percent of women who have debilitating periods (a constellation of symptoms known as premenstrual dysphoric disorder), the rest of us may be puzzled by the fuss.

And there will be none other more puzzled by the fuss, of course, than the 7.8 million teenage girls and women who suffer from iron deficiency, 3.3 million of which have a more severe form called iron-deficiency anemia. [The main cause of iron-deficiency anemia in premenopausal women is blood lost during menses.] Or those with heavy bleeding and pain (dysmenorrhea), endometriosis, or epilepsy.

Since menstrual disorders are the most common gynecologic problems suffered by women in the United States Ms. Houppert's ignorance of the routine indications for menstrual suppression is appalling.

What's also appalling is Ms. Houppert's cheery assumption that menstrual suppression may be good news only for women who suffer from period-related problem. 'Cause as we all know, if you're female, unless you're suffering or you're at death's door you're not worthy to take advantage of anything medicine has to offer.

If you are one of the millions of women who don't have bothersome periods, but who, for whatever reason, would like to suppress your period just to benefit your lifestyle, off with your head!

4. Be unaware of women's attitudes about the period.

Sure, getting our periods can be a bother sometimes, but after the traumatic moment of menarche — "How can this be happening to me when the sixth-grade pool party is tomorrow and I have no idea where that tampon goes?" — most of us get used to it.

It just is.

Actually what just is is presumptuousness. Assume your views of the period magically apply to most women, ignore all the available evidence and, presto, you're on the op-ed pages of The New York Times. Nice gig if you can tolerate it, but utterly unconnected to reality.

Studies, surveys and polls have consistently found that most of us don't, in fact, get used to getting a monthly period. The evidence shows that a majority of women would prefer not to bleed every month. [Interestingly, this finding holds true across decades, age groups and countries.]

5. Don't hesitate to make ignorant claims and wild accusations (the more, the better).

Lybrel is landing on pharmacy shelves this month. And now war has been declared on menstruation.

Ignore for a moment the grandiosity of the claim and the type of solid proof it would require. Note what's actually claimed--that a war on menstruation has been declared in support of Lybrel, a Pill brand that has no effect on the menstrual period (in that Pill users don't have periods). Good to know pharam is crafty enough to wage a propaganda war, but inept enough to not know what to indoctrinate us about.

Already the first few volleys in this battle have been exchanged. Gird yourselves, women, for a barrage of advertising and research highlighting the debilitating effects of periods and the joys of menstrual suppression.

Because, obviously, the second Lybrel becomes available, all research highlighting the debilitating effects of periods should cease immediately, and the subject of period-related problems is to became taboo. You know, just to be on the safe side and insure womenfolk are protected from undue influences on their pea-sized brains.

Also, yeepee, the joys of menstrual suppression; just dreamy! Seriously, what is this, an op-ed in the kindergarten newsletter? Does anyone seriously think this level of condescension works on actual women?

So what’s a poor company to do? Re-conceptualize menstruation as a disease in need of treatment.

Let's make this very easy. If Ms. Houppert produces one single instance of a legitimate medical or pharma source equating the normal menstrual period with a disease I'm prepared to eat her hat.

And what’s a poor menstruating woman to do? Get cranky with the prophets who offer to cure us of menstruation; who minimize the complex interplay of hormones and their many roles in our bodies; who gloss over the still unknown long-term effects of menstrual suppression; who promise that cycle-free women are better lovers, mothers, workers.

If you want to be taken seriously, don't project your odd fantasies--prophets who offer to cure us of menstruation, really?--on pharma, or make wild, misguided accusations.

Questioning, for example, the effect of the extra weeks of estrogen exposure with Lybrel shows you've bothered to familiarize yourself with the topic you are venturing an opinion on. Throwing complex interplay of hormones and their many roles in our body around and hoping it will stick only denotes your ignorance of facts.

As does the accusation that the long-term effects of menstrual suppression are still unknown. They're not. [See, this is where knowing what you're talking about comes in handy.]

The effects of menstrual suppression and the effects of eliminating the monthly withdrawal bleed are two distinct issues.

We know that suppressing your period long term is not detrimental (actually, there's evidence it's beneficial, but I digress). And how do we know that? From decades of observing the effects of menstrual suppression in women who, you know, don't menstruate for extended intervals: Pill users, pregnant women, breastfeeding women.

