Posts Tagged alternative medicine

Is your vagina depressed?

Are you femme presenting? Do you sometimes wish more people would have more of an opinion on how you have sex? How often you have sex? How you should behave when you don’t want to have sex? How often you should want sex? How your body behaves when you do/don’t have sex? Whether your experience of sex is real? What ‘real’ sex is and who ‘real’ sex happens with?

Well, you’re in luck! Because over the last year and a half the British media have been telling us all about a “study” which says if you’re not having “enough” sex, your vagina (if you have one) will get depressed and “atrophy”.

Woman's head and shoulders from behind, in grayscale. Her head is dropped down.

As far as I can tell, this all started a little over a year ago when The Sun wrote this headline:

SORE POINT Do you have a ‘depressed’ vagina? This could be why sex is SO painful (and it’s nothing to do with an STI)”. The story resurfaced just a few weeks ago when Higher Perspectives said “New Research Says Lack Of Sex Makes Your Vagina Depressed

The Higher Perspectives article begins “We all know that a healthy sex life keeps our immune system humming, lessens pain and relieves stress. It makes for a happier life. But what happens when we don’t have a sex?”. The article goes on to explain that “research” shows that “Sexual abstinence can make our vagina depressed and this can also lead to vaginal atrophy.”

Do they link to this research? Well, no. And having a look on Pubmed shows no sign of any such research in existence. But they said their claims were “backed in science” it so it must be true, right?

Digging a little deeper, it becomes clear that the media – including The Sun, Maxim, The New York Post and Women’s Health Magazine seem to think a diagnosis of vulvodynia is a synonym for vaginal depression. The Sun even claims that vaginal atrophy is “The horrifying thing that can happen to your vagina if you don’t have enough sex” – again, this begs the question of where they get this claim that a lack of sex can cause vaginal atrophy – and again, this news outlet does not link a reliable source to support the claim.

Two stormtrooper lego figures holding hands stood in front of a sunset over water

They do however, mention that Louise Mazanti, a “sex therapist” from London, has just released a book…More on Louise Mazanti later.

Vulvodynia ≠ vaginal depression

The idea that vulvodynia and vaginal depression are equivalent terms, seems to come from an episode of Sex and the City where Charlotte is diagnosed with the condition (the real one, not the media hyperbole one). She remarks that her doctor prescribed her antidepressants and it’s “hilariously” questioned if her vagina is depressed.

Nearly ten years after Sex and the City finished broadcasting, we collectively know so little about vulvodynia that this misnomer seems to have stuck.

And yet vulvodynia is a significant diagnosis that affects a huge proportion of people with vaginas at some point in their lives.a stethoscope and sphygmomanometer on a white surface

Simply put, vulvodynia is chronic pain (lasting 3 months or more) of the vulvar area. Vulvodynia is a tricky condition to treat, as with many chronic pain conditions, and requires collaboration between doctor and patient to find the right treatment.

One treatment option is a tricyclic antidepressant.

This is where the confusion starts – but antidepressants used in this way are prescribed in far lower doses than required for an antidepressant effect. These drugs are actually used because in low doses they act as pain modifiers. The comparison of vulvodynia to depression is completely inaccurate.

Having “enough” sex?

For some people with vulvodynia, penetrative sex is not possible. Suggesting women have more sex to solve all their medical problems, can actually cause harm far more than it helps. We know that our society tends to view penis in vagina sex as the only “real” sex. The consequences of this are significant – sex between two women is dismissed, oral and digital forms of sex are considered “foreplay” and there is a huge pressure placed onto the idea of “virginity”. And for people with the forms of vulvodynia that make penetration very difficult, this idea can have a damaging effect on their mental health. Across our society “women” are expected to “provide” for their “men” and this includes having sex frequently (but not too frequently). It is easy for people with vulval pain to feel dysfunctional and that can be damaging to their mental wellbeing – not helped when a lack of libido is often termed “female sexual dysfunction” but that’s a rant for another day.

