Comments: 13
BrokenTune 2 months ago
Yup. It's well worth a read. And yes, I will be flinging this book at people.
Is the heart attack symptoms thing mentioned in here?
BrokenTune 2 months ago
Absolutely!
The heart attack symptoms thing, the way that pain meds work differently, the way that pain meds are prescribed differently, the way that research grants are distributed differently, the way that pharmaceutical companies are more interested in marketing Viagra at a male market than furthering the research into what it was originally created for (relief of period pain) because that would cut income from traditional pain meds, the way that economics does not take account of work provided by women (for free) - but when the same work is provided by industry it causes an increase in GDP, .... the list is pretty endless. It's a fascinating book.
Lillelara 2 months ago
Viagra for relief of period pain? Does the author claim this in her book, because that is the first I have heard of that. And knowing, what kind of effect Viagra has on the body, I´m not sure if it would work to relieve period pain.
Viagra was originally intended to be a medicine for the treatment of heart conditions and Sildenafil is used to treat the life threatening condition of pulmonary hypertension. And to treat pulmonary hypertension one tablet 30-40 Euro (or even more, I don´t know the exact price of this medicin), while one tablet Viagra or its cheaper counterparts costs 1-2 Euro per tablet.
BrokenTune 2 months ago
I'll look up the parts in the book and references when I get home. :) But, yeah, in this one the use for heart conditions is mentioned also.
The fact that I did not know of the hoped for benefits for period pains may just be another example of the problem...
BrokenTune 2 months ago
Let me look this one up again. It is possible I may have misremembered last night, but I'm positive it was something like this before they found the benefits to heart conditions. I'll find the part and references when I get home.
BrokenTune 2 months ago
Ok, here we go. I've copied the relevant parts from the book - I have left the citations in as "(numbers)" and list the references at the end:

"So imagine my joy when I read about a 2013 study that seemed to have found a cure. The ‘primary outcome’ of a double-blind, randomised, controlled trial of sildenafil citrate, was, ladies, you may want to sit down for this: ‘total pain relief over 4 consecutive hours’, with ‘no observed adverse effects’. (96) Imagine. Created in 1989, sildenafil citrate is themedical name for Viagra. In the early 1990s, the drug was being tested as a heart-disease medication. (97) It turned out not to be great at that, but one thing participants did report was an increase in erections (yes, all the trial participants were men). Total erectile dysfunction affects between 5– 15% of men depending on age, (98) with about 40% of men experiencing it to some degree – and so naturally the researchers were keen to explore this alternative use for their drug. By 1996, sildenafil citrate had been patented in the US and by March 1998 it was approved by the FDA. (99) A happy ending for men, then.

But what if the trial had included women? The outcome of the 2013 study is suggestive. The trial had to be stopped because the funding ran out, meaning the researchers did not meet their sample size and therefore could not confirm the primary hypothesis. They called for ‘larger studies of longer duration, likely multi-center’ to confirm their findings. These studies have not happened. Dr Richard Legro, who led the study, told me he applied twice to the NIH for funding ‘to do a longer and larger study and also to compare sildenafil to the standard of care, a non-steroidal anti-inflammatory agent’. He was rejected both times. In each case, the grant ‘was deemed to be in the lower half of grants submitted’. It wasn’t even reviewed. Legro tells me that the comments he received ‘indicated that the reviewers did not see dysmenorrhea as a priority public health issue’. They also didn’t ‘fully understand clinical trial design of dysmenorrhea trials’. When I ask him if he thinks he will ever get funding, he says, ‘No. Men don’t care or understand dysmenorrhea. Give me an all-female review panel!’

The failure of pharmaceutical companies to step in here and capitalise on what is surely a gold-plated commercial opportunity may seem baffling, but it’s quite possibly just another data-gap problem. In an email, Legro told me that, for cost reasons, the pharma industry ‘doesn’t usually fund investigator-initiated projects’, particularly of drugs that are available generically. And this may be where the data gap comes in: there simply isn’t much research done on dysmenorrhea, (100) which makes it difficult for pharma companies to know exactly how much money could be made on such a drug – and therefore makes it harder for them to decide to fund trials. Especially if the people making the decisions happen not to be women. Legro also suggested that pharma companies may not want to risk doing tests in women in case of negative findings that would endanger the use of sildenafil in men. In short, it seems that pharma companies may in fact not see this as a gold-plated commercial opportunity. And so women carry on being incapacitated by pain on a monthly basis."

(96) Dmitrovic, R., Kunselman, A. R. and Legro, R. S. (2013), ‘Sildenafil citrate in the treatment of pain in primary dysmenorrhea: a randomized controlled trial’, Human Reproduction, 28: 11, 2958– 65
(97) http:// edition.cnn.com/ 2013/ 03/ 27/ health/ viagra-anniversary-timeline/ index.html
(98) http:// www.clevelandclinicmeded.com/ medicalpubs/ diseasemanagement/ endocrinology/ erectile-dysfunction/
(99) http:// edition.cnn.com/ 2013/ 03/ 27/ health/ viagra-anniversary-timeline/ index.html
(100) http:// www.telegraph.co.uk/ women/ life/ period-pain-can-feel-bad-heart-attack-ignored/

Some background on the Dr. Legro, who seems to have been her source for much of the background on this:
https://pennstatehealthnews.org/2018/10/legro-named-chair-of-department-of-obstetrics-and-gynecology/

Lillelara 2 months ago
Ah, dysmenorrhea ... that´s a more severe condition than the "normal" period pain an otherwise healty female has to endure. I have to look into those links over the weekend. And it´s baffling that I never even have heard about these studies.
Anyway, I think I have to put this book on my TBR wish list. This does sound fascinating.
BrokenTune 2 months ago
I'm sure there are some references throughout the book that I looked up and questioned, but my questioning may itself have been informed by some of the sources being articles rather than more traditional sources.
However, I liked that she actually did include and reference her sources throughout.
I also liked that, even if one disagrees with some of the research, the perspective that she proposes is thought-provoking and does make one question things. Whether one comes to the same conclusions is secondary. I like that she does try to make people look at things and change angles.
It sounds like a must-read. I'll check it out. Many thanks.
Hol 2 months ago
Sounds fascinating.