Vagina Dentata

I’m quite ashamed to admit that I’ve been duped by complimentary and alternative medicine (CAM). A long while ago I mentioned to my general practitioner (GP) that I suffered from breast tenderness, or mild mastalgia, just prior and during my period (i.e. cyclical mastalgia). She suggested I try Evening Primrose Oil as that should help.

I thought fair enough and sauntered off to Boots to buy a jar. As it turns out, I’ve never actually got round to trying it. Then recently, with all of the hullabaloo around homeopathy, I decided to look up Evening Primrose Oil (EPO) on PubMed to find this:

Evidence-based management of Mastalgia: a meta-analysis of randomised trials

Which states:

“EPO did not offer any advantage over placebo in pain relief”

Now this pissed me off lots and lots. I had believed that my medically trained GP would suggest something that was evidence-based and had not done so because either a) she was unaware of the current evidence and/or was one of these CAM-peddling NHS doctors or b) she was trying to placebo my ass. Both of which are troubling.

Firstly, if it was because she was unaware/a CAM peddler then this undermines my trust in the medical opinion of NHS doctors (and none of this “but she was only a GP”). Not everyone is going to check their medical advice online or if they do they are more likely to come across pseudoscience and quackery than know where to look for a systematic review. We can’t check everything all the time and so generally we rely on the expertise of those we assume will have more knowledge than us.

Obviously this was a very minor aliment for me and so I didn’t check. Most people on finding out that they have a serious illness do and should investigate it as much as possible.

But secondly, if she was trying to palm me off with a placebo then I’m fucking livid. There is over-prescribing in certain areas of general practice because people go expecting an intervention for their health problem. I, however, didn’t want an intervention and mentioned the jublies pain as an aside.

If she knew that EPO only acted as a placebo not telling me has left me feeling stupid and lied to. If I had had all the information at the time I would have made a different decision on the basis that the tit ache isn’t that bad, just a mild annoyance, and chocolate is my preferred placebo.

This of course links nicely to homeopathy; if it is simply a placebo then doesn’t the positive outcome justify the means? The placebo effect is real and therefore if homeopathy works solely as a placebo can’t it still ‘help’?

The significance is displayed in my outrage at finding out that EPO has no evidence-base for treating bap pain. I felt stupid and disempowered. I had been made an unwilling victim of marketing over substance. And this is what is wrong about homeopathy; its marketing and spin masquerading as authoritative medical knowledge. It dupes individuals into thinking they are taking control of their own health when in fact they are not being given access to the full facts.

If you want to know what my GP should have done, here’s a handy guideline flow-chart from NHS Lothian (*cough* her Health Board).

For people with ouchy knockers there’s some helpful guidance here and here.

I guest blogged at Bright Green over the weekend, whoop here it is:

On Saturday at 10.23am hundreds of people across the country opened a small vial of pills and swallow them all. There was a group of 42 of these people in Edinburgh (video), but no emergency services were called and no deaths or complications were reported. This was because it was a mass overdose of homeopathic remedies.

The ‘Swallowers’, as they are delicately calling themselves, are conducting this stunt as part of the 10:23 campaign (hence the timing) which seeks to raise awareness about the case against homeopathy and those who supply it.

As one of the organisers of the London event, Carmen D’Cruz put it:

“The public have the right to know what we put into our bodies. “Freedom of choice” is not possible without the ability to make an informed decision. A large part of this campaign is to raise public awareness of what homeopathy actually is. Once people understand both sides of an argument, they are better able to make a real choice.”

Homeopathy was invented by Samuel Hahnemann, a German physician, in the late 18th century. It is based on the principle that “like cures like”, but significantly, that a substance taken in small amounts will cure the same symptoms it would cause if taken in large amounts. And when I say small amounts …

Homeopathic remedies are usually diluted to a factor of 30c, that is:

1:1000000000000000000000000000000000000000000000000000000000000.

Or to give you some idea of what that represents; imagine a sphere of water with a diameter from the Earth to the Sun (a distance that takes light, yes light, about 8 minutes to travel), then imagine one single molecule of that sphere is an active ingredient of the substance that is supposed to cure you. Remember, it isn’t a drop; it’s a single molecule. THAT is what 30c looks like.