two women holding hands in a field

Vaginal atrophy

These latest stories are particularly keen to mention frequency of (penetrative) sex being a preventative for vaginal atrophy (a thinning of the vaginal walls which the NHS website refers to as vaginal dryness). They claim this is founded in science but give no supporting evidence of this. Vaginal atrophy does happen – but it is scientifically understood to be a response to changes in hormone levels, and therefore is most common during and after the menopause. There is very little a person can do to control it and it is not as “horrifying” as The Sun claims – sexual frequency might enhance blood flow to the area to help delay or prevent this but that is not dependent on penis in vagina penetration. Using dilators, dildos, vibrators or manual penetration and stimulation will help just as well.

Louise Mazanti

So, if there’s no obvious “new” study which triggers this year’s media interest in our sexual habits, why else might this be “newsworthy”?

Perhaps it’s all to do with a new book that Louise Mazanti published earlier this year titled “Real Sex: Why Everything you Learned about Sex is Wrong” alongside her husband Mike Lousada.

Mike was an investment banker before his spiritual awakening led him to retrain as a counsellor and “sexologist” while Louise was a Professor in art and design before her own spiritual awakening and retraining in sex therapy. They both see clients in London and give talks and write books together and separately.

Louise is touted as an expert sex therapist in a number of articles discussing vulvodynia. On her webpage about her “expertise” is the claim that “Louise holds a strong energetic field for you to start exploring your own inner truth, and she can guide you into states of expansion that will give you a new direction in life.”. Louise is “trained in energy psychology [and] esoteric wisdom”.

And apparently that’s good enough to be an expert on the medical health of the vagina, or at least that seems to be the opinion of the media who think vaginal depression is a synonym for vulvodynia.

Read more about vulvodynia:

 

Dr Alice Howarth, PhD

Alice is a cell biologist and cancer researcher who works in the Institute of Translational Medicine at the University of Liverpool. She is the Treasurer of the Merseyside Skeptics Society and co-hosts the popular sceptical podcast Skeptics with a K. In her free time she Instagrams photos of her ridiculous dog, Lupin and watches Buffy the Vampire Slayer ad infinitum. Find her at DrAlice.blog or @AliceEmmaLouise on social media.

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Arsenic cures cancer!

Last week The Daily Mail boldly asked “Could arsenic be a miracle cure for cancer? Scientists say it had astonishing results when added to a leukemia drug”. It’s worth pointing out here, that even in the subheading bullet points the Mail Online downplayed their excitement a little, de-escalating from arsenic being a potential “miracle cure” to “makes chemotherapy more effective”.

Headline from the Mail Online reading "Could arsenic be a miracle cure for cancer? Scientists say it had astonishing results when added to a leukemia drug"

The Mail Online wasn’t the only one to cover this story. Medical News Today headlined “Poison or cure? Arsenic can help treat cancer, study finds” while Science Daily said “Arsenic in combination with an existing drug could combat cancer – An ancient medicine shows new promise” and Harvard Magazine asked “Is Arsenic a Key Ingredient in the Battle Against Cancer?”. So, the Mail Online seem to be in good company in reporting this apparently exciting news.

New use for a traditional medicine?

One thing all of these stories had in common was the detailing of arsenic in traditional Chinese medicine. Harvard Magazine quoted study author Kun Ping Lu: “In Chinese traditional medicine, “Arsenic has been used for thousands of years,” said Lu. “Its oxidized form is the active ingredient” for a concoction the Chinese called “magic bullet,” which was used to treat a specific kind of leukemia, APL”.