But what about the effects of eliminating the monthly withdrawal bleed? Unlike the menstrual period, withdrawal bleeding is an artificial manipulation. The bleeding frequency isn't intrinsic; it's arbitrarily set (monthly by the Pill's inventors; every 3 months by Seasonale's manufacturer; never by Lybrel's manufacturer).

Briefly, the correct question is, will the shift in bleeding frequency (prolonged hormone exposure) negatively impact, for example, the risk of uterine cancer or cardiovascular side effects? Based on all the available evidence--clinical (long-term) and studies (short-term)--the answer is no. Eliminating the monthly withdrawal bleed is safe.

Bottom line: The menstrual period is a normal body function, not an affliction. You suppress your period to improve your health, if having a period is a health concern, or to benefit your lifestyle, if the period is a simple inconvenience. And you eliminate withdrawal bleeding because there's no reason to bleed monthly while on the Pill.

Now if only The New York Times and its columnists could figure out that, even for op-ed articles about the menstrual period, accuracy still matters, I could.....

You know, I had a few clever endings for that phrase, but if you really think about it, there's nothing funny about this much misinformation, relentlessly repeated and prominently displayed.

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Wednesday, July 18, 2007

Steam Explosion in NYC

I just found out about the steam pipe explosion at 41st Street between Lex and 3rd Ave., shortly before 6 PM. No indication it's terrorist-related. No subway service in and out of Grand Central. Buses are running. NY 1 reports at least 4 serious injuries, but no deaths. Looking at a live picture, it's under control right now.

UPDATE: How terrible; one person dead.

Sunday, July 15, 2007

The Washington Post Botches Article On Plan B

The Plan B article by Rob Stein in the Washington Post is a joke.

Here are the top 5 reasons why:

1. Use of incorrect and misleading terminology.

Plan B is not so much the morning-after pill as it is the emergency contraception pill.

When your article opens with The popularity of the morning-after pill Plan B has surged... without an indication that morning-after is an incorrect term, you are giving your readers misleading information. [And, no, having controversial emergency contraceptive (controversial?) in the same phrase doesn't count. "Morning-after" has to do with dosage timing, "emergency contraceptive" refers to the name of the contraceptive class.]

You take Plan B after an act of unprotected intercourse in order to prevent an unintended pregnancy. The sooner you take it--ideally, immediately after sex or within the first 12 hours--the better it works. But, and this is very important, you can use Plan B up to 5 days (120 hours) and still reduce your pregnancy risk. Referring to Plan B as the "the morning-after" pill without a qualifier is detrimental because it leads to incorrect usage.

You don't have to wait until the morning after to use Plan B. You can take it right away (preferably) or up to 5 days after unprotected sex.

2. Passing off a consistent position as evidence of a surge in controversy.

Rob Stein asserts that approval of Plan B OTC sales and the resulting increased use has lead to a surge in controversy about making Plan B available without a prescription. One piece of evidence he offers to support his assertion is that conservative groups that fought the change say they are disturbed by the surging use...."We think [the surging use] is putting women's health at risk."

Use of a drug (prescription-only or OTC) known to have detrimental side effects can put users' health at risk. Plan B is a drug. Like any drug Plan B has side effects. That Plan B has no serious or long term side effects is a medical fact.

The surging use of Plan B, a drug without serious or long term side effects, is not putting women's health at risk.

Now, conservative groups like the Family Research Council have never based their discussions about Plan B on medical evidence. They have been consistent in their use of propaganda--Plan B puts women's health at risk--and their ignorance, real or feigned, of science. Conservative groups used propaganda to feed to gullible reporters elicit controversy about Plan B when the drug was available by prescription only. And now that Plan B is available OTC, they continue to use the exact same propaganda.

How is maintaining a consistent position--continued ignorance of science and use of propaganda--on the part of conservative groups evidence of an increased surge in controversy?

3. Incorrect information about Plan B's ingredients.

It's possible Plan B consists of higher doses of the hormones found in standard birth control pills in mirror-Spock's universe. But if we're limiting our discussion to Plan B's ingredients here on planet Earth, we need to be accurate.