Homeopaths claim that this works because water “has a memory” which preserves the active ingredient through the dilutions due to a special shaking. After each dilution the mixture is vigorously agitated in a machine that delivers a calibrated amount of shaking (That last sentence was a direct quote from the Society of Homeopaths website, just in case anyone thinks I’m trying to make them sound stupid. I mean actively trying to make them sound stupid).

Many scientists say that the only possible impact of such remedies is as a placebo.

Therefore, there was no need to perform mouth-to-mouth on any Swallowers. But what are the implications? Raise awareness yes, but should these remedies be provided on the NHS? Should commercial businesses be able to sell them?

This is the second aim of the 10:23 campaign, targeting outlets such as Boots. As D’Cruz explains: “It’s a bit unethical for Boots to sell these pills in their medicine section whilst admitting they don’t work. They’re a trusted company. Why are they lying to their customers (or at least being ambiguous with the truth)?”

Many who wouldn’t go so far as to defend the “science” of homeopathy will at least espouse the positive effects of placebo. And indeed the effects of placebo are amazing and well documented. But should we market a product that we know is a placebo with a mythology of how it works? I would argue that this kind of marketing has a corrosive effect on the public’s understanding of science and medicine. Rather than empowering the patient, it dupes them in the time-honoured tradition of the snake-oils salesmen.

But this stunt has got some people’s backs up. “My inbox is full to the brim with people from all over telling me how much they enjoyed taking part,” says D’Cruz, “with only two people contacting me who were against what we were trying to do.”

“One of them was actually really lovely, and seemed glad that I’d replied in a sensible way (I suggested a couple of books she might find interesting to see things from my point of view if I wasn’t being articulate enough: Trick or Treatment and Bad Science). The other said I was an attention seeker and that I should be arrested. I’m pretty sure that was my mum. She’s got a really good sense of humour.”

To those who have taken homeopathic remedies and believe that they cured them, it is scientifically more likely that you experienced the placebo effect (you got better because you thought you were going to get better) or regression to the mean (you were going to get better anyway, like with a cold).

Now let’s not talk down the placebo effect, it is a truly amazing phenomenon. People have even got better with placebo surgery. It doesn’t mean that you were previously faking it; believing an intervention will make you better can really can make you better (listen to Dr Ben Goldacre’s two part radio programme on the placebo effect).

We can and should harness the power of the placebo effect without misleading people. And we should be just as uneasy with the aggressive marketing of the billion dollar homeopathy industry as we are of the (albeit bigger) billion pharmaceutical industry.

Links:
More on the overdose in Edinburgh
Follow 10:23 tweets: #1023

And a historical look at Apple vs Feminine Hygiene (boak) marketing. Hmmmm.

Via Society for Menstrual Cycle Research.

I’ve been away from blogging for a while, so now I’ve got time I thought I’d better catch up with the goings on in the media reporting of science stories about gender. I looked first to the Daily Mail but I had to back away slowly as it has now become obvious that this paper is beyond satire: ‘Killers in your kitchen: Gender-bending packaging, exploding floor cleaners and toasters more deadly than sharks…‘

I don’t know where to even begin with this story as it is so chocka block with the most ridiculous statements I have ever read that it has rendered me speechless (for the time being). I will come back to the plastic packaging turning boys into girls soon as that little gem has been doing the rounds for a while and is, guess what, shite.

So I turned instead to our old friend, the Daily Telegraph who confidently tells us: ‘Married women ‘4lbs heavier than unmarried counterparts” and for good measure, includes the subheading: ‘Women really do let themselves go when they get married according to a new study which found that they are 4lbs heavier than their unmarried counterparts.’

Now, the Daily Telegraph have a rich history of ensuring that their headlines and subheadings have only a tangential bearing on the facts within the story, as demonstrated well in this previous article on rape. And they don’t let us down here.

This article is based on a paper; ‘Effects of Having a Baby on Weight Gain‘, published in the American Journal of Preventive Medicine. The purpose of the research was to see how much weight gain within a cohort of women was attributable to having a baby or to other factors.

Spot the difference between that and the headline?

