Monthly Archives: May 2021

Female sexual problems

Female sexual problems doctors should be aware of

Naveed Saleh, MD, MS|April 22, 2021

The following article is the first in a two-part series on sexual dysfunction. This article focuses on sexual dysfunction in women, while the second will cover sexual dysfunction in men.

It’s not all bliss in the bedroom. According to the Cleveland Clinic, about 43% of women and 31% of men say they experience some degree of sexual dysfunction—and along with it, stigma. Nervous female patient with hands clasped and doctor pointing to tablet

Female sexual dysfunction causes major distress for women, but research and treatment options have not kept pace with advances made for male sexual dysfunction.

Is female pleasure sidelined?

Despite the fact that sexual dysfunction is more common in women, male sexual dysfunction has received the lion’s share of attention in society, including more research and treatment options. In 1998, the FDA approved sildenafil (Viagra) for erectile dysfunction, and since then—thanks to an endless marketing blitz from pharmaceutical companies and new medicines—the topic of male sexual dysfunction has moved into the mainstream. 

The same can’t be said for women, however. Treatment options for sexual dysfunction in women have been much slower to arrive on the market, although some progress has been made. In 2013, the FDA approved ospemifene (Osphena) for moderate to severe painful intercourse in women. In 2015, the FDA green-lighted flibanserin (Addyi) for low sexual desire in premenopausal women. Most recently, the FDA approved bremelanotide (Vyleesi ) in 2019, also for premenopausal women with low sexual desire. 

Moreover, social stigma around female sexuality remains strong in Western culture, and as a result, women often avoid or are embarrassed to discuss their sexual health with their health care professionals (HCPs), according to the authors of an article in the Journal of Women’s Health.

“Based on cultural norms and biases, conversations about sex are sometimes thought of as taboo in American society and in many other cultures worldwide. This is especially true for women, and particularly when sex is for pleasure rather than reproductive purposes,” the authors wrote.

In addition, women in midlife are often unaware or have misconceptions about conditions that may adversely impact their sexual life, such as genitourinary syndrome of menopause and hypoactive sexual desire disorder. “Lack of training, tools, time, and limited treatment options impede HCPs from providing women with necessary sexual health support,” they added.

Any physician treating sexual dysfunction navigates a complex condition that’s emotionally charged and multi-layered. Let’s have a look at female sexual dysfunction.

Female sexual dysfunction

Sexual dysfunction in women typically presents as loss of desire, sexual pain, decreased arousal, and/or inability to reach orgasm—and these frequently overlap, according to the Journal of Women’s Health article. While sexual dysfunction can occur at any age, women in the menopausal transition and beyond tend to experience sexual health-related conditions or concerns more often. 

Sexual dysfunction in women is less recognized than its counterpart in males, but the subject is attracting more research, according to the authors of a review published in the Canadian Urological Association Journal (CUAJ).

“Fortunately,” wrote the authors, “over the past decade there has been an increase in the clinical and academic interest in female sexual function. The times appear to be changing.” 

Today, there are published guidelines and position papers that reinforce the practical aspects of female sexual dysfunction evaluation and management, an increase in research on the impact of cancer and its treatment on female sexual function, along with the new FDA-approved therapies for low desire and sexual pain, they added.

Here’s a closer look at the four common categories of female sexual dysfunction. 

Low sexual desire

Loss of sexual desire in women can be distressing and is the most common of the sexual disorders in women, according to the Mayo Clinic.

Various etiologies for low sexual desire exist, including medical conditions (eg, cancer, kidney failure, multiple sclerosis; heart disease, or bladder problems; hormonal changes due to menopause or childbirth/breastfeeding; medications (eg, certain antidepressants, antipsychotics, opioids); hormonal contraception; and psychosocial factors like untreated anxiety and depression, or a history of sexual abuse.

Treatment often entails a multidisciplinary approach, and can include sex education and counseling; medications like the above-mentioned FDA-approved flibanserin and bremelanotide for premenopausal women; hormone therapy such as estrogen, testosterone (or ospemifene, if sexual pain is related to low desire); a vaginal insert called prasterone (Intrarosa); and lifestyle remedies, such as exercise, stress reduction, taking time for sexual intimacy, and more.

Sexual pain

Sexual pain refers to pain associated with sexual stimulation or vaginal contact. Sexual pain is common among women of all ages and includes vulvar pain (eg, vulvodynia); deep pain with penetration (dyspareunia); or tightening of the pelvic musculature

Many conditions can cause sexual pain, including insufficient lubrication, vulvar skin lesions such as lichen sclerosus and lichen planus, pelvic floor muscle abnormalities leading to deeper pelvic pain, and endocrine abnormalities such as low testosterone or changes induced by oral contraception. 

Depending on the cause, treatment can include vulvar physiotherapy, switching forms of contraception, and topical anesthetics. The above-mentioned treatment ospemifene is indicated for moderate to severe painful intercourse in women, and prasterone (Intrarosa) vaginal capsules are also designed to relieve dyspareunia. 

Emerging research is also investigating local hormone treatment with intravaginal testosterone and estradiol-releasing vaginal rings, according to the CUAJ article. Vaginal laser therapy is also being explored, the authors wrote, and resection of vestibular tissues with posterior vaginal advancement flap (ie, vestibulectomy) can also be considered for refractory and severe cases of vulvodynia.

Low arousal

Low arousal—difficulty or inability to become or stay physically aroused or excited during sexual activity—can present as a decrease in vaginal lubrication or genital warmth due to decreased blood flow. A full medical and sexual history and physical examination should be conducted. 

Low arousal states can be due to hypertension, hyperlipidemia, or diabetes, and should be treated. Also, low arousal may be related to hormonal changes following menopause. A decrease in estrogen leads to decreased blood flow to the pelvic region, which can result in less genital sensation, as well as needing more time to build arousal and reach orgasm, according to the Mayo Clinic.

In some, but not all, women with low arousal, PDE5 inhibitors (eg, sildenafil) have shown some efficacy, according to the CUAJ article. Cognitive behavioral therapy may also be helpful

Why Is Perimenopause Still Such a Mystery?

Why Is Perimenopause Still Such a Mystery?

Over 1 billion women around the world will have experienced perimenopause by 2025. But a culture that has spent years dismissing the process might explain why we don’t know more about it.

Credit…Monica Garwood
Jessica Grose

By Jessica GroseApril 29, 2021

Angie McKaig calls it “peri brain” out loud, in meetings. That’s when the 49-year-old has moments of perimenopause-related brain fog so intense that she will forget the point she is trying to make in the middle of a sentence. Sometimes it will happen when she’s presenting to her colleagues in digital marketing at Canada’s largest bank in Toronto. But it can happen anywhere — she has forgotten her own address. Twice.

Ms. McKaig’s symptoms were a rude surprise when she first started experiencing them in 2018, right around when her mother died. She had an irregular period, hot flashes, insomnia and massive hair loss along with memory issues she describes as “like somebody had taken my brain and done the Etch A Sketch thing,” which is to say, shaken it until it was blank.

She thought she might have early-onset Alzheimer’s, or that these changes were a physical response to her grief, until her therapist told her that her symptoms were typical signs of perimenopause, which is defined as the final years of a woman’s reproductive life leading up to the cessation of her period, or menopause. It usually begins in a woman’s 40s, and is marked by fluctuating hormones and a raft of mental and physical symptoms that are “sufficiently bothersome” to send almost 90 percent of women to their doctors for advice about how to cope.

Ms. McKaig is aggressively transparent about her “peri brain” at work, because she “realized how few people actually talk about this, and how little information we are given. So I have tried to normalize it,” she said.

An oft-cited statistic from the North American Menopause Society is that by 2025, more than 1 billion women around the world will be post-menopausal. The scientific study of perimenopause has been going on for decades, and the cultural discussion of this mind and body shift has reached something of a new fever pitch, with several books on the subject coming out this spring and a gaggle of “femtech” companies vowing to disrupt perimenopause.

If the experience of perimenopause is this universal, why did almost every single layperson interviewed for this article say something along the lines of: No one told me it would be like this?

