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November 29, 2023



... that is definitely a creative idea with what to do with that information.


KC - well, that’s why we have penicillin, right? If it cured cramps do you think we'd have it?


*sigh* If men, as a group, were truly rational, long-term thinking, and mostly monogamous, in addition to valuing having sex, they'd pour money and time into women's health, since a healthier wife (who is typically in less pain and/or less tired and/or not having hot flashes, etc.) is more interested in sex.

Anyway. Now to look up the history of penicillin...


KC - to be fair, the focus on women's health is so much better than it was before.


It is, but 1. that doesn't take all that much and also 2. there's a heck of a gap to make up and also 3. it's *still* not normal/required to verify appropriate medication dosages for women instead of just men despite it being recognized that there can be significant/harmful differences in appropriate dosage.


KC - I didn't know that women need different dosages. I suppose in an ideal world you would get a dose that was tied to a percentage of your weight, male or female.


Yep! It was "discovered" several years ago that a number of medications work differently in women. (some practicing doctors had realized this and had been adjusting the dosage, I think, and then researchers were informed?) But since the tests for safe/unsafe levels and for optimal dosage had only been done on men and male mice, that hadn't turned up, oops.

Yep, height/weight, and also age should be a factor for some medications. (there actually *are* research gerontologists, and it comes up in their research, some of which I read because while I am not actually that old, some of the weirdest issues I've had have only showed up in gerontology research papers so... yeah. But also they're all talking about obviously this and obviously that and I'm like: how many family practice doctors prescribing things to 80 year olds have *ever heard* these field-settled conclusions that have been there for *ages* but which probably don't even make the cut for what you learn about gerontology for med school?...)

(there are a few things where ethnicity or genetics affect matters [heeey redhead gene and anesthesia], and age is a factor for some things via mechanisms including metabolism [and metabolism is a factor independent of age for some things]. So it's not *just* half the population getting the short end of the stick in terms of consistently not being sampled for routine medications/conditions that both genders experience. But still: yes, it is more slightly more complex to figure out how to avoid confounding factors when you have to consider a menstrual cycle, but also IT MATTERS that an entire gender gets less-appropriate medication levels for literally every medication except things given only to women or only to men?)

That said, I don't know how many administrators and marketers I'd want to strangle if I was told "get the OTC allergy med in the pink bottle, it's better-suited to women and it only has the same markup vs. men's products as women's razors do." So there is that. But still. It'd be nice if there was work to close up some of the gaps, instead of things being declared all done, nothing more to do, nothing to see here, doesn't matter if a lot of medications work more poorly on average for women, it's not significant research...


KC - oh, lord the pink bottle. Next it’ll be the pink pacemaker.


Pink pacemakers would be hilarious, I'll admit.

It'd be really nice, though, if more medications came in more quantity variations. I'm a particularly weird weirdo, so I'm not sure much can be argued from me specifically, but 3 (3!) of my medications have to be chopped, and an additional one has to have two different sizes prescribed so I can take the goldilocks-spot number of milligrams (35 = 10+25) instead of 25 (doesn't have noticeable positive effect) or 50 (has noticeable positive effect but wheeee really dizzy). And then if things came with more options, then maybe patients who are not absolutely bog-standard average medium-height medium-weight medium-age male could fine-tune their dosage more easily in general? (or maybe it'd be too complicated or unsafe for the average person to be allowed to experiment with *this* medication's dosage because then they might experiment with dosages you *really* need to not mess with? I don't know.)

(one of the meds we chop is one that nearly everyone with POTS chops, though, because we're using it for the effects it gives at small doses and specifically *don't want* the effects it gives at normal doses, so I'm not *that* weird for that one. But they still haven't come out with a smaller pill size, even though people have been using it this way for decades; I guess it'd be more expensive if they did, because of the economies of scale, and I don't know what price point would be worth not having to chop the stupid things every week...)(and also the majority of people with POTS are women and thus less-researched, although the people whose Long Covid *is* POTS are swelling the ranks generously, which is going to be great for research but I do not approve of more people being sick, and also the poor POTS specialists have seen their caseloads spike like crazy.)


KC - aren’t there some meds they insist you don't chop because they become less effective? How does that work? Does it destroy the chemical bonds? I’m glad you have the option to chop and get the exactly right result.

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