The article goes on to explain some of the possible reasons why women who live with a partner and have a baby are heavier than those that don’t which include “eating unhealthier food because of their partner” and having less time for exercise.

So not ‘letting themselves go’ then? And actually one of the reasons points to both of the partners eating unhealthily. But no, of course it is much easier to tap into the stereotypical myth of people ‘going to seed’ after getting married. In this instance it’s women only bothering to keep thin till they get a man then stuffing their cake-holes with, er, cakes. They are therefore tricking men into marrying them then ballooning up to 4lbs heavier.

Why does the Daily Telegraph stop there, why don’t they just go the full Burt Bacharach?

I’ve been reading a lot recently about the new book from Barbara Ehrenreich, Smile Or Die: How Positive Thinking Fooled America And The World, and it looks fascinating. I first have to admit to not reading it yet – it’s published in the UK at the end of the week and on pre-order. But the extracts I’ve read have been interesting, disturbing and depressing in equal measure. I’ll do my first book review as soon as I’ve got through it. But here are a couple of my initial thoughts about some of the issues Ehrenreich raises.

Firstly, I’m genuinely very interested in her views on chemotherapy and the science and medicine behind the development of breast cancer treatment. Its not my area of expertise, but I’ll follow up on her sources from the book. If any readers know more please link to studies in the comments. But in summary, here is Ehrenreich talking about her book and why if she ‘had her time again’ she wouldn’t go through chemotherapy:

Plus, she believes (probably rightly) that it was the HRT that she was on that ‘caused’ or increased her risk of getting breast cancer. Certainly, there is increasing evidence for a link between HRT and breast cancer.

The two things that really struck me from the extract from her book in the Guardian was a) the devaluing of negativity and b) the particular reliance on a narrow definition of ‘ultrafemininity’ in breast cancer campaigning.

Ehrenreich’s whole book is about how alienating and divisive the positive-wash that cancer is given can be, how she was encouraged to view her cancer as an ‘opportunity’ or even ‘gift’ and how her anger and frustration were often scorned by others. This kind of approach is something that pisses me off on a far less extreme or important level than Ehrenreich – but I think is part of an approach within Western cultures to gloss over the shite in life.

I agree we shouldn’t wallow in negativity and if we focus on all the bad things in life we become insular, boring Emos, or worse, Goths. But sometimes we need to call a spade a fucking useless piece of shit shovel. Sometimes negativity is a good thing, a real emotion, actually brings perspective to what is positive and denying the steaming piles of turd in life can be hugely damaging.

Ehrenreich points to a few studies in the Guardian column*:

• Emotional well-being does not predict survival in head and neck cancer patients: a Radiation Therapy Oncology Group study. Cancer. 2007 Dec 1;110(11):2568-75.
• Guardian article links to Discover article on the study: Hope may be useless against cancer.
• Tomich, P. L., & Helgeson, V. S.  (2004).  Is finding something good in the bad always good?  Benefit finding among women with breast cancer.  Health Psychology, 23, 16-23. Summary here.
• Optimism and survival in lung carcinoma patients, Cancer. 2004 Mar 15; 100(6): 1276-82.
• Guardian article links to Medical News Today article: A positive attitude does not help cancer outcome.

* See some writers can link to primary sources!!

These studies show that at best “positive thinking” does not affect cancer survival but at worse that it can lead to the “tyranny of positive thinking” which can conceal distress and leave patients feeling worse. So if you’ve got cancer – its alright to feel shit, angry and frustrated. That doesn’t mean you’re allowed to be a full-time arsehole but you can let rip once and while.

The second point that I found striking was the specific type of femininity attached to breast cancer and breast cancer awareness/campaigning and again I don’t think this is a wholly positive thing. Breast cancer campaigning has been incredibly successful, has turned around society’s perception of what was once a hidden and shameful disease and with that has raised phenomenal amounts of money for breast cancer research. But, as Ehrenreich points out, this has been inextricably linked to stereotype of ultrafemininity which is pink, fluffy, appearance-focussed and somewhat reductive of womanhood to boobies.