“You’re hearing what I’m hearing, ‘Nobody ever told me this, my mother never told me this,’ and I had the same experiences many years ago with my mother,” said Dr. Lila Nachtigall, a professor of obstetrics and gynecology at N.Y.U. Grossman School of Medicine who has been treating perimenopausal women for 50 years, and is an adviser to Elektra Health, a telemedicine start-up.

Dr. Nachtigall said her mother had the worst hot flashes, and even though they were living in the same house when her mother was experiencing perimenopausal symptoms, they never discussed it. “That was part of the taboo. You were supposed to suffer in silence.”

The shroud of secrecy around women’s intimate bodily functions is among the many reasons experts cite for the lack of public knowledge about women’s health in midlife. But looking at the medical and cultural understanding of perimenopause through history reveals how this rite of passage, sometimes compared to a second puberty, has been overlooked and under discussed.Sign up for the Well Newsletter: Get the best of Well, with the latest on health, fitness and nutrition.

Though the ancient Greeks and Romans knew a woman’s fertility ended in midlife, there are few references to menopause in their texts, according to Susan Mattern, a professor of history at the University of Georgia, in her book “The Slow Moon Climbs: The Science, History, and Meaning of Menopause.”

The term “menopause” wasn’t used until around 1820, when it was coined by Charles de Gardanne, a French physician. Before then, it was colloquially referred to as “women’s hell,” “green old age” and “death of sex,” Dr. Mattern notes. Dr. de Gardanne cited 50 menopause-related conditions that sound somewhat absurd to modern ears, including “epilepsy, nymphomania, gout, hysterical fits and cancer.”

Physicians in the 19th century believed that receiving bad news could cause early menopause, and that women who worked in “unwomanly” occupations, like fishwives, were most at risk, according to “The Curse: A Cultural History of Menstruation,” by Emily Toth, Janice Delaney and Mary Lupton. These Victorian doctors also believed that menopausal women grew scales on their breasts and experienced a “loss of feminine grace.”

Things did not get much better for women in perimenopause during the latter half of the 19th century. “A woman consulting the American gynecologist Andrew Currier in the 1890s would have been told that leeches were still an effective remedy for congested genitals,” more commonly known as pelvic pain, according to “The Curse.” Other physicians of the era thought that perimenopausal women were more susceptible to mental illnesses, “among them ‘morbid irrationality,’ ‘minor forms of hysteria’, melancholia and the impulses to drink spirits, to steal, and perchance, to murder.”

In the first half of the 20th century, the hormone estrogen was discovered and its role in menopause was clarified somewhat — after a woman’s period ceases, her estrogen levels are lower than they were during her fertile years. Even though doctors no longer thought menopausal women were murderous lizard people, cultural ideas about them did not improve.

It wasn’t until the 1980s that longitudinal studies — which followed the same cohort of women for years — deepened public knowledge about the role of hormones during menopause. Before that, doctors thought perimenopause was a slow draining of estrogen levels until you hit the end of your period. “But what we’ve learned is it is more of a turbulent process — hormones are bouncing around,” said Dr. Stephanie Faubion, the medical director of the North American Menopause Society.

Even now, perimenopause is described in medical research as an “ill-defined time period” primarily marked when the ovarian reserve is depleted and by irregular periods (but if one has a history of irregular periods, as 14 percent to 25 percent of women do, it may be tougher to tell when the transition has begun). This time period is still often referred to as menopause in common parlance, but the medical definition of menopause is just one day — the last day of your final period — though it is only diagnosed when a whole year has gone by without menstruation.

Because hormones fluctuate wildly during perimenopause, it can be difficult to test for. The average age of the beginning of perimenopause is 47, and the average age of menopause is 51, but again, the length of the transitional period may be much longer, and the onset of symptoms can happen earlier or later.

There are four symptoms of perimenopause that are most common: hot flashes, sleep disruption, depression and vaginal dryness, known as “the core four” among menopause experts. But the full panoply of symptoms related to the perimenopause transition “is not yet known with any great degree of certainty,” said Dr. Nanette Santoro, the chair of obstetrics and gynecology at the University of Colorado School of Medicine. At this point, the perimenopausal period is associated with as many as 34 different maladies ranging from hair loss to “burning mouth syndrome,” which is a tingling or numb feeling in your lips, gums and tongue.

There’s also what Dr. Faubion refers to as “the menopause management vacuum.” As she explained to Lisa Selin Davis, a Times contributor, no one medical specialty really “owns” treatment of perimenopausal and menopausal women, because the symptoms affect so many different systems and parts of the body. Furthermore, less than 7 percent of medical residents surveyed said they felt “adequately prepared” to manage women going through menopause.

Though images of midlife women have definitely improved — a popular meme compares Jennifer Lopez, who at 50 was pole dancing at the Super Bowl, to Rue McClanahan, who at 51 in 1985 was on “Golden Girls” drinking coffee on the lanai — there is still much progress to be made. It was only this year that an online Arabic dictionary changed the description of menopause from “age of despair” to “age of renewal.”

With so much negative cultural baggage, so much still unknown around symptoms and timing, and so few doctors confident in the treatment of midlife women, “no wonder people are confused,” Dr. Nachtigall said. And it helps explain why so many companies and writers are jumping into the morass.

What Angie McKaig is trying to do on a micro level by freely sharing her perimenopause travails with colleagues, health care start-ups, beauty companies and writers are trying to do on a macro level: raising awareness about the experience of this period of a woman’s life (and sometimes selling them products and services along the way).

“Femtech” companies such as the telemedicine providers Elektra Health and Gennev are moving into the perimenopause market; Stacy London, the stylist and reality TV star, just started a skin care company called The State of Menopause; and celebrities like Michelle Obama and Gwyneth Paltrow have spoken honestly about their perimenopause symptoms (though Ms. Paltrow did it in the service of promoting a supplement called “Madame Ovary” that she sells on her website, Goop).

Books on the topic from Heather Corinna, a sexual health expert, and Dr. Jen Gunter, a Times contributor and OB/GYN, will be published this spring; newsletters and online communities like TueNight and The Black Girl’s Guide to Surviving Menopause are gaining traction with tens of thousands of readers.

One community aimed at connecting women during their perimenopausal transition is called The Woolfer — named for the writer Virginia Woolf. The website and social platform started as a Facebook group called What Would Virginia Woolf Do? The name was meant to be a “dark joke,” said Nina Lorez Collins, 51, the founder and chief executive of The Woolfer — as in, “Should we just throw in the towel and wander into a river,” as Woolf did?

The answer, of course, is a resounding no. Ms. Collins said her group has helped women normalize the more shocking symptoms of the menopause transition. (More than one woman interviewed for this piece used the phrase “crime scene periods.”) And they have also reframed the journey into menopause as one of triumph, not irrelevance.

Though perimenopause presents as so many different symptoms, there are treatments available, however there “is not one single solution,” Dr. Faubion said. The treatment is symptom dependent: If heavy or irregular bleeding is the issue, an intrauterine device, or a birth control pill could help. A low-dose birth control pill may also relieve hot flashes. “Birth control pills are made up of so many different permutations and combinations of hormones,” it’s important to discuss which one is right based on your medical history and individual needs, Dr. Nachtigall said. If mood issues are the biggest complaint, an antidepressant might be appropriate. (Hormone therapy may be an option for some women to help ease symptoms, but it is more frequently prescribed after menopause).

Ongoing longitudinal studies are finding associations between women with intense perimenopause symptoms in midlife, and risks of heart disease and osteoporosis in later years. Currently, there is not evidence to support the use of vitamins or supplements like black cohosh or magnesium, contrary to claims that these products help with hot flashes.

Despite expanded and continuing research, finding a knowledgeable physician who won’t dismiss your symptoms or tell you there’s nothing they can do to help is a struggle for many women. Ms. McKaig said that though her therapist diagnosed her as perimenopausal, her family doctor keeps telling her that her symptoms can’t be perimenopause because she’s still having her period sometimes. She said she’s “given up trying to educate her.”