Plan B consists of a higher dose of one of the hormones [levonorgestrel, a progestin] found in standard combination birth control pills. Alternatively, Plan B consists of a higher dose of the hormone found in standard progestin-only birth control pills.

And just in case Mr. Stein was confusing Plan B with Preven, an emergency contraceptive pill which actually consists of higher doses of the hormones found in standard birth control pills: Preven is no longer available in the US, and this is an article about Plan B, not Preven.

4. Misleading readers about questions asked and answered.

Mr. Stein tells us that Conservative members of Congress and advocacy groups questioned the drug's safety and argued that easier availability could encourage sexual activity and make it easier for men to have sex with underage girls. They also maintain the pill can cause the equivalent of an abortion.

Approving a drug for OTC sale when there are questions about its safety, public health impact, and mechanism of action. Now that's one juicy controversy!

Except science has already asked and answered these questions.

Plan B has no serious or long term side effects. [See #2.]

The impact of OTC use is well documented in the medical literature. Progestin-only emergency contraceptive pills like Plan B have been in use without a prescription for years (in Europe, of course). The evidence shows that easier availability does not increase risk taking, either for adults or adolescents (projection fantasies about Plan B and men having sex with underage girls notwithstanding).

Finally, Plan B does not cause abortion.

Just because Conservative members of Congress and advocacy groups pretend-question the evidence about Plan B in an attempt to mislead the public does not mean you report their questions and leave it at that. Since you have an obligation to be factual, you have to note their deceit and give your readers the correct information about Plan B's safety, impact, and mechanism of action.

5. Misrepresenting the FDA's findings on Plan B.

The FDA did not say there was too little safety data to approve the drug for teenagers younger than 18.

What the FDA actually said is that for women 17 and older the existing Rx dispensing requirements for Plan B are not necessary to protect the public health and that an Rx-only to non-prescription switch for those consumers is authorized under 21 U.S.C. 353(b)(3) and 21 CFR 310.200. (emphasis mine)

Note to Mr. Stein: 17 and 18 are not one and the same. But then, what's a year here and there between political ideologues. In any case, when you report on what the FDA said, even if the agency's statement is just propaganda, you still need to insure you are reporting the propaganda accurately.

And speaking of the FDA, why exactly is what the agency said about Plan B OTC sales propaganda?

Since, clearly, just reading the Washington Post won't provide you with this information, allow me. Because the age restriction is not based on any scientific evidence that Plan B is not safe for women under 17. It is a purely political decision.

From the GAO report, Decision Process to Deny Initial Application for Over-the-Counter Marketing of the Emergency Contraceptive Drug Plan B Was Unusual (.pdf):

There are no age-related marketing restrictions for safety reasons for any of the prescription or OTC contraceptives that FDA has approved, and FDA has not required pediatric studies for them. All FDA-approved OTC contraceptives are available to anyone, and all FDA-approved prescription contraceptives are available to anyone with a prescription. For hormonal contraceptives, FDA assumes that suppression of ovulation would be the same for any female after menarche,13 regardless of age. FDA did not identify any issues that would require age-related restrictions in its review of the original application for prescription Plan B, and prescription Plan B is available to women of any age.

And from the FDA's Director of the Center for Drug Evaluation and Research, the person in charge of making public health decisions about Plan B, Dr. Steven "I'm Not Familiar With Plan B's Side Effects" Galson:

[Dr. Galson] said that the age restriction (which was originally set at 16) was changed to 18 to make it less confusing for pharmacists to enforce.

Mustn't.Confuse.The Pharmacists.

So, there you have it. A Washington Post article on Plan B which manages to misreport both basic medical facts about Plan B, as well as the less-than-subtle political propaganda directed at Plan B by some Conservatives and the FDA. Well done!

(via Our Bodies Our Blog)

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Saturday, July 14, 2007

Why Anthelios Sunblock Is A Great Choice For You

When I first started using Anthelios sunblock I did so for two main reasons:

- It contains Mexoryl and protects against both ultraviolet A and B (UVB) rays.

- It came highly recommended by dermatologists I trust.

Its excellent skin protection and ease-of-use are what kept me using it since, and what convinced me to recommend it to patients, family, friends, and, yes, even perfect strangers*. I’ve had a lot of experience with using sunscreens over the years, so when I find one that works I stick with it and tell everyone I can about it. [*I know, I know, I shouldn't bother unsuspecting strangers. In my defense, I do sometimes get carried away in my quest to inform.]