Arsenic, in fact, has been claimed to treat a whole range of diseases throughout history – in Ancient Greek times it was used to treat ulcers and in Chinese Traditional Medicine it’s been used for over 2000 years. Arsenic was once added to Indian Ayurvedic herbal remedies and when Paracelsus, an Italian Professor of Medicine from the 1500s was skeptical of the old methods of balancing humours to treat disease, he introduced arsenic as an alternative. Paracelsus, in fact, stumbled across a genuine therapeutic action of arsenic in its ability to treat syphilis – an indication for which arsenic was used well into the 20th Century until antibiotics came along.

an open brown medicine bottle laying on its side containing a white powder and labelled "acid arsenic"

But arsenic has not only been a persistent element in traditional medicine, it has also been used to treat cancer – first, to treat chronic myeloid leukaemia in the 1930s and later to treat acute promyelocytic leukaemia (APL). Arsenic trioxide (ATO) has been used to treat APL since its approval in 1995.

The study

The study the Mail Online et al. referenced was summarised in Nature Communications earlier this year in an article titled “Arsenic targets Pin1 and cooperates with retinoic acid to inhibit cancer-driving pathways and tumor-initiating cells”. The study is apparently based on three things:

  • A protein called Pin1 is important in cancer
  • Arsenic trioxide (ATO) is a treatment for cancer
  • All-trans-retinoic acid (ATRA) inhibits Pin1

A good introduction to any peer-reviewed article will use scientific literature to convince you that the question the researchers have asked is a valid one and set their work within the context of what is known in the field. At first glance, this article is particularly industrious in the effort to convince the reader on the three areas above. They strongly stress that “Pin1 is a critical “driver” and a unique drug target in cancer. Pin1 is hyperactivated in most human cancers and correlates with poor clinical outcome”.

ATO and leukaemia

ATO has been approved for use in a certain kind of leukaemia called acute promyelocytic leukaemia (APL) for many years and is successfully used in combination with ATRA in patients with APL. There are very few alternative treatments for this form of leukaemia and ATO combined with ATRA has low toxicity.

The underlying mechanism of this treatment is down to the existence of a protein called PML-RARα which causes APL. PML-RARα doesn’t exist in normal conditions however patients with APL have a genetic mutation which produces this fusion of the genes for two individual proteins PML and RARα – this generates the fusion protein, PML-RARα. It doesn’t really matter what PML-RARα does, only that it drives APL and it doesn’t exist outside of disease. Studies have shown that ATO binds to the PML part of this fusion protein and degrades it.

an image taken from one of the study figures showing the chemical structure of Pin1 and the chemical structure of ATO - the two are shown overlapping to indicate where ATO binds in Pin1

The chemical structure of Pin1 is shown with ATO (I) sitting within in apparent binding pocket on the protein. This image is adapted from the paper.

ATO and Pin1

But the authors of this study were interested in the effect of arsenic on a completely different protein – Pin1.

They don’t really explain why they thought arsenic might remove Pin1 in cancer cells. They used a technique to identify ATRA as a drug of interest, but it seems like they only looked at ATO because it’s already used in combination with ATRA.

In their study the authors find that treating cancer cells with arsenic in the lab reduces the levels of Pin1. They also show that ATO and ATRA combined, reduce cancer cell growth and reduce tumour size in mice. And they go some way towards explaining the mechanism behind these interactions and discounting alternative explanations for their findings.

In many ways, it’s a solid paper.

So why am I skeptical?

There are a few reasons, though, to be wary of the findings in this paper and the way it has been presented. Firstly, it’s the particularly hyped up nature of the story – arsenic has been used to treat leukaemia since the mid-1990s, this isn’t really news. But it does make me wonder if there’s a particular reason this article might be so strongly endorsed.

The authors also don’t really explain why they picked arsenic in the first place other than they’re interested in ATRA and Pin1… In fact they’re very, very interested in Pin1.

