Feminist narratives are being hijacked to market medical tests not backed by evidence
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Corporations have used feminist language to promote their products for decades. In the 1980s, companies co-opted messaging about female autonomy to encourage women’s consumption of unhealthy commodities, such as tobacco and alcohol.
Today, feminist narratives around empowerment and women’s rights are being co-opted to market interventions that are not backed by evidence across many areas of women’s health. This includes by commercial companies, industry, mass media and well-intentioned advocacy groups.
Some of these health technologies, tests and treatments are useful in certain situations and can be very beneficial to some women.
However, promoting them to a large group of asymptomatic healthy women that are unlikely to benefit, or without being transparent about the limitations, runs the risk of causing more harm than good. This includes inappropriate medicalisation, overdiagnosis and overtreatment.
In our analysis published today in the BMJ, we examine this phenomenon in two current examples: the anti-mullerian hormone (AMH) test and breast density notification.
The AMH test
The AMH test is a blood test associated with the number of eggs in a woman’s ovaries and is sometimes referred to as the “egg timer” test.
Although often used in fertility treatment, the AMH test cannot reliably predict the likelihood of pregnancy, timing to pregnancy or specific age of menopause. The American College of Obstetricians and Gynaecologists therefore strongly discourages testing for women not seeking fertility treatment.
Anastasia Vityukova/Unsplash
Despite this, several fertility clinics and online companies market the AMH test to women not even trying to get pregnant. Some use feminist rhetoric promising empowerment, selling the test as a way to gain personalised insights into your fertility. For example, “you deserve to know your reproductive potential”, “be proactive about your fertility” and “knowing your numbers will empower you to make the best decisions when family planning”.
The use of feminist marketing makes these companies appear socially progressive and champions of female health. But they are selling a test that has no proven benefit outside of IVF and cannot inform women about their current or future fertility.
Our recent study found around 30% of women having an AMH test in Australia may be having it for these reasons.
Misleading women to believe that the test can reliably predict fertility can create a false sense of security about delaying pregnancy. It can also create unnecessary anxiety, pressure to freeze eggs, conceive earlier than desired, or start fertility treatment when it may not be needed.
While some companies mention the test’s limitations if you read on, they are glossed over and contradicted by the calls to be proactive and messages of empowerment.
Breast density notification
Breast density is one of several independent risk factors for breast cancer. It’s also harder to see cancer on a mammogram image of breasts with high amounts of dense tissue than breasts with a greater proportion of fatty tissue.
While estimates vary, approximately 25–50% of women in the breast screening population have dense breasts.
Tyler Olsen/Shutterstock
Stemming from valid concerns about the increased risk of cancer, advocacy efforts have used feminist language around women’s right to know such as “women need to know the truth” and “women can handle the truth” to argue for widespread breast density notification.
However, this simplistic messaging overlooks that this is a complex issue and that more data is still needed on whether the benefits of notifying and providing additional screening or tests to women with dense breasts outweigh the harms.
Additional tests (ultrasound or MRI) are now being recommended for women with dense breasts as they have the ability to detect more cancer. Yet, there is no or little mention of the lack of robust evidence showing that it prevents breast cancer deaths. These extra tests also have out-of-pocket costs and high rates of false-positive results.
Large international advocacy groups are also sponsored by companies that will financially benefit from women being notified.
While stronger patient autonomy is vital, campaigning for breast density notification without stating the limitations or unclear evidence of benefit may go against the empowerment being sought.
Ensuring feminism isn’t hijacked
Increased awareness and advocacy in women’s health are key to overcoming sex inequalities in health care.
But we need to ensure the goals of feminist health advocacy aren’t undermined through commercially driven use of feminist language pushing care that isn’t based on evidence. This includes more transparency about the risks and uncertainties of health technologies, tests and treatments and greater scrutiny of conflicts of interests.
Health professionals and governments must also ensure that easily understood, balanced information based on high quality scientific evidence is available. This will enable women to make more informed decisions about their health.
Brooke Nickel, NHMRC Emerging Leader Research Fellow, University of Sydney and Tessa Copp, NHMRC Emerging Leader Research Fellow, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How To Stop Binge-Eating: Flip This Switch!
