This past week the #FDA approved a new drug #Flibanserin for use in female sexual dysfunction. It is likely that obgyns and midwives will get more than a few calls about this.The drug is intended to help women with low #libido increase their desire, and has been dubbed by the media as “the female #Viagra.” While this may be a catchy nickname, it is not really an accurate one. The two drugs are very different. Viagra helps men with erectile dysfunction by affecting blood flow but does not in itself affect desire. While Flibanserin is intended to help with sexual desire and satisfaction, it was actually first studied for use as an antidepressant. Unfortunately, it was not terribly effective for depression. So, is it effective for women with low libido?
The story is not so simple. Interestingly, this is not the first time the FDA considered approving Flibanserin for this use. In fact, they rejected the application several times before. The drug has a number of side effects and does not appear to be particularly effective. Still, the FDA decided to give the green light this time, citing that the need for such a drug was so great that approving even a minimally effective drug made sense.
Obstetricians and midwives (including ours) have long encouraged their pregnant patients and those attempting pregnancy to take vitamins such as prenatal vitamins or multivitamins. The main reason for taking the vitamins is the folic acid and iron that they contain. The benefits of folic acid on pregnancy are well established. It has been known for some time that folic acid reduces the risk of what are called in neural tube defects, which include spina bifida among other birth defects, and new research suggests even more benefits of folic acid supplementation. Pregnant women are frequently anemic due to low iron, and so iron supplementation is also recommended women in pregnancy. What has not been so clear is about all the other vitamins contained in the prenatal and multivitamins. Are they really helpful? Do they actually improve the chances for a healthier pregnancy and healthier children? A recent study from researchers at Johns Hopkins suggests they may. The investigators looked at thousands of pregnant women in Bangladesh who received either a multivitamin or just iron and folic acid and found that those who took a multivitamin supplement had lower rates of preterm birth and fewer low birth weight babies. However, when looking at the health of the babies from the pregnancy, there was no reduction in infant mortality. The results were mixed and if there was a benefit to the vitamins it is unclear which vitamins were actually helpful, and if there are any significant benefit to one vitamin over another. Regardless, this is another reason to take your prenatal vitamin or multivitamin.
Expectant parents and their friends and family are always trying to figure out they sex of their unborn baby. Now a group in Poland has devised a potential new way to determine whether a woman is carrying a boy or girl. They looked at ” the disgust factor, ” asking women to rate how disgusting they found certain things (such as seeing a human hand in a jar or a scurrying rat) with the different trimesters of pregnancy. It turns out that women carrying male fetuses were far more likely to be disgusted by these scenarios (at least in the first 2 trimesters) than those carrying females. Will this be any more useful than the any of other the old urban myths currently in vogue? Nobody knows, but it is an interesting idea.
For years, we have know about the dangers of drinking alcohol during pregnancy. Fetal alcohol syndrome is collection of abnormalities in infants whose mothers consume moderate to heavy or chronic alcohol during pregnancy. It has never been clear whether women who drink lesser amounts of alcohol are endangering their unborn babies, so OBs and midwives advised against drinking any alcohol, on the presumption that smaller amount will cause the same problems, but to a lesser extent. Several recent studies attempt to resolve this issues but have reach different conclusions. A study from Yale showed that infants exposed to low amounts of alcohol where not more likely to grow slowly in utero (IUGR) or delivery prematurely. Another study, published in the journal Pediatrics, suggest that 4.8% of children may have actually have a spectrum of fetal alcohol syndrome, a far greater incidence than was previously thought since the incidence of full blown Fetal Alcohol Syndrome is less than 1 %. So, what to believe. The original advice is probably the best. Even if the chance of problems with an occasional drink may be small, it is always best to avoid drinking when pregnant.
For years, obstetricians, midwives and fertility specialists have relied on a classification system to let us know whether drugs are safe for our patients to take during pregnancy. The current classification system uses a letter system that runs from A (safe to take during pregnancy) to D (only should be taken if absolutely necessary), and X for drugs that are never appropriate to take during pregnancy. Unfortunately, most drugs fall into category C, meaning that there are some concerns about safety from animal studies, but the drug has not been studied adequately in humans. The leaves us with little good information to counsel patients.
Patients in our office will see the staff sporting this stylish T-shirts in our office every Friday this month in honor of Breast Cancer Awareness Month. Breast cancer affects more women than any other cancer in the U.S. with the exception of skin cancer. That means that 1 in 8 women will be diagnosed with this disease. When caught early, your chances for survival are the best. So, what can you do?