Here are the top 3 reasons I think Anthelios is the best choice for your skin cancer protection needs as well:

3. Non greasy. The quick skin absorption (I've used both the lait and the cream) makes it extremely practical to use. You can protect your skin from sun damage without having to walk around all greasy and sticky.

2. The fact that it's nonirritating and fragrance free allows you to use it even if you have sensitive skin. This is important, especially if you're using the SPF 50 or SPF 60 lines, or if you're pregnant and your skin is hypersensitive to begin with.

1. The absolute number one reason - protection against both ultraviolet A and B (UVB) rays. Most of the other products available in the US protect only against UVB, yet UVA accounts for over 80 percent of the damage that occurs to the skin in terms of aging, DNA damage and ultimately skin cancer. [Have I mentioned Anthelios has been available in Europe for over 10 years?] If you want skin cancer protection you have to have dual UVA and UVB protection, period. So...

Start using Anthelios today.

Tip # 1:

Using the daily moisturizing cream with sunscreen available directly from L'Oreal US is not good enough. I don't recommend it because of the SPF 15 (and only 2% Mexoryl). For adequate protection against skin cancer you need a minimum SPF of SPF 30 (and >3% Mexoryl). [I use SPF 60 because my skin is very sun-sensitive, but for normal most people SPF 30, SPF 45 or SPF 50 should be adequate protection.]

Tip #2:

If you're pregnant, use Anthelios to prevent the "mask of pregnancy" (chloasma). Some degree of skin darkening is seen in 90% of all pregnant women, and at least half of pregnant women develop the "mask of pregnancy"**--blotchy areas of darkened skin (primarily on the cheekbones, forehead and upper lip). The cause is a combination of genetic, hormonal and sun related factors. Not much you can do about genes and hormone fluctuations during pregnancy. To avoid developing the "mask of pregnancy" you can, and should, use sun protection. I've had very good results with patients using Anthelios XL SPF 50+ Tinted Cream. [I don't have much clinical experience with this, but the manufacturer says it also works to prevent drug-induced photosensitization.]

Anthelios sunblock

Note: Other than the Amazon links, I have no financial ties (unfortunately) with Anthelios' manufacturer.

**Williams 21st ed., p1430

[page template via Copyblogger]

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Friday, July 13, 2007

Diaphragm Not Protective Against HIV

A somewhat expected, but still disappointing, finding from a study of 5,045 women:

WASHINGTON (Reuters) - Giving women diaphragms to use in addition to condoms provides no extra protection against the AIDS virus, researchers reported on Thursday.

The hope was that a female-controlled method of contraception might give women a little extra protection against the virus, especially when so many men are reluctant to use condoms.

But the approach failed to help, Dr. Nancy Padian of the University of California San Francisco and colleagues found.

"These results do not support the addition of the diaphragm to current HIV prevention strategies. Condoms remain the only proven barrier method for HIV prevention," Padian said in a statement.


They tested 5,045 women in South Africa and Zimbabwe, giving them all an HIV prevention package, consisting of condoms, pre-test and post-test counseling about HIV and sexually transmitted infections, testing and treatment. Half the women also got diaphragms.

But the incidence of the human immunodeficiency virus that causes AIDS was the same in both groups -- around 4 percent.

"We observed no added protective benefit against HIV infection when the diaphragm and lubricant gel were used in addition to condoms and a comprehensive HIV prevention package," the researchers wrote.

AIDS, which infects close to 40 million people globally, is now transmitted mostly during sex between a man and a woman. There is no cure and the virus has killed 25 million people.

UPDATE: More on the study from Women's Health News.

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Wednesday, July 11, 2007

In Our Country, We Do Sex, Too

And we'd also like to talk about it. Unfortunately, sex education is censored (or replaced with lies) by our most beloved leaders.

When it comes to sex education, let's hope India does a better job than we do:

NEW DELHI (AFP) - India's health minister on Wednesday lamented opposition from several states to a government plan to introduce sex education from next year, a report said.

"In our country, we do sex. But we don't want to talk about it and that is why we have a billion population," Health Minister Anbumani Ramadoss said at an event to mark World Population Day.