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“The Big Eating Therapist” Sarah Dosanjh has insights from both personal and professional experience:
No “Tough Love” Necessary
Eating certain foods is often socially shamed, and it’s easy to internalize that, and feel guilty. While often guilt is considered a pro-social emotion that helps people to avoid erring in a way that will get us excluded from the tribe (bearing in mind that for most of our evolutionary history, exile would mean near-certain death), it is not good at behavior modification when it comes to addictions or anything similar to addictions.
The reason for this is that if we indulge in a pleasure we feel we “shouldn’t” and expect we’d be shamed for, we then feel bad, and we immediately want something to make us feel better. Guess what that something will be. That’s right: the very same thing we literally just felt ashamed about.
So guilt is not helpful when it comes to (for example) avoiding binge-eating.
Instead, Dosanjh points us to a study whereby dieters ate a donut and drank water, before being given candy for taste testing. The control group proceeded without intervention, while the experimental group had a self-compassion intervention between the donut and the candy. This meant that researchers told the participants not to feel bad about eating the donut, emphasizing self-kindness, mindfulness, and common humanity. The study found that those who received the intervention, ate significantly less candy.
What we can learn from this is: we must be kind to ourselves. Allowing ourselves, consciously and mindfully, “a little treat”, secures its status as being “little”, and “a treat”. Then we smile, thinking “yes, that was a nice little thing to do for myself”, and proceed with our day.
This kind of self-compassion helps avoid the “meta-binge” process, where guilt from one thing leads to immediately reaching for another.
For more on this, plus a link to the study she mentioned, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
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What Menopause Does To The Heart
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World Menopause Day: Menopause & Cardiovascular Disease Risk
Today, the 18th of October, is World Menopause Day.
The theme for this year is cardiovascular disease (CVD), and if your first reaction is to wonder what that has to do with the menopause, then this is the reason why it’s being featured. Much of the menopause and its effects are shrouded in mystery; not because of a lack of science (though sometimes a bit of that too), but rather, because it is popularly considered an unimportant, semi-taboo topic.
So, let’s be the change we want to see, and try to fix that!
What does CVD have to do with the menopause?
To quote Dr. Anjana Nair:
❝The metabolic and clinical factors secondary to menopause, such as dyslipidemia, insulin resistance, fat redistribution and systemic hypertension, contribute to the accelerated risk for cardiovascular aging and disease.
Atherosclerosis appears to be the end result of the interaction between cardiovascular risk factors and their accentuation during the perimenopausal period.
The increased cardiovascular risk in menopause stems from the exaggerated effects of changing physiology on the cardiovascular system.❞
Source: Cardiovascular Changes in Menopause
See also: Menopause-associated risk of cardiovascular disease
Can we do anything about it?
Yes, we can! Here be science:
- Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association
- Cardiovascular risk in menopausal women and our evolving understanding of menopausal hormone therapy: risks, benefits, and current guidelines for use
This (in few words: get your hormone levels checked, and consider HRT if appropriate) is consistent with the advice from gynecologist Dr. Jen Gunter, whom we featured back in August:
What You Should Have Been Told About The Menopause Beforehand
What about lifestyle changes?
We definitely can do some good things; here’s what the science has to say:
- Mediterranean diet: yes, evidence-based
- High soy consumption: mixed evidence, unclear. So, eat it if you want, don’t if you don’t.
- Supplements e.g. vitamins and minerals: yes, evidence-based.
- Supplements e.g. herbal preparations: many may help, but watch out for adverse interactions with meds. Check with your pharmacist or doctor.
- Supplements; specifically CBD: not enough evidence yet
- Exercise: yes, evidence-based—especially low-impact high-resistance training, for bone strength, as well as regular moderate-intensity exercise and/or High-Intensity Interval Training, to guard against CVD.
For a full low-down on all of these:
Revealing the evidence-based lifestyle solutions to managing your menopause symptoms
Want to know more?
You can get the International Menopause Society’s free downloadable booklet here:
Menopause & Cardiovascular Disease: What Women Need To Know
You may also like our previous main feature:
What Does “Balance Your Hormones” Even Mean?
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Better Sex = Longer Life (Here’s How)
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This is Dr. Candice Hargons. She’s a professor of psychology, and has served on the Kentucky Psychological Association Board, the Society of Counseling Psychology Executive Board, and the American Psychological Association (APA)’s Council of Representatives. She also served on the APA Board of Directors, after receiving the APA’s Presidential Citation award for her research and leadership.
She leads the Study of Mental And Sexual Health Equity in Relationships (SMASHER Lab), with a predominant focus on promoting good sex, sexual wellness, and liberation among couples and communities.