For Black women, there is an added layer of difficulty in finding a sympathetic doctor, with ample research showing racial bias in physicians’ consideration of symptoms. As The Washington Post noted earlier this year, Black women “have a higher risk of experiencing hot flashes but are less likely to be offered effective hormone replacement therapy.” Jennifer White, 46, a journalist who recently relocated to the Washington, D.C., area, has been experiencing perimenopause-related insomnia and painful, irregular periods for a year. “Finding the right clinician to take seriously my concerns as a Black woman, and not tell me to walk it off, is top of mind,” she said.

The North American Menopause Society’s website lists qualified physicians throughout the country and abroad, but if you live outside major metropolitan areas, the pickings may be slim (for example, there are only two NAMS-certified menopause practitioners listed for the entire state of Wyoming). Telemedicine is aiming to fill the void, but even in the Covid era, there are limitations and complications to practicing medicine across state lines.

Though finding a qualified and sympathetic doctor may be a challenge, shifting the cultural narrative may be just as vital.

“I actually think it’s extraordinarily important to change the conversation. Because so much of what you hear about perimenopause is spoken about in an anti-feminist and ageist way,” said Dr. Lucy Hutner, a reproductive psychiatrist in New York. Dr. Hutner said that many of her patients who are navigating these midlife shifts find them deeply empowering. They feel more resilient, and are following their “inner compass.”

While part of it is just the wisdom that comes with age, many women feel that once they are through the menopause transition, they don’t have to make themselves appealing to the world. As Dr. Hutner put it: “I feel liberated because I’m not trying to take care of everyone else or correspond to anyone’s societal view. I have been able to shake off the shackles.”

Statins and Womens Health.

Do You Really Need That Statin? This Expert Says No

Statins are medications that lower cholesterol by inhibiting an enzyme involved in its production by the liver and other organs. First approved by the FDA in 1987, statins are arguably the most widely-prescribed medicine in the industrialized world today.By Martha Rosenberg, Contributorreporter and author08/28/2012 11:50am EDT | Updated October 28, 2012This post was published on the now-closed HuffPost Contributor platform. Contributors control their own work and posted freely to our site. If you need to flag this entry as abusive, send us an email.

This is an interview with Barbara H. Roberts, M.D., author of The Truth About Statins: Risks and Alternatives to Cholesterol-Lowering Drugs.

Statins are medications that lower cholesterol by inhibiting an enzyme involved in its production by the liver and other organs. First approved by the FDA in 1987, statins are arguably the most widely-prescribed medicine in the industrialized world today — and the most profitable, representing billions a year in profits to the drug industry. In fact, Lipitor was the world’s best-selling drug until its patent expired recently. Yet most trials that prove statins’ effectiveness in preventing cardiac events and death have been funded by companies and principle investigators who stand to benefit from their wide use. In February, the FDA warned that statins can increase users’ risk of Type 2 diabetes and memory loss, confusion and other cognition problems.

Barbara H. Roberts, M.D., is director of the Women’s Cardiac Center at the Miriam Hospital in Providence, R.I. and associate clinical professor of medicine at the Alpert Medical School of Brown University. She spent two years at the National Heart, Lung and Blood Institute of the National Institutes of Health (NIH), where she was involved in the first clinical trial that demonstrated a beneficial effect of lowering cholesterol on the incidence of heart disease. In addition to The Truth About Statins: Risks and Alternatives to Cholesterol-Lowering Drugs, she is also author of How to Keep From Breaking Your Heart: What Every Woman Needs to Know About Cardiovascular Disease.An essential daily guide to achieving the good lifeSubscribe to our lifestyle email.Successfully Subscribed!Realness delivered to your inbox

Martha Rosenberg: Statins have become so popular with adults middle-aged and older in industrialized countries, they are almost a pharmaceutical rite of passage. Yet you write in your new book there is little evidence they are effective in many groups and no evidence they are effective in one group: women without heart disease. Worse, you provide evidence, including stories from your own patients, that they are doing serious harm.

Barbara Roberts: Yes. Every week in my practice I see patients with serious side effects to statins, and many did not need to be treated with statins in the first place. These side effects range from debilitating muscle and joint pain to transient global amnesia, neuropathy, cognitive dysfunction, fatigue and muscle weakness. Most of these symptoms subside or improve when they are taken off statins. There is even growing evidence of a statin link to Lou Gehrig’s disease.

Martha Rosenberg: One patient you write about caused a fire in her home by forgetting that the stove was on. Another was a professor who experienced such memory loss on a statin he could no longer teach; others ended up in wheelchairs. The only thing more shocking than the side effects you write about is the apparent blindness of the medical establishment to them. Until half a year ago, there were practically no warnings at all.

Barbara Roberts: There is no question that many doctors have swallowed the Kool-Aid. Big Pharma has consistently exaggerated the benefits of statins and some physicians used scare tactics so that patients are afraid that if they go off the statins, they will have a heart attack immediately. Yet high cholesterol, which the statins address, is a relatively weak risk factor for developing atherosclerosis. For example, diabetes and smoking are far more potent when it comes to increasing risk.

Martha Rosenberg: One group you say should not be given statins at all because there is no benefit and significant risk is women who have no heart disease.

Barbara Roberts: In three major studies [1-3] of women without diagnosed heart disease, but who were at high risk (in one of these studies, each participant had to have high blood pressure and three other risk factors), 40 women out of 4,904 on statins had either a heart attack or cardiac death, compared to 44 women out of 4,836 on placebo. That is not a statistically significant difference. Since the likelihood of experiencing a statin side effect is about 20 to 25 percent, the risk of putting a healthy woman on a statin far outweighs the benefit. Still, statins are routinely given to this group because the guidelines are shaped by Big Pharma. The guidelines are not supported by the evidence, and in the case of healthy women I don’t follow them.

Martha Rosenberg: You give a story in your book about your 92-year-old patient who had a total cholesterol of 266, triglycerides of 169, HDL cholesterol of 66, and LDL cholesterol of 165. Her primary care doctor wanted her to take a statin, but you did not feel she needed to because she had no evidence of heart disease, had never smoked, did not have high blood pressure and was not diabetic.

Barbara Roberts: Yes and today she is 103.5 — and doing fine, never having taken a statin.

Martha Rosenberg: In The Truth About Statins you explain pretty clearly how studies have made statins look more effective and safer than they are. How has this been done?

Barbara Roberts: First of all, the studies are of short duration, and some of them even have a “run in” phase during which people are given the drug to see if they tolerate it. If not, they are not enrolled in the study. Secondly, study subjects are cherry-picked to exclude the very elderly, people with liver or kidney disease or those with any chronic illness that might “muddy” the results —

Martha Rosenberg: In other words, the very people who will be taking them?

Barbara Roberts: Yes, and of course patients will also be staying on the drugs for life unlike trial subjects. Then, the data from the studies are usually given in terms of relative rather than absolute risk. The absolute risk of a cardiac event is only reduced by a few percentage points by statins and in some patients, like the women without heart disease we just talked about, the reduction is not even statistically significant. In some studies surrogate endpoints like inflammation or artery thickness are used but a favorable change in surrogate markers does not always translate into clinical benefit. In addition, many studies use composite end points, which include not only “hard” end points like heart attack or death (which are pretty hard to misdiagnose) but also “softer” end points like the “need” for revascularization or the occurrence of acute coronary syndromes. For example, studies may be performed in many countries with very different rates of revascularization procedures, making use of this as an end point very problematic.

Martha Rosenberg: This brings to mind the JUPITER trial, which enrolled people without heart disease, with normal levels (less than 130) of LDL or bad cholesterol, but evidence of increased inflammation as measured by the hsCRP test and treated them with placebo or rosuvastatin. JUPITER stood for “Justification for the Use of Statins in Prevention,” and both the study and its principle investigator were funded by AstraZeneca, who makes the statin Crestor. The principal investigator also holds the patent for the hsCRP blood test. Why was JUPITER regarded as medical science and not marketing?