"In our close-knit society, we have to enlighten and create awareness among our children," he was quoted as saying by the Press Trust of India.

The government has been fighting with around a dozen out of 29 states to introduce sex education in a bid to spread awareness of AIDS and condoms as well as family planning.

The Council of Boards of Education of India, which sets the teaching curriculum for schools, has prepared a package on sex education, according to a Times of India report earlier this year.

"We have recommended to make it a mandatory subject to be taught twice a week," Ramadoss said.

"They will be the losers if awareness is not created at the right age," the minister said of state opposing the plan.

Schools in the conservative nation, which ironically brought the world the Kama Sutra, have shied away from educating youngsters about such topics as human reproduction.

But the minister said education would not provoke promiscuity.

"We are not taking up sex education in a blatant manner, but in a subtle way," said Ramadoss. "We don't want to create controversy. But we have 55 per cent population that falls in the reproductive age and we have to create awareness among them."

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Mitt Romney Now Says It's OK For Women To Receive Medical Care

But only if they've been brutalized or they're about to die. In all other cases, not so much.

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Tuesday, July 10, 2007

Bush Administration Censored Talk On Birth Control And Sex Ed

So says Dr. Richard Carmona, the former U.S. surgeon general appointed by President George W. Bush (emphasis mine):

WASHINGTON (Reuters) - The first U.S. surgeon general appointed by President George W. Bush accused his administration on Tuesday of political interference and muzzling him on key issues like embryonic stem cell research.

"Anything that doesn't fit into the political appointees' ideological, theological or political agenda is ignored, marginalized or simply buried," Dr. Richard Carmona, who served as the nation's top doctor from 2002 until 2006, told a House of Representatives panel.

"The problem with this approach is that in public health, as in a democracy, there is nothing worse than ignoring science, or marginalizing the voice of science for reasons driven by changing political winds. The job of surgeon general is to be the doctor of the nation, not the doctor of a political party," Carmona added.

Carmona said Bush administration political appointees censored his speeches and kept him from talking out publicly about certain issues. He mentioned political interference preventing him from discussing the science on embryonic stem cell research, contraceptives and his misgivings about the administration's embrace of "abstinence-only" sex education.

Carmona's comments came two days before a Senate committee is due to hold a hearing on Bush's nomination of Dr. James Holsinger, who faces Democratic criticism, as his successor. The administration allowed Carmona to finish his term as surgeon general last year without a replacement in place.

I can't say I'm utterly surprised by the confirmation that this administration is censoring accurate reproductive health information. What I don't get is this administration's blinding ideological fervor. I mean, all the players involved are seasoned political operatives. They must be aware that actively working to substitute propaganda for science fundamentally, and irreparably, damages the process. They must also be aware that they don't get to rule for life or install their successors.

Once it has become acceptable to make health policy and medical decisions based on propaganda, any subsequent administration can, and will, propagandize science and medicine according to the dogma of its preferred Sky Fairy or "Power to the People" ideology.

This administration got away with a trailblazer--using the FDA to decide a drug's (Plan B) availability based strictly on party ideology. It set the precedent for a future administration to behave equally as irresponsible.

When a future administration institutes a one-child policy, or executes officials who don't tow the party line, or makes stoning part of the treatment protocol for rape patients, we mustn't forget to thank the Bush administration for its visionary conduct.

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A Cig A Day Keeps Parkinson's Away

CHICAGO (Reuters) - There is more evidence to back up a long-standing theory that smokers are less likely to develop Parkinson's disease than people who do not use tobacco products, researchers reported on Monday.

The apparent protective effect of tobacco against the degenerative nerve disease has been observed for years but a University of California Los Angeles School of Public Health report said a new review of existing studies seems to confirm it, with long-term and current smokers at the lowest risk.

The review also found that the effect seems to extend beyond cigarettes to pipes and cigars, and possibly to chewing tobacco, and that it persisted among those who had stopped smoking years earlier.

What would cause such a preventive effect is not well understood, said the report in the Archives of Neurology, but studies on test animals suggested two possibilities.

One is that carbon monoxide or other agents in tobacco smoke exert a protective effect and promote survival of brain neurons that produce dopamine, which allows muscles to move properly and is lacking in Parkinson's cases.