They argue “that Pin1 is a critical “driver” and a unique drug target in cancer” – which is particularly interesting because as a cancer researcher with a PhD in cancer cell biology, I’ve never even heard of this protein. They reference three papers to support their claim but two of them are from the group’s own lab – the final paper they reference, an article titled “Pin1 in cancer” is from a separate source. This unrelated (and therefore, unbiased to some degree) article argues that Pin1 is hyperactivated in around 10% of all cancers. That number is pretty high, but it is certainly not enough to say that Pin1 is a “critical driver” in “most human cancers”.

So why are the authors so keen on Pin1? The suggestion that it’s a “unique drug target” might give us a clue.

five stacks of silver coins increasing in height from left to right

At the end of the article is the heading “Competing interests” under which is stated “K.P.L. and X.Z.Z. are inventors of Pin1 technology, which was licensed by BIDMC to Pinteon Therapeutics. Both Dr. Lu and Dr. Zhou own equity in, and consult for, Pinteon. Their interests were reviewed and are managed by BIDMC in accordance with its conflict of interest policy. The remaining authors declare no competing interests.”

Pinteon Therapeutics is a “private venture backed biotechnology company focused on the discovery and development of breakthrough therapeutics targeting Pin1” and we can therefore assume that this company will make money from the generation of Pin1 inhibitors that can be used to treat cancer.

Of course, Pin1 inhibition might well make for an interesting cancer target – there’s no disputing that – but its promise might well be overstated both in this article and in the media coverage of the article.

Me? I’m suspending judgement until we see more compelling evidence.

 

Dr Alice Howarth, PhD

Alice is a cell biologist and cancer researcher who works in the Institute of Translational Medicine at the University of Liverpool. She is the Treasurer of the Merseyside Skeptics Society and co-hosts the popular sceptical podcast Skeptics with a K. In her free time she Instagrams photos of her ridiculous dog, Lupin and watches Buffy the Vampire Slayer ad infinitum. Find her at DrAlice.blog or @AliceEmmaLouise on social media.

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NHS Wirral and The North West Friends Of Homeopathy: A Typical Wednesday Evening Out

I’ve had a rather interesting evening. Last week, MSS member and local councillor Darren Dodds alerted me to the fact that Wirral NHS were holding an open meeting to discuss whether to continue funding homeopathy in the region, with the recommendation being very much ‘No, we absolutely shouldn’t’. Needless to say, I agree with this recommendation, and wanted to go along to let them know that I – and by extension the hundred or more local MSS members – applaud their step in the right direction. Interested parties should read the report they came up with, it’s really pretty good. Some highlights:

The paper concludes that the lack of evidence on efficacy and cost-effectiveness of homeopathic therapies means that it should not be a high priority for the PCT at this time. It is recommended that NHS Wirral does not commission homeopathictherapies.

The key risk is that NHS Wirral fails to maintain its reputation as an evidence-based commissioning PCT.

Excellent stuff. Still, it seems we weren’t the only ones made aware of the open meeting – also invited were patients currently or formerly using homeopathy, and the ‘North West Friends of Homeopathy‘. This latter group are most interesting, and I’ll come back to them a little later in more detail, but first it’s worth pointing out that I appeared on local radio with a member of the group on Monday morning, in an exchange that might amuse, and will certainly give a far better impression of who John Cook is than I could ever do justice with words. UK-based readers can listen here, it starts around the 2hour 13minute mark and lasts about 10 minutes. I’ll wait.

For those not able, willing or interested in listening, what we have from John is a charming ability to hog a conversation, and the maniacal insistence that the date of the meeting was aired. Clearly, John wanted his supporters to arrive mob-handed. Fair enough, he probably feels he has a strong case. As it was, when I arrived with a couple of other MSS members there were maybe 40 or so people present, a number which I presume to be in excess of the general norm for these meetings.