Barbara Roberts: Actually, the JUPITER study was criticized to some extent. But you have to remember that medical journals depend upon Big Pharma for their ads and reprint orders just as medical centers and medical professionals rely on Big Pharma for funding. It is a round robin situation that probably won’t change until the patients, doctors and the public demand change. As for CRP, it can also rise if a patient has a cold, bronchitis or is taking post-menopausal hormones.

Martha Rosenberg: You are very outspoken about the problem of industry shaping and influencing medical practice, yet you also admit that you accepted Big Pharma money yourself.

Barbara Roberts: In 2004, Pfizer asked me to become a speaker, specifically on Lipitor. I told the drug rep who invited me to be a speaker that I would be interested in giving talks on gender-specific aspects of cardiac disease, but not in just talking about their statin, and I gave lectures in restaurants and hospitals. Despite the fact that Pfizer was sponsoring my talks, I never failed to point out that there was no evidence that Lipitor — or any statin — prevented cardiac events in women who did not have established cardiovascular disease. They tolerated this until one day a regional manager came to one of my talks, and then I was disinvited. I was on the speaker’s bureau for another company, Abbott, but when they began to insist that I use their slides rather than my own, I gave up being on any Big Pharma speaker’s bureaus. I write in my book that even though my interactions with drug and device companies complied with ethical guidelines it does not mean I was not influenced.

Martha Rosenberg: In journalism, when a reporter takes money from someone she is writing about, she is regarded as no longer a reporter but a publicist. Yet doctors who consult to Pharma are not judged as harshly and most contend they are not influenced by industry money…

Barbara Roberts: They are wrong. An article in the American Journal of Bioethics in 2003 found that gifts bestow a sense of indebtedness and influence behavior whether or not the recipient is directly conscious of it. More recently, research presented at a symposium at Houston’s Baylor College of Medicine called the Scientific Basis of Influence and Reciprocity mapped actual changes in the brain when gifts are received.

Martha Rosenberg: I was surprised to find recipes in your book and even more surprised by some of your dietary recommendations, such as avoiding a low-fat diet and eating a lot of olive oil. A lot of experts have recommended a low-fat diet.

Barbara Roberts: The first thing I prescribe to my patients who have low levels of the “good” or HDL cholesterol is two to three tablespoons of olive oil a day, and in every case the HDL increases. Olive oil is rich in polyphenols, which have anti-inflammatory and antioxidant effects. Several studies [4-5] have shown that the Mediterranean diet reduces total mortality and especially death from cardiovascular disease, yet it gets little media attention. The Mediterranean diet is a plant-based diet that includes colorful vegetables, fruits, whole grains, beans, cheese, nuts, olive oil, seafood, red wine with meals, and very little meat.

Martha Rosenberg: You indict professional medical associations like the American Heat Association (AHA) for profiteering at the public’s expense by calling harmful foods healthful in exchange for corporate money.

Barbara Roberts: For years, the AHA preached the gospel of the low-fat diet, calling it the “cornerstone” of its dietary recommendations though there was, and is, no evidence of its benefit. The AHA rakes in millions from food corporations for the use of its “heart-check mark.” Some of the so-called heart-healthy foods it has endorsed include Boar’s Head All Natural Ham, which contains 340 milligrams of sodium in a two-ounce serving, and Boar’s Head EverRoast Oven Roasted Chicken Breast, which contains 440 milligrams of sodium in a two-ounce serving. High sodium intake raises blood pressure, which increases the risk of cardiovascular disease. In addition, studies have shown that eating processed meat increases the risk of diabetes and atherosclerosis.

Martha Rosenberg: You are not afraid to express strong opinions. You say that the AHA has “sold its soul,” that medical centers conducting drug trials for Big Pharma have become “hired hands” and that one university medical center is Big Pharma’s “lapdog.” Are you afraid of retaliation from Big Pharma, medical centers or the colleagues you work with?

Barbara Roberts: I haven’t received any communiqués from Big Pharma. A few colleagues have expressed dismay, but I am thick-skinned and hard-headed and don’t care what they say. My main concern is the health and safety of my patients.



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LDN Research Trust Documentaries

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Ovarian Cancer


‘Devastated and sad’ after 36 years of research — early detection of ovarian cancer doesn’t save lives

May 19, 2021 6.11am AEST


  1. Ian Jacobs President and Vice-Chancellor, UNSW

Disclosure statement

Ian Jacobs is a President and Vice-Chancellor of UNSW Sydney and a Board member of Ovarian Cancer Australia. He is a director and shareholder of Abcodia Ltd which holds a licence from Massuchusetts General Hospital for the Risk of Ovarian Cancer Algorithm and as a Co-Inventor of the Algorithm he has a potential royalty stream. He received funding awards for UKCTOCS from the Medical Research Council, Cancer Research UK, the National Institute of Health Research and the Eve Appeal.



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My colleagues’ and my efforts to develop a screening test for the early detection of ovarian cancer capable of saving lives arrived at a sad moment last week. The final trial results of the research I’ve focused on for 36 years, published in The Lancet, found early ovarian cancer detection doesn’t save lives.

The advances we have seen in science and technology over the past three decades have been nothing short of phenomenal. Each smartphone has more computational power than NASA had at its disposal during the moon landings. In medicine, researchers have sequenced the human genome, created life-saving treatment for HIV and rapidly developed vaccines for COVID-19.

There have been significant improvements in ovarian cancer treatment involving surgery and chemotherapy, but the sad and frustrating truth is of the four women diagnosed with ovarian cancer in Australia each day, three will eventually die from the disease.

Read more: INTERACTIVE: We mapped cancer rates across Australia – search for your postcode here

Donate today and support non-profit news.

The diagnosis of ovarian cancer is dependent on women reporting symptoms to their doctor. However, few develop symptoms until they have advanced stage cancer, by which time the outlook is poor. Of all women’s cancers, ovarian cancer has the lowest survival rate, with just 46% of patients in Australia surviving five years. For breast cancer, it’s now 91%.

Back in the 80s

I was motivated to improve the outcome for women with ovarian cancer by my experience as a junior doctor in London in 1985. I was training with a brilliant surgeon who undertook operations for many women with ovarian cancer. In spite of the exhaustive surgery and the chemotherapy that followed, we saw far too many women suffer and die from ovarian cancer.

That experience inspired me to initiate a program of research designed to find a screening test to detect this cancer early. Women with the earliest stage of ovarian cancer had survival rates of 70%, but less than 20% of women with ovarian cancer were diagnosed that early.

My hypothesis was that if we could detect more cancers at an early stage it would save lives.

We saw too many women suffer and die from ovarian cancer. Shutterstock

Based on evidence from other cancers, there was reason to be hopeful and two potential tests were available – a blood test called CA 125 and the use of ultrasound scanning which was then widely used in obstetrics.

Over the next 15 years, working with colleagues in the United Kingdom and United States, I developed and refined the screening tests and had great hope for what we called “multimodal screening”. This involved a “risk of ovarian cancer algorithm” for interpreting the change in blood levels of CA 125 over time to identify women who had a rising pattern, indicating an elevated risk of ovarian cancer. Women with an elevated risk could then have a secondary test involving ultrasound scanning.

During those 15 years, we published convincing evidence in studies involving over 50,000 women that this approach to screening was safe, acceptable to women, could detect over 85% of the cancers early and would probably be cost effective if sufficient lives were saved.

Promising early results

Before advocating screening of the general population, a massive trial would be needed to determine whether the screening would actually save lives.

The trial needed to involve screening and follow up of approximately 200,000 women for around 20 years. This would eventually include 2,000 women with ovarian cancer – enough to determine whether or not screening saved lives.

The trial involved great numbers of participants. Shutterstock

Work got underway in the United Kingdom in 2000 and optimism grew as initial results confirmed the ability of multimodal screening to detect cancer early in over 85% of cases.

By 2015, the preliminary mortality data were available and were tantalising. The curves hinted at a 20% or more reduction in deaths from ovarian cancer, but the findings did not quite reach statistical significance. So another five years of painstaking follow up was needed.