Cigarettes may also somehow prevent the development of toxic substances that interfere with proper neurological functioning.


"Although we found that current smokers and those who had continued to smoke to within five years of Parkinson's disease diagnosis exhibited the lowest risk, a decrease in risk (13 percent to 32 percent) was also observed in those who had quit smoking up to 25 years prior to Parkinson's disease diagnosis," it said.

"Other tobacco products also appeared to be protective. Men who smoked pipes or cigars had a 54 percent lower risk. The number of chewing tobacco users was small, but there was a suggestion of reduced risk associated with this product," it added.

[Sorry, but I just couldn't resist writing the title.]

Monday, July 09, 2007

More Bad News About Commonly Used Spermicide

The widely used spermicide nonoxynol-9 (N-9) was found to enhances genital transmission of human papillomavirus (HPV) in an animal model:

"The findings add to the growing list of why it is preferable to recommend alternative contraceptives to N-9 spermicides," Dr. John T. Schiller from National Cancer Institute, Bethesda, Maryland told Reuters Health. "Others are that they are not particularly effective and may increase the risk of HIV infection."

Dr. Schiller and associates used a mouse model of cervicovaginal infection with HPV16 to investigate the effects of nonoxynol-9 and carrageenan on genital transmission of HPV.

Both N-9 and an over-the-counter spermicide that contains 4% N-9 sensitized the genital tract to HPV infection, the authors report.

N-9 treatment was associated with disruption of the epithelium which allowed viral capsids to enter and bind to the basement membrane.

In contrast, carrageenan prevented infection in the genital mucosa rendered susceptible to infection by either mechanical disruption or chemical disruption with N-9.


Dr. Schiller said that his team is working with the NCI's Division of Cancer Prevention to initiate a placebo-controlled trial of carrageenan as a topical microbicide to prevent HPV infection in women.

"If a trial confirmed broad spectrum activity against genital HPV types, carrageenan might become a useful adjunct to the current prophylactic HPV vaccines, which target a narrower spectrum of genital HPVs," the investigators write. "Because spermicidal activity of N-9 is retained in carrageenan-based gels, carrageenan might also be considered as a protective additive in over-the-counter vaginal contraceptives."

However, note this:

"We actually don't want to overly discourage the use of N-9 containing spermicides at this point, if a woman doesn't have other choices at hand," Dr. Schiller said. "This is because unwanted pregnancy will be more of problem than unwanted HPV infection for most women."

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Birth Control Hormones

Nice progestins chart from Medscape:

Pill Hormones

A 2004 Cochrane review of 22 randomized controlled trials comparing different progestins, including mono- and multiphasic OC formulations, demonstrated that overall, second- and third-generation progestins performed better than first-generation progestins. Findings included significantly fewer discontinuations due to adverse events with OCs containing second- or third-generation progestins; significantly better cycle control was also demonstrated for both mono- and multiphasic formulations containing these progestins. Effectiveness for pregnancy prevention and bleeding abnormalities were similar between OCs containing gestodene (not available in the United States) and levonorgestrel, although less intermenstrual bleeding occurred with gestodene. The performance of drospirenone was similar to that of desogestrel. Participants preferred using OCs containing second- or third-generation progestins to those with early progestins that included norethindrone, ethynodiol diacetate, lynestrenol, and norethynodrel.

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Drug Prices At Military Pharmacies

Four packs of Ortho-Tri-Cyclen for $99.96.

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Thursday, July 05, 2007

Happy Fourth Of July!


Monday, July 02, 2007

Skipping Your Period With a Triphasic Pill, Update

Skipping your period with a triphasic pill brand, like Ortho Tri-Cyclen Lo or Trivora can be a bit of a challenge, for patient and physician alike.

To help out with this challenge, I have updated and expanded my previous posts on using a triphasic to skip a period.

Skipping Your Period With a Triphasic Pill, Part I is an introduction to the birth control Pill, and the various types of pills. Start with this post if you're not familiar with the basics.

Skipping Your Period With a Triphasic Pill, Part II covers using a triphasic Pill brand to delay, or skip the monthly bleeding. I go over five extended regimens in detail.

If you're a patient, print the regimens from Part II, or email them to your doctor, and use the information to discuss with your Ob/Gyn which regimen would be best suited to your needs.

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