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.

Woman sits in a medical waiting room
The AMH test can’t predict your chance of getting pregnant.
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.

Young woman has mammogram
Dense breasts can make it harder to detect cancer.
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.The Conversation

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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  • 10 Unexpected Benefits Of Slow Jogging

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    Sometimes, less is more:

    Slow and steady wins the race?

    Here’s the rundown… Slowly:

    1. You burn more body fat: running at 50-60% of max heart rate primarily burns fat without having the usual compensatory metabolic slump afterwards, unless you go for a very long time.
    2. You can build more muscle: lower-intensity workouts improve muscle recovery, which is essential too.
    3. You can reduce muscle soreness: light jogging helps clear lactic acid faster (10almonds note: muscle soreness after exercise isn’t about lactic acid)
    4. You avoid injuries: less impact on joints reduces injury risk.
    5. You learn the proper form: running slowly allows better focus on technique.
    6. You can enjoy it more: slower pace lets you take in surroundings and boosts mood.
    7. You still improve your cardiorespiratory fitness: strengthens heart and lungs over time.
    8. You’ll burn more calories than you think: can burn 200–400 calories per 30 minutes.
    9. You’ll improve your mobility: gentle movement supports joint health and collagen production.
    10. You can improve your performance: builds endurance and strength for faster running

    For more on each of these, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

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  • Eat To Avoid (Or Beat) PCOS

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Polycystic ovary syndrome, PCOS, affects very many people; around 1 in 5 women. It can show up unexpectedly, and usually the first-identified sign is irregular vaginal bleeding. We say “vaginal” rather than “menstrual” as it’s not technically menses, although it’ll look (and can feel) the same.

    Like many “affects mostly women” conditions, science’s general position is “we don’t know what causes it or how to cure it”.

    Quick book recommendation before we continue:

    Unwell Women: Misdiagnosis and Myth in a Man-Made World – by Dr. Elinor Cleghorn

    …is a top-tier book about medical misogyny. We’d say more here, but well, you can read our review there 🙂

    What doesn’t work

    Since PCOS is characterized by excessive androgen production, it is reasonable to expect that foods containing phytoestrogens (such as soy) may help. They won’t. The human body can’t use those as estrogen, and in fact, consuming unusually large quantities of phytoestrogens can actually get in the way of your own (or bioidentical) estrogen, by competing for the same receptors but not really doing the job.

    But, you won’t get that problem from moderate consumption of soy; the warning is more for those tempted to self-medicate with megadoses, or are opting for dubious supplements such as Pueraria mirifica ← will have to do a research review on that one of these days, but suffice it to say meanwhile, it has some serious drawbacks

    See also: What Does “Balance Your Hormones” Even Mean?

    What can work

    There are some supplement-based approaches that actually can help, and those are the ones that rather than trying to manufacture estrogen out of thin air, work to reduce testosterone and/or reduce the conversion of free testosterone to its more potent form, dihydrogen testosterone (DHT); here are two examples:

    What will work

    …or at least, barring additional confounding factors, what the evidence strongly supports working. Here’s where we get into diet properly, and there are three main dietary approaches:

    Low-GI diet: focus on high-fiber, low-carb foods (e.g. whole grains, legumes, berries, leafy greens). Eating this way results in improved insulin sensitivity, lower fasting insulin, cholesterol, triglycerides, waist circumference, and (for women) yes, lower testosterone levels.

    See: What Do The Different Kinds Of Fiber Do? 30 Foods That Rank Highest

    High antioxidant diet: focus on foods rich in antioxidants (e.g. vitamin A, α-tocopherol specifically, vitamins C and D, and polyphenols) as these lower PCOS incidence.

    See: 21 Most Beneficial Polyphenols & What Foods Have Them

    Ketogenic diet: focus on high-fat, very low-carb foods (e.g. fatty fish, dairy, leafy greens). This significantly reduces androgen levels, improves insulin sensitivity, and regulates hormones. But… It’s recommended for short-term use only due to its negative health impacts from poor (i.e. narrow) nutritional coverage:

    See: Ketogenic Diet: Burning Fat, Or Burning Out?