Disappointing final results

The final results of the UK Collaborative Trial of Ovarian Cancer Screening showed the multimodal screening approach could detect cancers early and increase the number of early-stage ovarian cancers by almost 50%.

But to our surprise and despair, that did not reduce the number of deaths from ovarian cancer. All it seemed to do was to bring forward the time of diagnosis of the cancers in these women, without improving their survival.

Woman has blood taken for a blood test.
Under the multimodal screening program, women were first given a blood test for levels of CA 125. Shutterstock

This is deeply disappointing. Disappointing of course for those who like myself have dedicated much of their professional lives to this effort, but much more importantly for the women across the world who we had hoped would have access to an effective screening test able to save lives.

The hope had been to deploy ovarian cancer screening for women in the general population alongside breast and cervical cancer screening, but that will not happen – for a while at least.

Why didn’t early detection save lives?

To answer that, we need to further analyse samples and data from the trial. Our suspicion is that the women whose cancers were detected early by screening had more aggressive cancers than those (the 10%) whose cancers were detected early without screening, on the basis of symptoms.

So even with early detection, their cancers progressed relentlessly despite them receiving the best available surgery and chemotherapy.

If that is the case, we are likely to require screening tests which can detect ovarian cancer even earlier than our algorithm, which we estimate picks up ovarian cancer 18 to 24 months early. Saving lives may require a test capable of picking up the cancers five or more years early.

Read more: Why we need to pay more attention to negative clinical trials

Fortunately, there are exciting avenues of research involving advances in protein and DNA technologies which researchers in Australia and around the world are exploring. So there is hope.

But realistically, given the five-plus years needed to develop better screening tests and the ten to 15-plus years needed to have enough cases to conduct another large randomised trial, the solution is likely to be more than 20 years away.

Still, we’ve learnt a lot

This massive commitment of expertise, time, energy and funding has most definitely not been wasted. Much has been achieved along the way in this 36-year journey in developing ways to assess risk, diagnose cancer and prevent ovarian cancer which are now used in clinical practice.

New generations of researchers have been trained. The data and the blood bank collected is available to all researchers seeking new and better screening tests and is a unique resource. And the ability to detect ovarian cancer early may be invaluable in assessing new treatments.

I feel privileged to have led this effort and will always be grateful to the collaborators, researchers, health professionals, funding agencies and above all the 200,000 women who took part in the trial.

I feel a deep sadness that lives will not yet be saved by ovarian cancer screening, but I’m confident the next generation of researchers will build on our work and find approaches to screening and treatment of ovarian cancer which dramatically reduce the loss and suffering caused by this insidious disease

Oestrogens and Post-natal Depression

Oestrogens and Post-natal Depression

Psychiatrists have little understanding of the importance of hormones in the treatment of depression in women

Professor Studd’s reply to an article in  ‘The Obstetrician & Gynaecologist:

I was shocked to read your articles on perinatal depression in that all sorts of psychiatric and psychological help was discussed without a mention of oestrogen therapy. We are used to psychiatrists being utterly ignorant of the effects of oestrogens on Reproductive Depression, ie premenstrual, post natal and perimenopausal depression, no doubt because they cannot cope with the minor complications of oestrogen therapy such as sore breasts, occasional vaginal bleeding and progestogen side effects. Although these complications can be dealt with by any competent general practitioner they are clearly beyond the ability of psychiatrists.

There is good evidence that oestrogens are effective in the treatment of post natal depression even with women who have not been helped by antidepressants (1). Regrettably, this original Lancet study has not been repeated after 10 years either because it was perfect (which I doubt) or because psychiatrists are not interested in this form of therapy and the pharmaceutical companies not interested in testing their profitable SSRI’s against non-profitable out of patent oestrogens. There are even experimental studies where women with a previous history of post natal depression are given hormonal pseudo pregnancy and then the hormones discontinued. Those with a history of post natal depression become depressed, those with no history do not become depressed (2).

There seems to be little doubt that this excess of depression in women in the premenstrual and post natal period are due to changes in oestradiol levels which can be so easily treated with replacement transdermal oestrogens in moderately high doses. For further information on this, readers are referred to the review articles by Studd and Panay (3).


  1. Gregoire A J, Kumar R, Everitt B, Henderson A F, Studd, J W – Transdermal oestrogen for the treatment of severe post natal depression. Lancet 1996, 347, 930-933.

  2. Bloch M, Schmidt B J, Danaceau M et al – Affects of gonadol steroids in women with a history of post partum depression. MJ Psychiatry, 2000, 157, 124-230.

  3. Studd, J, Panay N – Hormones and depression in women. Climacteric 206, 7338-7346

Iodine and Breast Cancer Prevention Part Two

Iodine and Breast Cancer

Iodine and Breast Cancer Prevention Part Two

Spontaneous Regression of Breast Cancer After Iodine

In his book on Iodine, David Brownstein MD reports three cases of spontaneous regression of breast cancer after iodine supplementation.(1)
(page 63)

Case One

The first patient, Joan a 63 year old English teacher, was diagnosed with breast cancer in 1989, declined conventional treatment, and took 50 mg per day of Iodoral, (Iodine). Six weeks later, a PET scan (left image) showed, “all of the existing tumors were disintegrating”.

Above Left Image: Pet scan showing breast cancer )(red arrows) Courtesy of Wikimedia Commons.
Case Two

The second patient, 73 year old Delores, was diagnosed with breast cancer in 2003.  She declined conventional treatment with radiation and chemotherapy.  Instead, Dolores took 50 mg of Iodoral daily. A follow up ultrasound of the breast 18 months later showed,” It appears that these malignancies have diminished in size since the last examination. Interval improvement is definitely seen,”  Two years later a follow up mammogram and ultrasound failed to show any abnormality and were read by the radiologist as normal.

Case Three

The third patient, 52 year old Joyce was diagnosed with breast cancer two years prior (left image), and started on Iodoral 50 mg per day.  Three years after starting Iodoral, her follow up mammograms and ultrasound exams show decreasing size of the tumor with no progression.(1)

Mammogram showing breast cancer mass (white lump)Left Image: Mammogram showing breast cancer courtesy of wikimedia commons.

Iodine Deficiency Causes Breast Cancer – The Overwhelming Evidence

Human Studies of Areas with Low Iodine

Iodine deficiency is associated with a higher rate of goiter and breast cancer.  Similarly, higher dietary Iodine intake is associated with less goiter and breast cancer.  For example, Japan has the highest dietary intake of iodine (13 mg per day), and the lowest rates for goiter and breast cancer.  However, when Japanese women immigrate and change dietary intake of Iodine to the lower 150 mcg/day in America, breast cancer rates increase.(1)

Iceland is another country with high Iodine intake and low rates for goiter and breast cancer.  The high dietary iodine came from the fishing industry before WWI.  In those days, the fish meal was fed to dairy cows providing milk with high iodine content.  After WWI, the fish meal was eliminated from the dairy cows, and breast cancer rates soared ten-fold. (2)

Animal studies

Iodine deficient diets in animals induces breast cancer and goiter.(1)

Iodine Research from Mexico, India and Japan. 


