Medical news roundup

The FDA mulls a return to the hormone-heavy birth control pills of yore. Plus: Women's plasma is no good for transfusions!

By Catherine Price
Published January 24, 2007 12:16AM (EST)

For your edification and general wellness, here are a few women-related health issues that are out on the wires this week.

First off, an article from the Associated Press reporting that "the plasma transfused into victims of burns, car crashes and other serious conditions soon will come almost completely from men."

Why? Because apparently women's plasma occasionally contains antibodies that (even more occasionally) lead to a lung injury that's now the leading risk from transfusions in the United States. It's a reaction called TRALI -- "transfusion-related acute lung injury" -- that causes victims' lungs to fill with fluid after they receive a transfusion.

TRALI's exact causes are unclear, but it seems that some women who've been pregnant carry immune cells that their bodies created as a defense against the cells from the fetus' father. These antibodies don't do anything to the women themselves, but if their plasma is transfused into a patient who -- for reasons also not entirely understood -- is particularly susceptible, the antibodies can trigger TRALI.

A few clarifications: This development does not mean that women shouldn't donate blood, or that their plasma won't be used at all. Rather, blood banks need more donations -- from both men and women -- and while the majority of women's plasma might not be used in direct transfusions (because of supply problems, some will have to be), women's plasma can still be used in drug manufacturing.

A smaller number of antibodies also exist in platelets, but since those are in such short supply, there's no way to exclude women's.

If women's plasma were to be excluded, the result wouldn't be numerically dramatic -- the medical director of BloodSource estimates that approximately 150 cases of TRALI, and 15 TRALI-related deaths, would be prevented each year. And according to the AP, blood banks are looking for other solutions, like easy screening tests for the antibodies.

But if nothing else, TRALI emphasizes the need to further investigate the physiological differences between men and women, since apparently those differences can have consequences for both genders.

Following on that theme, here's an article from Canada's CanWest News Service about a study suggesting that cholesterol-lowering drugs (statins), taken preventatively, do not benefit healthy women in the same way that they do men. To quote from the piece, "In a brief article published in the most recent issue of the journal The Lancet, Dr. Wright and co-author Dr. John Abramson of Harvard Medical School pooled data from eight randomized trials comparing statins with a placebo in people at increased risk of cardiovascular disease. The statins did not reduce total deaths. And, when they looked at women alone, they found no benefit."

And finally, this from the AP: The FDA is considering new standards for birth control drugs. The issue at hand is apparently that the current selection of birth control pills -- which have lower doses of hormones than their predecessors -- have a slightly higher risk of unintended pregnancies.

OK, fair enough -- I guess the main point of taking the pill is not to get pregnant. But if you weigh the options, the FDA's choice of emphasis seems a bit questionable. Earlier pills had a failure rate of about one unintended pregnancy per 100 women taking the Pill for at least a year, according to the article. These newer, lower-hormone pills have a pregnancy rate of about two in 100. Sure, that is technically a 100 percent increase in failure rate. But when you look at the actual numbers, the difference between one and two failures per 100 women per year seems pretty minimal, given the original reasons for lowering hormone doses -- earlier versions of the Pill were linked to blood clots and cardiovascular problems.

Readers should weigh in, but personally, I'd rather risk that failure rate and have a lower chance of blood clots and problems with my heart. I imagine that those women who take birth control pills for reasons other than contraception (for example, as a Type 1 diabetic, taking the Pill helps me regulate my blood sugar) would also prefer the lower-dose option. Here's hoping the FDA's panel of experts agrees -- or, better yet, helps to develop a pill that has the best of both.


Catherine Price

Catherine Price is an award-winning journalist and author of Vitamania: How Vitamins Revolutionized the Way We Think About Food. Her written and multimedia work has appeared in publications including The Best American Science Writing, The New York Times, Popular Science, O: The Oprah Magazine, the Los Angeles Times, The San Francisco Chronicle, The Washington Post Magazine, Salon, Slate, Men’s Journal, Mother Jones, PARADE, Health Magazine, and Outside. Price lives in Philadelphia.

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