In her own words:
❝Sex is one of the most common and normal human behaviors, and yet it remains relatively taboo as a topic. Many people worry about being judged, either for being perceived as too sexual or not sexual enough, and a major focus of my work is to normalize talking and learning about sex to improve sexual functioning across the adult lifespan.❞
~ Dr. Candice Hargons
So, let’s do that!
What does good sex do for health?
We’ve written previously about the health aspects of orgasms specifically:
“Early To Bed…” (Mythbusting Orgasms) ← including resources pertaining to anorgasmia, the inability to orgasm
…but orgasms are not the be-all-and-end-all of sex; see for example:
A Urologist Explains Edging: What, Why, & Is It Safe? ← when the journey is genuinely more of a focus than the destination
And certainly, good sex is simply a very good way to relax and de-stress, which is important, given how important stress management is to general health in very many ways (affecting things ranging from inflammation to heart health and more).
Plus, while the level of athleticism deployed may vary, sex is a physical activity, and physical activity is, as a rule, good.
There’s more to it than that though! It also can help us bind closely to our loved ones, in a positive way, which—critically—has a very positive impact on healthy longevity:
Only One Kind Of Relationship Promotes Longevity This Much! ← this is about the seriousness of the relationship, not the sex, but for most people, a strong and fulfilling relationship will include having good sex.
The scientific relationship between sex and longevity also got a whole chapter in this excellent book that we reviewed all so recently:
Age Proof: The New Science of Living a Longer and Healthier Life – by Dr. Rose Anne Kenny
What makes it “good”?
Dr. Hargons considers (and her opinion is backed by extensive research in the SMASHER Lab, if you’ll pardon the mental image that that might conjure) that first and foremost… It has to feel good to all parties involved.
In contrast, oftentimes, one partner’s pleasure is prioritized over another’s, and that becomes a problem.*
*assuming that’s not part of an established kink dynamic with enthusiastic affirmative consent, such as if the partner whose pleasure is being deprioritized is enthusiastically requesting to be denied orgasms, for example. Yes, that’s a real kink and even a popular one, but it’s not what’s happening in most sexually uneven relationships.
This kind of unplanned disparity often goes undiscussed by the couple in question—especially in heterosexual couples if the man is getting what he wants/needs and the woman isn’t, because there’s a rather lop-sided societal expectation in that regard. And even a loving, well-intentioned man can simply not know how to do better and be afraid to ask. And for that matter, it’s also entirely possible for his partner to not know either.
Dr. Hargons lists the four main keys as:
- Communication
- Intimacy
- Passion
- Pleasure
And communication indeed comes first, so to speak. For example, she advises:
❝Begin by identifying what you like and don’t like sexually. An easy way to do this is to create a “Yes, No, Maybe So” list. You can use paper or a Notes app on your phone.
Create three columns: one for Yes, No, and Maybe So sections. In the Yes section, write all the things you enjoy and want to keep doing sexually, as well as things you have not tried yet that you want to try. In the No section, write all the things you don’t enjoy and do not want to do anymore. It can also include things you haven’t tried that you’re uninterested in trying. Finally, in your Maybe So list, write all the things you’re curious about and/or are only willing to try in specific settings or circumstances.
You can share this list with your partner, but even if you are not ready to do that, you will already have enhanced your sexual self-awareness and be better positioned to talk with your sexual partner about what you want.❞
This represents an important shift from “whatever” to taking an active role in your sex life at your own pace.
And from there, it’s just a matter of exploring, together, and learning as you go. Could anything be more exciting than that?
“What if I’m single?”
We talked about this a little previously, more relationally than sexually specifically, though:
Now, a single person can of course still have an active sex life if you so choose, in which case, the above advice still applies, just, it’ll be conversations with your partner-of-the-moment rather than with a life partner. And that’s important too! Just because something is casual, doesn’t mean it need not be entered into mindfully and with a sense of what you want out of it, and communicating that effectively (while encouraging the same from others, and of course actually listening to, and caring about, what they say too).
And if you are, perchance, single and decided on a life of celibacy now, you can and (if you are sexual at all) should still figure out what you like and don’t like sexually, because even if it’s going to be you-on-you action, it will be good for you to love yourself enough to do it right.
Seriously, treat yourself at least as well as you would any other lover.