The Shrivastava group in India reported molecular iodine induces apoptosis (programmed cell death) in human breast cancer cell cultures.  “Iodine showed cytotoxic effects in the cultured human breast cancer cells”.(3)


From Mexico,  the Carmen Aceves Velasco Group reported Iodine to be safe, with no harmful effects on thyroid function, and an anti-proliferative effect on human breast cancer cell cultures. (5)(6)(7) Their 2009 paper reported the mechanism by which Iodine works as an anti-cancer agent.  Iodine binds to membrane lipids called lactones forming iodo-lactones which regulate apoptosis (programmed cell death).  Iodine causes apoptosis which makes cancer cells undergo programmed cell death.(4) Dr. Aceves concluded that continuous molecular iodine treatment has a “potent antineoplastic effect” on the progression of mammary cancer. (10)


From Japan, Dr Funahashi reported a common seaweed food containing high iodine content is more beneficial than chemotherapy on breast cancer .   “He found that administration of Lugol’s iodine or iodine-rich Wakame seaweed to rats treated with the carcinogen dimethyl benzanthracene suppressed the development of mammary tumors. The same group demonstrated that seaweed induced apoptosis in human breast cancer cells with greater potency than that of fluorouracil, a chemotherapeutic agent used to treat breast cancer.”(8)

Untreated Mice With Breast Cancer Tumors  Funihashi   Iodine Treated Mice No Tumores
Left Images are untreated rats with large breast cancer tumors (red arrows) .  Right Images are rats treated with Iodine showing no breast cancer tumors. From Funahashi Japan (8)

Mechanism of Action-Altering Gene Expression

A 2008 paper by Bernard A. Eskin MD showed that Iodine actually altered gene expression in breast cancer cells, inducing programmed cell death. (9)

Lung Cancer and Iodine

A 2003 study by Ling Zhang ahowed that molecular Iodine caused lung cancer cells to undergo programmed cell death (apoptosis).  These lung cancer cells had been genetically modified to increase iodine uptake.(12)  Interestingly, a 1993 case report describes spontaneous remission of lung cancer in a patient incidentally treated with Amiodorone which contains iodine (about 9 mg per day)(13)

In Conclusion

Current Iodine research calls for use of molecular Iodine for all patients with breast cancer. (10)(11)  Other cancers such as lung and prostate may also benefit.  Further research on Iodine as cancer chemotherapy should receive top priority for NIH funding

Breast Cancer Prevention and Iodine Supplementation

Breast Cancer Prevention and Iodine Supplementation by Jeffrey Dach MD mammogram jeffrey dach d breast cancerBreast Cancer Prevention

and Iodine Supplementation

by Jeffrey Dach MD 

Iodine Prevents Breast Cancer

A good friend of ours just went through an ordeal with breast cancer. The incidence of breast cancer has increased to 1 in 8 women, with 4,000 new cases weekly. You might ask, could there be a preventive measure which is safe, cheap and widely available that has been overlooked?

The answer is YES , and it’s the essential mineral, Iodine , which was added to table salt in 1924 as part of a national program to prevent Goiter. It turns out that this same Iodine in table salt is the key to breast cancer prevention as proposed by the following list of prestigious doctors: Guy Abraham, MD (1), Robert Derry MD PHD (2) (3), David Brownstein MD (4)(5), George Flechas MD (6)(20), Donald Miller, M.D. (7)(8)

Above Left Image:
Mammogram showing , arrow points to spiculated breast cancer. 

Our Diet is Iodine Deficient 

Iodized salt jeffrey dach mdMany of us have been told by our doctors to avoid salt, manily becasue they say it causes high blood pressure.  Because of this advice, dietary intake of iodized salt has decreased to low levels, and we have a generalized iodine deficiency in the population.  Of course, salt intake from processed foods is quite high in the American diet, yet none of this added salt contains iodine.

Currently 15% of the US adult female population is classified by the World Health Organization (WHO) as iodine deficient. (9) We consume a large queatity of salt in processed food, however, the salt in processed foods is not iodized salt.  Unfortunately iodized table salt is not a reliable way to supplement with Iodine, It makes sense to use an Iodine supplement.

Image upper left Courtesy Hain Salt: Iodized Sea Salt available at grocery store.  

The RDA for Iodine
is too Low for Optimal Health  

iodized salt jeffrey dach mdAccording to Guy Abraham MD, our dietary intake of Iodine is too low, set at 150 mcg by the government RDA. Dr. Guy Abraham tells us that a healthier level of Iodine intake would be 100 times greater at 12.5 mg, which is the average Iodine intake for Japan, and this higher Iodine intake could explain why the Japanese have the lowest rates for cancer of the breast, prostate and thyroid. 

Image Left: Courtesy Morton Iodized Salt 
How Safe is Iodine Supplementation? 

Iodine is PurpleIodine Treats Breast Cancer, Overwhelming EvidenceIodine Treats Breast Cancer, Overwhelming EvidenceVery Safe. Iodine is the only trace element that can be ingested safely in amounts up to 100,000 times the RDA. For example, potassium iodide has been prescribed safely to large numbers pulmonary (COPD) patients in amounts of up to 6 grams per day for several years. This potassium iodide is a well known treatment for COPD which helps mobilize lung secretions. (18)

Left Image: Elemental Iodine Courtesy of Wikimedia Commons.

The FDA has officially stated that Iodine supplementation is safe and actually recommends 165 mg of Iodine for adults in case of Radiation Emergency to protect the population from thyroid cancer. (17) “Iodine allergy” is a misnomer since this name applies to allergy to iodinated radiographic contrast agents, and not to elemental iodine which is quite different. (10) Elemental Iodine is an essential mineral and required for health.  Deficiency of Iodine in the developing embryo causes cretinism, and deficiency in the developing child causes goiter.   

Iodine Deficiency
Causes Fibrocystic Breast Disease,
Breast Cancer, and Thyroid Cancer 
Povidone iodine Jeffrey Dach  Iodine, a well known topical antiseptic and antimicrobial agent, also directly kills cancer cells and serves as the key player in our body’s surveillance system for removing abnormal pre-cancer cells. There is considerable medical research to support this statement.

Upper Left Image: Povidone Iodine, a topical antiseptic, available at the grocery or drugstore.

Dr. B.A. Eskin published 80 papers over 30 years researching iodine and breast cancer, and he reports that iodine deficiency causes breast cancer and thyroid cancer in humans and animals.(11)(12)  Iodine deficiency is also known to cause a pre-cancerous condition called fibrocystic breast disease. (13) Ghent published a paper in 1993 which showed iodine supplementation works quite well to reverse and resolve fibrocystic changes of the breast, and this is again the subject of a current clinical study.(14)(15

Despite its obvious potential, not much has been done with Iodine treatment over the past 40 years in the United States. Since iodine isn’t patentable and is therefore unlikely to be profitable to market, there is no money to fund studies for “FDA approval”. However, FDA approval is not required since Iodine is already an additive to table salt at the supermarket.  

Iodine Deficiency Diseases   

As an interventional radiologist working in the hospital for 25 years, a large part of my job was evaluating thyroid abnormalities, nodules, and cysts with ultrasound, radionuclide scans, and needle biopsy. Although it was obvious these common thyroid abnormalities were due to iodine deficiency, I often wondered why none of the patients ever received iodine supplementation. The obvious answer is they should have been and that this is a blind spot in mainstream medicine.

Part of my day was also spent reading mammograms and breast ultrasound studies. Fibrocystic breast disease was quite common, and these women would return for needle aspiration procedure of the many breast cysts, and needle biopsy of the benign solid nodules. Many of these ladies returned multiple times for the procedures because the medical system had no useful treatment to offer them. Well, as we have just discussed, we now know there is a very useful medical treatment, namely, Iodine supplementation which not only resolves breast cysts and fibrocystic breast disease, it also resolves ovarian cysts and thyroid cysts. Actually Iodine supplementation has always been available, but again this is a blind spot in mainstream medicine, and hospital based physicians are unaware of it.

Goiter casued by Iodine deficiency jeffrey dach mdGoiter is Caused by Iodine Deficiency

Iodine deficiency is the direct cause of Goiter (thyroid enlargement).  In advanced cases, thyroid enlargement can be massive. (see image at left) Image courtesy of wikimedia commons, shows large goiter in the neck caused by Iodine Deficiency. 

Iodine deficiency also causes the formation of thyroid nodules and cysts. Currently, 60-70 per cent of the population has thyroid nodules detected with thyroid ultrasound.  This thyroid nodule epidemic is directly caused by Iodine Deficiency.

Iodine deficiency is also associated with increased risk for anaplastic thryoid cancer, the most aggressive form.

Which Iodine Supplement to Use? 
There are many Iodine supplements. Lugol’s Solution has been used for many years. A new one is the 12.5 mg Iodoral tablet from Optimox (16) and is the iodine supplement tablet made by Dr. Guy Abraham, a former professor of obstetrics and gynecology at UCLA who started “The Iodine Project” in 1997, and engaged two family practice physicians, Jorge Flechas and David Brownstein to carry out clinical studies of the hypothesis that the body needs 12.5 mg of iodine a day.