John, having lobbied for inclusion, was amongst the speakers, joined by Dr. Hugh Neilsen BA MA BM BCh MRCP FFHom (it’s worth pointing out that his name is actually Hugh Nielsen, and the NWFoH’s own website, while painstaking in it’s detail of Hugh’s many qualifications, mispells the name of their own president), and the panel was completed by two local GPs who were involved in making the recommendation, and who spent the evening ranging between bemused, compassionate and at times startled. Startled, not least, by the quite spectacular opening by John, the homeopath’s friend (which I imagine is rather like a Fisherman’s Friend, but lacking in clout), in which he directed a quite flattering string of insults at me directly, and at the Merseyside Skeptics Society. Read the rest of this entry »

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Of Needles and Dentistry

Last month the BBC news website published an article about recent research on the use of acupuncture in treating phobias, particularly dental phobia – a fear of going to the dentist’s.

The research was published in the international peer-reviewed journal Acupuncture in Medicine, and was carried out by eight dentists, including the research leader Dr Palle Rosted. It involved twenty people, each of whom spent five minutes recieving treatment in the chair prior to their check-up, with needles placed at two specific acupuncture points on their head reputed to aid relaxation Read the rest of this entry »

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Dogs And Autism: Human Sanity Concerns Over ‘Canine Health Concern’

As friends, stalkers, regular readers or simply plain-old psychics might know, I’ve been out of the country for a week, throwing myself off the side of mountains in the name of adrenaline, enjoyment and over-priced middle-class adventure-holiday fun. Hence my shocking goggle-tan, slight working-class-guilt-pangs and radio silence here on the blog. Fortunately, I had a great time away… but I’ve got to say I’m a bit disappointed by how things were when I got back. People are still pretending to talk to the dead, homeopathy’s still on the NHS, and the Daily Mail is still pumping out batshit lunacy. Really, did you all do nothing while I was gone? Shocking.

Speaking of the Daily Mail and my own relative silence of late, here’s something uber-old-hat by now (news these days moves so fast) but I felt I had to write it up partly because a) it’s batshit insane, b) it’s a good example of how fallacious arguments are entirely interchangeably applicable to a whole range of topics and c) it gives me a chance to make some cheap gags:

Vaccines ‘are making our dogs sick as vets cash in’ Source: Daily Mail (obviously).

See what I mean? Replace ‘dogs’ for ‘babies’ and ‘vets’ for ‘doctors’, and you’ve got a textbook anti-vaccination statement, a la Miss McCarthy. And it doesn’t stop there:

“Vaccines given to dogs are making them ill, a pet charity claimed yesterday. Profit-hungry drug companies and vets are ‘frightening’ dog owners into inoculating their pets more often than necessary, according to Canine Health Concern.”

If this isn’t PR for the Canine Health Concern charity, I don’t know what is. And it doesn’t stop there, either Read the rest of this entry »

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Homeopathic Mass ‘Overdose’ – The 10:23 Campaign

10:23 Campaign

The 10:23 Campaign

Cross-posted from the JREF Swift blog.

Generally speaking, when homeopathy hits the headlines here in the UK skeptics have cause to wince – whether it’s B-list celebrities advocating homeopathic malaria preventionnewspaper lifestyle columns promoting the benefits of the long-discredited pseudomedical practice or simply major pharmacies out to make an easy profit, there are very seldom many good days for succussion-skeptics.

Saturday, 30th January 2010, however, was different. At precisely 10:23am that morning, over 400 protesters took to the streets of cities around the UK as part of the 10:23 campaign – aiming to demonstrate the ineffectiveness of homeopathic pills. Gathering in a dozen town centres the length and breadth of the land, activists bravely took their lives into their hands by ‘overdosing’ on entire bottles homeopathic remedies.

Unsurprisingly, no skeptics were harmed in the making of this protest – for, as we know, there’s nothing in homeopathy. Zip. Zilch. Nil. What’s more, the event didn’t go unnoticed – with prominent press coverage from the BBCThe GuardianThe Telegraph and even the Huffington Post, amongst many, many other sources. Radio stations had phone-ins on the the story. It made the TV news. All in all, this wasn’t a day for skeptics to wince. Read the rest of this entry »

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