On which note, corded wand-style vibrators like the famous “Magic Wand” kind are much more powerful than the battery kind, and you will feel the difference, in a good way.
And if you really want to invest in your sexual wellness and you like the idea, saddle-style vibrators like this one will rock your socks off in ways handheld vibrators couldn’t dream of.
Want to know more?
You might want to check out Dr. Hargons’ book:
Good Sex: Stories, Science, and Strategies for Sexual Liberation – by Dr. Candice Hargons ← this covers so many important areas, more than we have room to here. Just check out the table of contents, and you’ll see what we mean.
…which we haven’t reviewed yet, but here are some excellent related books that we have:
- Come Together: The Science (and Art) of Creating Lasting Sexual Connections – by Dr. Emily Nagoski
- Better Sex Through Mindfulness: How Women Can Cultivate Desire – by Dr. Lori Brotto
Enjoy!
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Natural Alternatives for Depression Treatment
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Questions and Answers at 10almonds
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
Natural alternatives to medication for depression?
Great question! We did a mean feature a while back, but we definitely have much more to say! We’ll do another main feature soon, but in the meantime, here’s what we previously wrote:
See: The Mental Health First-Aid That You’ll Hopefully Never Need
^This covers not just the obvious, but also why the most common advice is not helpful, and practical tips to actually make manageable steps back to wellness, on days when “literally just survive the day” is one’s default goal.
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Applesauce vs Cranberry Sauce – Which is Healthier?
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Our Verdict
When comparing applesauce to cranberry sauce, we picked the applesauce.
Why?
It mostly comes down to the fact that apples are sweeter than cranberries:
In terms of macros, they are both equal on fiber (both languishing at a paltry 1.1g/100g), and/but cranberry sauce has 4x the carbs, of which, more than 3x the sugar. Simply, cranberry sauce recipes invariably have a lot of added sugar, while applesauce recipes don’t need that. So this is a huge relative win for applesauce (we say “relative” because it’s still not great, but cranberry sauce is far worse).
In the category of vitamins, applesauce has more of vitamins B1, B2, B5, B6, B9, and C, while cranberry sauce has more of vitamins E, K, and choline. A more moderate win for applesauce this time.
When it comes to minerals, applesauce has more calcium, copper, magnesium, phosphorus, and potassium, while cranberry sauce has more iron, manganese, and selenium. Another moderate win for applesauce.
Since we’ve discussed relative amounts rather than actual quantities, it’s worth noting that neither sauce is a good source of vitamins or minerals, and neither are close to just eating the actual fruits. Just, cranberry sauce is the relatively more barren of the two.
While cranberries famously have some UTI-fighting properties, you cannot usefully gain this benefit from a sauce that (with its very high sugar content and minimal fiber) actively feeds the very C. albicans you are likely trying to kill.
All in all, a pitiful show of nutritional inadequacy from these two products today, but one is relatively less bad than the other, and that’s the applesauce.
Want to learn more?
You might like to read:
From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?
Enjoy!
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The Diabetes Code – by Dr. Jason Fung
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Cure this serious disease with diet!” is often a bold-claim that overreaches scientific rigor, but in this case, it’s well-established as scientifically valid.
Caveat up-front: the only known circumstance in which this won’t work is if you have comorbidities that prevent you from following the advice.
You may be wondering: is this just the Mediterranean diet again? The answer is that the Mediterreanean diet (or similar) is part of it. But there’s a lot more to this book than that.
Dr. Fung explains to us a lot of the physiology of type 2 diabetes; how insulin resistance occurs, how it becomes a vicious cycle that we get locked into, and how to escape it.
- We learn about the role of fructose, and why fruit is very healthful whereas high-fructose corn syrup and similars are very much not.
- We learn about the role of the liver in glycogen metabolism, and how to un-fatty a fatty liver. Good news: the liver has famously strong self-regenerative abilities, if we give it a break to allow it to do so!
- We learn why portion control doesn’t work, and why intermittent fasting does (here be science).
Dr. Fung’s very readable explanations are free from needless jargon while not dumbing down. The writing style is clear and direct: “this happens this way”, “do this, not that”, etc.
Bottom line: if you have type 2 diabetes and would like to not have that (or if you are pre-diabetic and would like to avoid diabetes) this is a book for you. If you are in great metabolic health and would like to stay that way as you get older, then this is a book for you too.
Click here to check out The Diabetes Code, and get/keep your metabolic health in order!
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