Image upper left Courtesy of Optimox: Iodoral, Iodine tablets

Buy Iodoral on Amazon:

Health Benefits of Iodoral

More than 4,000 patients in this project consumed Iodine supplements from 12 to 50 mg per day, and in those with diabetes, up to 100 mg a day. They reported their findings that Iodine does indeed reverse fibrocystic disease; diabetic patients require less insulin; hypothyroid patients require less thyroid medication; symptoms of fibromyalgia resolve, and patients with migraine headaches stop having them.

Albert Szent Györgi

The Nobel laureate Dr. Albert Szent Györgi (1893–1986), the physician who discovered vitamin C, used Iodine freely in his medical practice. The standard dose of potassium iodide given in those days was 1 gram, which contains 770 mg of iodine.

Dr. Albert Szent Györgi writes: “When I was a medical student, iodine in the form of KI (Potassium Iodide) was the universal medicine. Nobody knew what it did, but it did something and did something good. We students used to sum up the situation in this little rhyme: “

“If ye don’t know where, what, and why,
Prescribe ye then K and I
” .

In view of all the above, I take one Iodoral tablet (12.5 mg Iodine) daily as do all of my family members. Iodoral is available without a prescription as a nutritional supplement. 

Iodoral is an important part of our breast cancer prevention program.

Iodine by David Brownstein MD

David Brownstein’s
Book on Iodine     is an excellent resource and highly recommended.(4)  

David Brwonstein has treated thousands of patients with iodine supplements in the Iodine Project and reports his clinical experience in this book.

Link to Iodine Research Here.(19)  Left Image: Book Cover Courtesy of David Brownstein MD

Iodine by David Derry MD PhD
 David Derry MD PhD on Iodine and Breast Cancer Prevention
is  another useful book.

Here is my book review on Amazon.

(Book cover courtesy of David Derry MD)

The book, Breast Cancer and Iodine by David Derry MD PhD, is a unique 100 page volume which presents the academic case for iodine as prevention and treatment of breast cancer. The book should be handed out freely during October Breast Cancer Awareness Month. Although written for the lay reader, it should be required reading for all medical students, breast surgeons, mammographers, breast cancer oncologists and any doctor who orders mammograms.

With ten pages of medical references including the work of B A Eskin and W R Ghent, Dr. Derry discloses the remarkable connection between iodine deficiency, fibrocystic breast disease and breast cancer. Iodine’s anti-cancer activity lies in its control of apoptosis, or programmed cell death.

Derry presents case studies complete with surgical pathology confirmation showing regression of both fibrocystic breast disease and carcinoma-in-situ breast cancer with iodine treatment. He also presents a case report case of infiltrating breast cancer involving the skin which regressed after prolonged application of topical Lugol’s iodine solution.

I can report from the experience of my own family members that iodine supplementation causes regression of fibrocystic breast disease.

Derry’s ideas in the book could be easily revised into an NIH grant proposal to research and confirm the role of iodine. To do so would advance the nation’s health and be a great public service. Iodine is safe, inexpensive and readily available without a prescription. A US policy of iodine supplementation matching the Japanese dietary intake of iodine could very well be our best preventive measure against breast cancer.

The Iodine Crisis by Lynn Farrow is a more recent book highly recommended to you.

Lynne Farrow is a gifted writer and her book chronicles in exquisite detail her personal story and discovery of Iodine, and her journey as an Iodine advocate. Her book describes how Iodine was used for decades as a natural medicine, and then virtually eliminated from mainstream medicine and our food in the 1960′s by bad research.

Lynne Farrow’s web site is Breast Cancer Choices.

Essential Medical Studies Not Commonly Reported in Mainstream News

Essential Medical Studies Not Commonly Reported in Mainstream News

Ginkgo Supplement for Stamina and Sexual Performance

Ladies, Ginkgo was found to enhance stamina and sexual performance in male rats. It would be a very good idea to supplement your partner with Ginkgo. In addition, to enhancing their memory, it will improve their sexual being.

Hysterectomies Are Not The Answer

Women with hysterectomies are more likely to have later surgery for incontinence. Women who had given birth vaginally to more than four children before receiving a hysterectomy had substantially a greater risk of subsequent urinary incontinence. The constant repetitious lie that ‘hysterectomies do not cause any ill effect because women don’t need their uterus after reproductive years’ again is shown not to hold. This article was published in the reputable journal that is called Lancet in 2007.

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Birth Control Pills Aren’t As Safe As Advertised

Birth Control Pills aggravate inflammation in women with polycystic ovaries. Polycystic ovaries is a common and debilitating condition in up to 20% of the women that suffer from acne, increase hair growth, weight gain, tendency towards diabetes, and irregular period. Traditional medicine put all these women from a young age on the birth control pill, something that makes no sense to me. The core of this disease is an increase in inflammation. Dr. Meghan M. McKeever has shown clearly that birth control pills farther aggravate the inflammation of women with polycystic ovaries. This practice should be abandoned.

Fosamax’s Deadly Side Effects

Fosamax is a type of drug for osteoporosis that you get brainwashed into using by TV advertising. Fosamax has new reported life threatening side effects in addition to the ones that are already described in my last book. The side effects are serious arterial fibrillation that could potentially be deadly. This was published in The New England Journal of Medicine in May of 2007.

Bilateral Mastectomies Do Not Have Enough Evidence of Effectiveness

More patients with breast cancer are opting for a bilateral mastectomy despite lack of proof that it is efficient. The incidence has soared close to 3 fold since 1999. Oncologists cannot understand why women are doing this, but they have forgotten that they are the reason for propagating this death scare into the minds of the women in this country. This was reported in The Journal of Clinical Oncology in the end of 2007 by researchers from the University of Minnesota public health and medical schools in Minneapolis.

Estrogen Helps To Increase Longevity and Health

Estrogen treatment increases telomere length. The length of the telomere determines our longevity and health. Women who use hormonal replacement therapy have longer telomeres than women that don’t use hormonal replacement therapy. This is another argument for the long term significant longevity benefit of hormonal replacement treatment.

Hypothyroidism Increases Risk of Breast Cancer

Women with hypothyroidism have significantly higher incidence of breast cancer. Many women with clinical symptoms of hypothyroidism are not being treated because they don’t meet the rigid biochemical criteria of hypothyroidism. We may enhance the likelihood that these women will develop breast cancer by delaying treatment for thyroid disease. This was reported in the annual North American menopausal society by Dr. Maria Francheta.

Low Testosterone Studies with No Scientific Evidence

Low testosterone level in European men was associated with an increase in death. The common statement I hear frequently is that if you take hormones, you feel good today but you die quicker tomorrow. This holds no physiological or scientific grounds and is just meant to frighten people from adjusting their physiological need as they get older. Here is another serious study that shows without a doubt that men with lower testosterone levels are going to die faster, especially from cardio vascular disease and cancer, compared to the same people in the study that have a much higher level of testosterone. This was published in Circulation, November 26, 2007.

A Six years follow-up of 410 men sixty five and older in the Chianti area of Italy had shown that higher levels of testosterone, DHEA, and human growth hormone (HGH) would give you longer longevity and a decline in mortality. This study takes the previously mentioned study one step further. It didn’t look only at the testosterone level, but also at the DHEA and IGF-1 that indirectly represents human growth level. We are learning here that all these hormones are the essence of living, and are indispensable to maintain longer longevity. If anybody frightens you into thinking that the use of DHEA, testosterone and human growth hormone will be a long term disaster, they base it on hysteria and not on factual medical science that shows the opposite. This was published by the National Institute of Health in the Archive of Internal Medicine in November 2007.

Curcumin Spice Helps Decrease Fibroid Development

Curcumin the common Indian spice is shown to be effective in decreasing the development of fibroids that are so problematic and common in our population. It probably does it via its strong anti-inflammatory function by decreasing the nuclear factor, Kappa Beta. In my practice I use Body Guard. This includes curcumin, grape extract, pomegranate extract and green tea that all together synergistically decrease many inflammation factors and are proven to decrease the proliferation of fibroids. This was published as a presentation in the 2007 National Fertility and Sterility meeting by M. Malik.