    It is also reasonable to supplement, for example:

    Omega-3 fatty acids and vitamin D have powerful anti-inflammatory and antioxidant properties that significantly improve insulin sensitivity and reduce androgen levels in metabolic syndromes like PCOS. A higher intake of omega-3 and vitamin E also alleviates mental health parameters and gene expression of PPAR-γ, IL-8, and TNF-α in women with PCOS.

    Dietary supplements, such as antioxidants like N-acetylcysteine (NAC), vitamin D, inositol, and omega-3 fatty acids, and mineral supplements (zinc, magnesium selenium, and chromium) help in reducing insulin resistance. These supplements also enhance ovulatory function and decrease inflammation in PCOS patients.

    Omega-3 fatty acid supplements improve biochemical parameters LH, LH/FSH, lipid profiles, and adiponectin levels and regularize the menstrual cycle in women with PCOS. A recent RCT also indicated that probiotic/symbiotic supplementation significantly improves triglyceride, insulin, and HDL levels in women with PCOS.❞

    Source: The Role of Lifestyle Interventions in PCOS Management: A Systematic Review

    Want to know more?

    You might like this book that we reviewed a little while back:

    PCOS Repair Protocol – by Tamika Woods

    Take care!

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  • Tranquility by Tuesday?

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    I Know How She Does It: How Successful Women Make The Most of Their Time

    This is Laura Vanderkam, author of “Tranquility By Tuesday” (amongst other books). Her “thing” is spending more time on what’s important, and less on what isn’t. Sounds simple, but she’s made a career out of it, so condensed here for you are…

    Laura’s 7 Keys To Productivity

    Key One: Plan your weeks on Fridays

    You don’t want your Monday morning to be a “James Bond intro” (where everything is already in action and you’re just along for the ride, trying to figure out what’s going on). So, take some time last thing each Friday, to plan ahead for the following week!

    Key Two: Measure what matters

    Whatever that means to you. Laura tracks her use of time in half-hour blocks, and likes keeping track of streaks. For her, that means running daily and keeping a log of it. She also keeps track of the books she reads. For someone else it could be music practice, or a Duolingo streak, or eating fruit each day.

    On which note…

    “Dr. Greger’s Daily Dozen” is simpler than most nutrition trackers (where you must search for everything you eat, or scan barcodes for all ingredients).

    Instead, it keeps track of whether you are having certain key health-giving foods often enough to maintain good health.

    We might feature his method in a future edition of 10almonds, but for now, check the app out for yourself here:

    Get Dr. Greger’s Daily Dozen on iOS / Get Dr. Greger’s Daily Dozen on Android

    Dr. Greger’s Daily Dozen @ Nutrition Facts

    Key Three: Figure out 2–3 “anchor” events for the weekend

    Otherwise, it can become a bit of a haze and on Monday you find yourself thinking “where did the weekend go?”. So, plan some stuff! It doesn’t have to be anything out-of-this-world, just something that you can look forward to in advance and remember afterwards. It could be a meal out with your family, or a session doing some gardening, or a romantic night in with your partner. Whatever makes your life “living” and not passing you by!

    Key Four: Tackle the toughest work first

    You’ve probably heard about “swallowing frogs”. If not, there are various versions, usually attributed to Mark Twain.

    Here’s one:

    “If it’s your job to eat a frog, it’s best to do it first thing in the morning. And if it’s your job to eat two frogs, it’s best to eat the biggest one first.”

    Top Productivity App “ToDoist” has an option for this, by the way!

    ToDoist.com/productivity-methods/eat-the-frog

    ToDoist

    Laura’s key advice here is: get the hard stuff done now! Before you get distracted or tired and postpone it to tomorrow (and then lather rinse repeat, so it never gets done)

    10almonds Tip:

    “But what if something’s really important but not as pressing as some less important, but more urgent tasks?”

    Simple!

    Set a timer (we love the Pomodoro method, by the way) and do one burst of the important-but-not-urgent task first. Then you can get to the more urgent stuff.

    Repeat each day until the important-but-not-urgent task is done!

    The 10almonds Team

    Key Five: Use bits of time well

    If, like many of us, you’ve a neverending “to read” list, use the 5–10 minute breaks that get enforced upon us periodically through the day!