Possibly the worst example of this, which I have linked to before, is this breast cancer awareness advert for a ‘BoobiBall’ fundraiser:

Breast cancer awareness tends to promote the notion that women are and indeed should be obsessed with their appearance and that the loss of a or both breasts is the worst possible thing that could happen to a woman. Not to mention the hair loss, weight gain or loss, effect on skin etc.

Now there is no doubt that hair loss and mammectomy hugely affect a number of women with cancer and alter their sense of identity or femininity. My concern would be that this emphasis on the femininity of those going through cancer treatment may exacerbate this impact. Ehrenreich talks about the breast cancer marketplace with the prominence of cosmetics and jewellery and websites that talk about chemotherapy helping you to lose weight and smooth out the skin.

What is significant here is that this same femininity is not associated with lung cancer or heart disease – both huge killers of women as well as men. It is associated with uniquely female breasts** and therefore with women’s bodies being the be-all and end-all of their identity.

** I’d be fascinated to know how men with breast cancer relate to breast cancer campaigning.

Breast cancer is seen not only as a disease attacking part of the body but attacking a woman’s identity because women’s identity is so dominated by their physical appearance and attractiveness (with a special focus on breasts). Unfortunately, as with many things, this focus on ultrafemininity is couched in feminist empowerment language and indeed, in America at least, feminism seems to have been replaced by a breast cancer cult.

Maybe less of a focus on how a woman looks during treatment for a life threatening disease is the least we can offer them?

OK, I’ve been away from blogging a bit recently as work has been kicking my ass, then Christmas happened (who knew?) and then I was struck down with a dreaded lurgy (which you would have known if you’re following me live tweeting my snot).

However, I’m back and it’s the future! Personally, 2009 was a bit of a shitter but 2010 is already looking better for the following reasons.

Firstly, I recommend you listen to the fabulous podcast The Pod Delusion, not only because it is a fellow guest blogger/Podder on the Lay Scientist, but because it named me No.2 Best blogs of 2009 thanks to the infatigable Crispian Jago.

Secondly, watch out for me guest blogging elsewhere this year and giving some talks around UK-shire…more on this when all is confirmed.

And lastly a quick plug for Skeptics in the Pub London and Westminster. Do come along if you’re in London I’m often found propping up the bar PLUS the next gigs feature the wonderful Kat Akingbade (London – remember to book here) and Dr Petra Boynton (Westminster). Look women are taking over – hurrah!

Rather than the usual feminist rant, I bring to you important news of a story about the Guardian and the BBC being sued by oil-traders, Trafigura. The BBC’s story has mysteriously disappeared from their website. But here it is here (pdf).

Here’s all the background on the story you need at Don’t Get Fooled Again, here’s some Wikileaks stuff on this case. And here’s the BBC report about the travesty:

Please take part in this mass blog posting to ensure that human rights abuses continue to be reported and we get some reform of our shitty libel laws in the UK. So while you’re at it, take a look at the Libel Reform Campaign.

And you North Americans – don’t you think you’re immune from our libel laws (although you are doing pretty well at ensure our libel judgments cannot be enforced in the US, hat-tip)

And for any lawyers out there; the title of this blog is three separate fragments.

I have written before about my disdain for a lot of the pop psychology reported in the press *cough Oliver James*. I am sure that this does not represent a lot of the real research that goes on within the discipline but there does seem to be some fundamental problems within psychology that a few academics are finally shining a light on.

These fundamental problems include the lack of empiricism within the discipline (OK, fancy way of saying you’re making it up) which then feeds into implicit universal assumptions about human behaviour.

The problem with the lack of empiricism in psychology has been approached by Boon and Gozna in an article in The Psychologist which is a broad take on the subject and compares the disciple to other sciences.

But I was also struck by how much psychological research is based on WEIRD subjects.

And by weird, I mean Western, Educated, Industrialised, Rich and Democratic (WEIRD). A fairly recent paper in Behavioural and Brain Sciences (pdf) looked at how behavioural scientists routinely publish broad claims about human behaviour and psychology based entirely on people called Dave and Sarah who live in places like Tufnell Park and Happy Harbor (OK, that one’s where the Justice League hang out) and then assume that they are “standard subjects”*.