Studies with Wogonin Decreasing Cancer Effects

Wogonin has anti cancer effects in both estrogen positive and estrogen negative human breast cancer cell lines.

I’m over 50 and can now get my COVID vaccine. Is the AstraZeneca vaccine safe? Does it work? What else do I need to know?


I’m over 50 and can now get my COVID vaccine. Is the AstraZeneca vaccine safe? Does it work? What else do I need to know?

May 3, 2021 6.23am AEST


  1. Meru Sheel Epidemiologist | Senior Research Fellow, Australian National University
  2. Cyra Patel PhD candidate, Australian National University
  3. Margie Danchin Paediatrician at the Royal Childrens Hospital and Associate Professor and Clinician Scientist, University of Melbourne and MCRI, Murdoch Children’s Research Institute

Disclosure statement

Meru Sheel receives funding from the Westpac Scholars Trust.

Cyra Patel is an employee at the National Centre for Immunisation Research and Surveillance (NCIRS). NCIRS receives service contract funding from the Australian Government Departments of Health, NSW and other state government Departments of Health.

Margie Danchin receives funding from NHMRC, Commonwealth and State Departments of Health, DFAT and WHO


Australian National University

Australian National University provides funding as a member of The Conversation AU.

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Republish our articles for free, online or in print, under Creative Commons licence.

From today, Australians aged 50 or older are eligible to receive their COVID-19 vaccine from special respiratory clinics or mass vaccination hubs in some states. Appointments with selected GPs are available from May 17.

However, a recent poll shows many people over 50 are hesitant to get vaccinated, particularly with the AstraZeneca vaccine earmarked for them. That’s mostly due to reports of very rare, but serious, blood clots that can develop after vaccination.

So it’s understandable why people want to know about any safety issues and how they relate to age. It’s also natural to want to know how well the vaccine works to protect people over 50.

Here’s what we know about this safe and effective vaccine from clinical trials and around 136 countries using it so far.

Our newsroom needs you now more than ever.

Does the AstraZeneca vaccine protect people over 50?

Clinical trials, which have included more than 57,000 people to date, found the AstraZeneca vaccine to be safe and effective.

When researchers pooled the results from four large trials — including about 8,600 vaccinated people and a similar number of unvaccinated persons — there were 81% fewer COVID-19 cases in vaccinated people than in unvaccinated ones. No one who got the vaccine was hospitalised due to COVID-19.

While the studies haven’t been designed specifically to look at efficacy in distinct age groups yet, there is good evidence the AstraZeneca vaccine protects both the elderly and younger adults from COVID-19. In clinical trials, adults aged 18-55 and those older than 55 had similar immune responses.

How about serious disease and death?

When it comes to protecting people from serious disease, there’s good news again. We have data from England and Scotland that one dose of it reduces COVID-19 hospitalisations by 80-88% in the elderly, similar to that of the Pfizer vaccine (88-91%).

Based on our understanding of how vaccines work — generally, vaccines are more effective in younger adults — it’s safe to assume the vaccine is at least 80% effective in preventing severe COVID-19 in people over 50.

Emergency sign
We want to avoid people ending up in hospital with serious COVID-19. With the AstraZeneca vaccine, hospitalisations are down around 80%. from

What about the new variants?

New variants of SARS-CoV-2, the virus that causes COVID-19, affect the efficacy of the AstraZeneca vaccine, but only slightly for the B.1.1.7 strain (the UK variant). It’s about 70% effective against this strain, compared with about 82% for the original strain.

However, there have been some concerns about protection against the B.1.351 strain (the South African variant). This is because the AstraZeneca vaccine provides less protection against mild COVID-19 disease in people infected with it.

Does the AstraZeneca vaccine limit spread of COVID-19?

We still need more long-term data to say for certain whether the vaccine prevents transmission of COVID-19.

However, preliminary UK research provides some welcome news. Researchers looked at more than 365,000 households and nearly one million contacts of COVID-19 cases. They found the vaccine reduced transmission from people vaccinated with one dose by 40-50%. This is great news in terms of slowing the spread of the disease.

How safe is the AstraZeneca vaccine in people over 50?

Both clinical trials and real-world data confirm the AstraZeneca vaccine has a good safety profile similar to other vaccines commonly used in Australia.

Side-effects are common and are mostly mild to moderate, with few recipients needing medical attention. The most common are reactions at the injection site, fatigue, headache and muscle pain. These occur in half to three-quarters of people under 55 after their first dose, and are less common in older people. The side-effects generally start within 24 hours and last around one or two days, and indicate your immune system is working.

In Australia, data from the AusVaxSafety vaccine surveillance system shows about 22% of people vaccinated with the AstraZeneca vaccine missed a day or more of work or studies as they were unwell. Fewer than 2% needed to see a doctor.

Read more: COVID vaccines have been developed in record time. But how will we know they’re safe?

What about the blood clots I’ve been hearing about?

Serious reactions to the vaccine have been very rare, one of which includes thrombosis with thrombocytopenia syndrome, which is on everyone’s mind right now.

This is a very rare condition in which blood clots (thrombosis) and low levels of platelets (thrombocytopenia) occur 4-28 days after receiving the vaccine. This can lead to disability and 20-25% of people with these clots die.

About six in every million people vaccinated with the AstraZeneca vaccine develop the condition. And it tends to be more common in people under 50. Other than younger age, there are no other risk factors for these clots we know of yet.

In Australia, there have been six cases of this type of blood clotting: one person in their 30s, four in their 40s, and one in their 80s. Of these, a person in their 40s has died from it.

Read more: What is thrombocytopenia, the rare blood condition possibly linked to the AstraZeneca vaccine?

As Australia is largely COVID-free, is it worth me getting the AstraZeneca vaccine?

The risk-benefit analysis for Australians right now differs depending on the amount of COVID-19 in the community, your age and the availability of alternative vaccines.

Based on a small amount of data so far, the risk of these blood clots after the AstraZeneca vaccine, for people aged 50-59 is about 0.4 per 100,000 and for those aged 60-69, 0.2 per 100,000.

But the risk of getting severe COVID-19 or the risk of admission into intensive care from COVID-19 is much higher for the over 50s — nearly ten-fold higher than the risk of clots after the vaccine.

It’s about 6.5 per 100,000 people aged 50-59 and 7.0 per 100,000 for people aged 60-69, based on data from Victoria’s second wave in July 2020. There are different risk-benefit calculations for different scenarios.

In a scenario similar to the second wave of COVID-19 in Victoria, the risk of ICU admission due to COVID-19 is much higher than the risk of blood clots from the AstraZeneca vaccine. from the Australian Government Department of Health

Australia has almost no disease in the community. However, this could change very quickly if there were new outbreaks. We also have no alternative to the AstraZeneca vaccine for most people over 50 (more Pfizer vaccine is not available until the last quarter of 2021). So balancing the risks and benefits of the vaccine, is extremely challenging. People may not perceive their risk of COVID-19 as high enough to warrant vaccination and are preferring to wait, perhaps six months or more until other vaccines are available.

However, the potential benefits of the vaccine go far beyond what we’ve already mentioned. Vaccination will contribute to the prevention of long COVID-19 (symptoms that linger for months) as well as increased ability to move around freely in society, including being able to attend large events. Vaccination will help us avoid lockdowns or school closures, allow us to travel overseas and return to normal life.

Read more: A balancing act between benefits and risks: making sense of the latest vaccine news

How do I get vaccinated?

You can use the government’s vaccine eligibility tracker to check whether you can receive your COVID-19 vaccine from today, and to make an appointment.

This will give you details of the state- and territory-run vaccination clinics near you that are open from today (not all are taking appointments for the over 50s yet). From May 17, you can receive your vaccine at some GP clinics.

Two doses of the AstraZeneca vaccine are needed for best protection, preferably 12 weeks apart.