    • Use those few minutes before a meeting/phonecall!
    • Use the time you spend waiting for public transport or riding on it!
    • Use the time you spent waiting for a family member to finish doing a thing!

    All those 5–10 minute bits soon add up… You might as well spend that time reading something you know will add value to your life, rather than browsing social media, for example.

    Key Six: Make very short daily to-do lists

    By “short”, Laura considers this “under 10 items”. Do this as the last part of your working day, ready for tomorrow. Not at bedtime! Bedtime is for winding down, not winding up

    Key Seven: Have a bedtime

    Laura shoots for 10:30pm, but whatever works for you and your morning responsibilities. Your morning responsibilities aren’t tied to a specific time? Lucky you, but try to keep a bedtime anyway. Otherwise, your daily rhythm can end up sliding around the clock, especially if you work from home!

    Want more from Laura Vanderkam? Start Here!

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  • Cherries vs Cranberries – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing cherries to cranberries, we picked the cherries.

    Why?

    In terms of macros, cherries have a little more protein (but it’s not much) while cranberries have a little more fiber. Despite this, cherries have the lower glycemic index—about half that of cranberries.

    In the category of vitamins, cherries have a lot more of vitamins A, B1, B2, B3, B9, and a little more choline, while cranberries have more of vitamins B5, B6, C, E, and K. A modest win for cherries here.

    When it comes to minerals, things are more divided: cherries have more calcium, copper, iron, magnesium, phosphorus, potassium, and zinc, while cranberries have more manganese. An easy win for cherries here.

    This all adds up to a total win for cherries, but both of these fruits are great and both have their own beneficial properties (see our main features below!)

    Want to learn more?

    You might like to read:

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  • Why do some young people use Xanax recreationally? What are the risks?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Anecdotal reports from some professionals have prompted concerns about young people using prescription benzodiazepines such as Xanax for recreational use.

    Border force detections of these drugs have almost doubled in the past five years, further fuelling the worry.

    So why do young people use them, and how do the harms differ to those used as prescribed by a doctor?

    Dragana Gordic/Shutterstock

    What are benzodiazepines?

    You might know this large group of drugs by their trade names. Valium (diazepam), Xanax (alprazolam), Normison (temazepam) and Rohypnol (flunitrazepam) are just a few examples. Sometimes they’re referred to as minor tranquillisers or, colloquially, as “benzos”.

    They increase the neurotransmitter gamma aminobutyric acid (GABA). GABA reduces activity in the brain, producing feelings of relaxation and sedation.

    Unwanted side effects include drowsiness, dizziness and problems with coordination.

    Benzodiazepines used to be widely prescribed for long-term management of anxiety and insomnia. They are still prescribed for these conditions, but less commonly, and are also sometimes used as part of the treatment for cancer, epilepsy and alcohol withdrawal.

    Long-term use can lead to tolerance: when the effect wears off over time. So you need to use more over time to get the same effect. This can lead to dependence: when your body becomes reliant on the drug. There is a very high risk of dependence with these drugs.

    When you stop taking benzodiazepines, you may experience withdrawal symptoms. For those who are dependent, the withdrawal can be long and difficult, lasting for several months or more.

    So now they are only recommended for a few weeks at most for specific short-term conditions.

    How do people get them? And how does it make them feel?

    Benzodiazepines for non-medical use are typically either diverted from legitimate prescriptions or purchased from illicit drug markets including online.

    Some illegally obtained benzodiazepines look like prescription medicines but are counterfeit pills that may contain fentanyl, nitazenes (both synthetic opioids) or other potent substances which can significantly increase the risk of accidental overdose and death.

    When used recreationally, benzodiazepines are usually taken at higher doses than those typically prescribed, so there are even greater risks.

    The effect young people are looking for in using these drugs is a feeling of profound relaxation, reduced inhibition, euphoria and a feeling of detachment from one’s surroundings. Others use them to enhance social experiences or manage the “comedown” from stimulant drugs like MDMA.

    There are risks associated with using at these levels, including memory loss, impaired judgement, and risky behaviour, like unsafe sex or driving.

    Some people report doing things they would not normally do when affected by high doses of benzodiazepines. There are cases of people committing crimes they can’t remember.