*These assumptions are not always made explicit but are often implicitly implied in the article headings and are certainly routinely translated into universal truths by the mainstream media.

The paper compares datasets from different populations and finds that not only is there variation but that WEIRD subjects are also particularly unusual compared to the rest of the species and are frequent outliers.

This has huge implications for the bad science reporting on gender and race.

To be fair I do think the public have a responsibility to think for themselves once in a while and ask themselves one simple question when confronted with a headline such as “Shopping styles of men and women all down to evolution, claim scientists” (don’t worry I’m coming back to this little corker later) and that question should be:

“Is it likely that this is true for all or half of the world’s population?”

It’s a simple question, not that taxing. But if it seems abstract then lets break it down into manageable bite-size chunks:

a) Is this likely to be true for all** females/males that I know?

b) Is it likely to be true for all** females/males in this country regardless of age, ethnicity, education, intelligence, disability status, social class or background?

c) Is it likely to be true for all** females/males in all nations, cultures, environments, and geo-political regions regardless of age, ethnicity, education, intelligence, disability status, social class or background?

**I’ll even allow for a statistically significant majority here.

If your answer to these questions is ‘Yes, [X] is likely to be true for half the world’s population’ then I’m afraid you lack of the facility of rational thought. I suggest you become a homeopath.

Some interesting points from the Henrich, Heine & Norenzayan paper:

• A recent analysis of the top journals in six sub-disciplines of Psychology from 2003-2007 revealed that 68% of subjects came from the US, and 96% of subjects were from Western industrialised countries, specifically North America, Europe, Australia, and Israel (Arnett, 2008) reflecting the academics country of residence.
• This means that 96% of psychological samples come from countries with only 12% of the world’s population.
• And a randomly selected American undergraduate is more than 4000 times more likely to be a research participant than is a randomly selected person from outside of the West.

I was particularly interested in the section on spatial cognition because I mostly use my catchphrase ‘Oh, fuck off’, when reading about women not being able to read maps. The authors point to the variation in linguistic tools between societies:

Human societies vary in their linguistic tools for, and cultural practices associated with, representing and communicating (1) directions in physical space, (2) the color spectrum, and (3) integer amounts. There is some evidence that each of these differences in cultural content may influence some aspects of nonlinguistic cognitive processes (D’Andrade, 1995; Gordon, 2005; Kay, 2005; Levinson, 2003; Roberson, Davies, & Davidoff, 2000). Here we focus on spatial cognition, for which the evidence is most provocative. As above, it appears that industrialized societies are at the extreme end of the continuum in spatial cognition. Human populations show differences in how they think about spatial orientation and deal with directions, and these differences may be influenced by linguistically-based spatial reference systems.

So spatial cognition may be influenced by linguistic tools, or indeed may be influenced by other factors, but the fact that our research is using such a narrow and biased sample, the conclusions can at best be highly contextualised and at worst hugely flawed.

So if you come across an article saying women can’t read maps because of humans’ hunter-gatherer past (because of course it is always, always because of our hunter-gatherer past), it might be worth considering that other human populations don’t actually use A-Zs or EVEN Googlemaps and indeed wouldn’t describe directions in the same way as those in industrialised societies. So its unlikely that women, half the world’s population, are teh stupids and get themselves all in a tizzy when they have to get themselves somewhere.

I won’t go into the whole article, but it is fascinating so do check it out unfortunately some of their key references are behind a paywall. Grrrr.

OK, I’m quite late on this one as work has been hellish recently. But here’s the news we’ve all be waiting for – female Viagra has been invented. According to The Sun, it makes ‘girls’ sex drive soar’ (or airbrushed to oblivion it seems). This claim and Flibanserin have been well torn apart by Dr Petra and Neuroskeptic.

In sum, this was a preapproved drug being aggressively marketed for a likely manufactured ‘disorder’, and may be no better than a couple of glasses of wine.

There is of course a problem with the over-medicalisation of social problems, mental health or indeed just life, but female sexual dysfunction taps in to our historical beliefs about female sexuality. Whether nymphomaniacs or laced up prudes, women’s sexuality has been portrayed as a mysterious morass of hormones, guilt and secrecy.