    When taken at higher doses or combined with other depressant drugs such as alcohol or opioids, they can also cause respiratory depression, which prevents your lungs from getting enough oxygen. In extreme cases, it can lead to unconsciousness and even death.

    Using a high dose also increases risk of tolerance and dependence.

    Is recreational use growing?

    The data we have about non-prescribed benzodiazepine use among young people is patchy and difficult to interpret.

    The National Drug Strategy Household Survey 2022–23 estimates around 0.5% of 14 to 17 year olds and and 3% of 18 to 24 year olds have used a benzodiazepine for non medical purposes at least once in the past year.

    The Australian Secondary Schools Survey 2022–23 reports that 11% of secondary school students they surveyed had used benzodiazepines in the past year. However they note this figure may include a sizeable proportion of students who have been prescribed benzodiazepines but have inadvertently reported using them recreationally.

    In both surveys, use has remained fairly stable for the past two decades. So only a small percentage of young people have used benzodiazepines without a prescription and it doesn’t seem to be increasing significantly.

    Reports of more young people using benzodiazepines recreationally might just reflect greater comfort among young people in talking about drugs and drug problems, which is a positive thing.

    Prescribing of benzodiazepines to adolescents or young adults has also declined since 2012.

    What can you do to reduce the risks?

    To reduce the risk of problems, including dependence, benzodiazepines should be used for the shortest duration possible at the lowest effective dose.

    Benzodiazepines should not be taken with other medicines without speaking to a doctor or pharmacist.

    You should not drink alcohol or take illicit drugs at the same time as using benzodiazepines.

    Person takes Xanax out of pack
    Benzodiazepines shouldn’t be taken with other medicines, without the go-ahead from your doctor or pharmacist. Cloudy Design/Shutterstock

    Counterfeit benzodiazepines are increasingly being detected in the community. They are more dangerous than pharmaceutical benzodiazepines because there is no quality control and they may contain unexpected and dangerous substances.

    Drug checking services can help people identify what is in substances they intend to take. It also gives them an opportunity to speak to a health professional before they use. People often discard their drugs after they find out what they contain and speak to someone about drug harms.

    If people are using benzodiazepines without a prescription to self manage stress, anxiety or insomnia, this may indicate a more serious underlying condition. Psychological therapies such as cognitive behaviour therapy, including mindfulness-based approaches, are very effective in addressing these symptoms and are more effective long term solutions.

    Lifestyle modifications – such as improving exercise, diet and sleep – can also be helpful.

    There are also other medications with a much lower risk of dependence that can be used to treat anxiety and insomnia.

    If you or someone you know needs help with benzodiazepine use, Reconnexions can help. It’s a counselling and support service for people who use benzodiazepines.

    Alternatively, CounsellingOnline is a good place to get information and referral for treatment of benzodiazepine dependence. Or speak to your GP. The Sleep Health Foundation has some great resources if you are having trouble with sleep.

    Nicole Lee, Adjunct Professor at the National Drug Research Institute (Melbourne based), Curtin University and Suzanne Nielsen, Professor and Deputy Director, Monash Addiction Research Centre, Monash University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • The Squat Bible – by Dr. Aaron Horschig

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    You probably know the following three things about squats:

    1. Squatting is great for the health in many ways
    2. There are many different ways to squat
    3. Not all of them are correct, and some may even do harm

    Dr. Aaron Horschig makes the case for squats being a movement first, and an exercise second. To this end, he takes us on a joint-by-joint tour of the anatomy of squatting, so that we get it right from top to toe.

    Or rather: from toe to top, since he starts with the best foundation.

    What this means is that if you’ve struggled to squat because you find some discomfort in your ankles, or a weakness in the knees, or you can’t get your back quite right, Dr. Horschig will have a fix for you. He also takes a realistic look about how people’s anatomy varies from person to person, and what differences this makes to how we each should best squat.

    The explanations are clear and so are the pictures—we recommend getting the color print edition (linked), as the image quality is better than the black and white and/or Kindle edition.

    Bottom-line: squats are one of the single best exercises we can do for our health—but we can miss out on benefits (or even do ourselves harm) if we don’t do them well. This book is a comprehensive reference resource for making sure we get the most out of our squatting ability.

    Click here to check out The Squat Bible, and master this all-important movement!

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