What I also find disturbing is the appropriation of feminist language to sell these products; women deserve to have orgasms and this pill with help reap the rewards of the sexual revolution. This is of course a tried and tested method employed to sell anything from electro-shock Taser weapons to breast augmentation. To criticise these products, these grisly chunks in the vomit of capitalism, is to be anti-women or anti-choice.

Of course what these products do is actually limit choice by their very nature. By framing some women’s lack of sexual desire as ‘something that’s wrong with her head’ means that all the other potential factors – something wrong in the relationship, unsatisfactory sexual partner, stress and anxiety, unfulfilled sexual desires, it being temporary and just one of those things – are not being considered or addressed.

The flip side of ‘women not wanting sex’ is men wanting it all the time. This includes the myth that men think about sex every 7 seconds (tackled here with a number of other bogus stats), but can translate into the far more sinister ‘some women asked to be raped because men just can’t help themselves’.

A simplistic and historically-rooted view of male and female sexuality can at best be misleading and unhelpful and at worst can legitimise sexual violence or abusive behaviours.

So if you’re lacking sexual desire, chill out, have a glass of wine and think about it for a bit, considering what factors might be feeding the problem. Or maybe talk to someone; ideally someone who won’t financially benefit from selling you a pill.

The Earth has a filthy mind

One of the best things about blogging is obviously the people you get to meet but also the ‘interesting’ things that people start emailing/tweeting you about. And with a blog with the word ‘vagina’ in the title, my electronic gifts seem to be more interesting than most.

Now, I don’t usually allow ads on my blog (other than for other blogs obviously) but I do want to draw people’s attention to the wide variety of vajayjay-themed products you can get.

I don’t mean the hideousness that is ‘feminine hygiene’ products. I mean those gifts and crafts that celebrate, jubilate and honour the minge.

Call them gash goodies, poonanie presents, labia largesse, growler gratuity, beaver bounty, ok…I’ll stop.

The International Vulva Knitting Circle

Vulva knitting is big. I think this is because knitting has come back in a big way recently and as a way to redefine this for a new generation we have done it subversively. The International Vulva Knitting Circle was started as a way to bring grassroots activism to challenge female genital cosmetic surgery and the commercialisation of women’s bodies and sexuality more broadly. This is about using knitting to politicise young women about their sexuality – “the radicalism of making female genitalia visible”. Hurrah.

There is also a Facebook group.

Vulva Portrait Pendants

Thank you the commenter who first linked to this. These are custom-made vulva necklaces. You send in a picture of your (or your loved one’s) front bottom and the artist makes a pendant that resembles it. My favourite bit of the ad says that if you are too shy to send in a picture, you can describe it. I’d love to meet the person too shy to send in a picture of their fanny-foo-far but not so shy that they would wear it as a pendant round their neck.

All things Yoni

As the title suggests, everything you’d ever want (and some things you wouldn’t) gash-themed is here. Yoni is Sanskrit for ’sacred temple’ and also translates as vagina. I also like the word because it rhymes with my nickname. Coincidence or cosmic connection? Er, coincidence.

The Velvet Vulva

These are beef-curtain shaped bags and purses which are very much associated with the witch-goddess-earth-power type schtick (“radiating feminine energy” yadda yadda). However, anyone who describes their fanny purses are “portals to the feminine temple” deserves my support. I’d recommend the Big Capacity Bags and the vulva hat which I presume gives you that ‘being born’ look.

Best quote: “Indeed, the labia can be reshaped when damp, but not blown dry.”   This is a lesson for life people.

The Cunt Coloring Book

I actually really want this for Christmas. OK, if you’re old enough to colour this in, you’re probably too old to be colouring-in. But sometimes its good to have something to doodle with when on the phone or in work meetings.

I Heart Guts – Uterus

Great shop for all your gut-themed needs. You can also get plush diseases at Giant Microbes so that you can combine a plushy minge with the clap, frinstance.

The uterus is also the third bestseller behind the heart and kidney.

A couple of things that I notice from these: there definitely is a trend for the celebration of the vagina in defiance of the accusations of being religiously unclean. But also that this is mostly emanating from the US/North America. Are we slow to pick up on this in Europe or is it just not that much of a statement here?