Unequal medical treatment for women

[AllyCat]

Chatting with my sister yesterday. Her teenage daughter is being treated for acne with Accutane. This drug can cause some birth defects. They have to cut their vacation short to get back to the clinic within 33 days or they are in violation of her “I pledge”. And after she is finished with treatment, she has to go back for monthly pregnancy tests in addition to being on 2 forms of birth control.

Boys being treated have no hoops to jump through.

No one wants to subject babies and families to lifelong complications from taking a teratogenic substance. But this seems like another way women are treated differently because they can bear children.

[dflprincess]

1. That's because Accutane can harm a fetus

there is no evidence that it damages sperm. There really is no reason males would have to jump through any hoops for this.

It could be argued that the doctors should just take the word of the young woman that she'll use birth control but, if a patient doesn't follow through on that, there could be a child who suffers life long problems as a result. Or it could just be the doctor protecting her/himself from a nuisance suit if something went wrong.

There's other inequities in medical care that make more sense to get upset about.

[AllyCat]

2. Of course there are worse things

How about her being on 2 forms of birth control is enough? Why the 33 day rule that hits on winter break and is completely inflexible? And like you said, how about taking her word for it?

[FreeState]

7. Because that's the FDAs standards for treatment

It’s based on research that showed it reduced deformities because people were still getting pregnant: https://www.webmd.com/drug-medication/news/20010817/birth-defects-still-happening-with-accutane

Accutane, also known as isotretinoin, is known to cause birth defects, including brain, heart, and face deformities, if women take it while pregnant. Because of this, it is recommended that women of childbearing age taking the drug be tested for pregnancy before starting it and then repeatedly during their treatment. They should also use two forms of birth control while on the medication.

The manufacturer, drug company Hoffman-LaRoche, started placing warnings about this risk all over Accutane packages in 1988 and even started advertising about these risks in 1996. This effort does not appear to be enough, however, according to two new studies.

[Ms. Toad]

3. Do you think women should be forced to undergo prostate checks

just to make medical care equal?

The reality is that people with uteri can bear children. The particular medication causes birth defects. Anyone with a uterus (female or transman) has the potential to get pregnant (voluntarily or via rape) - so anyone with a uterus who wants to take the medication (for an annoying, but non-fatal, condition) has to comply with requirements designed solely to avoid the known consequence.

There are biological differences between bodies - and some medical care is designed to address those differences.

That said - medical treatment is actually unequal for women. Most drugs are tested on men, not women - so XY/XX - based differences are not apparent until an entire population of women are used as unwitting guinea pigs. Women's concerns are frequently dismissed as hysteria or hypochondria. To the extent more women are overweight than men - complaints are dismissed as caused by weight, even when weight has nothing to do with it. It has taken just short of forever to recognize that women's heart attack symptoms are different than men's. I'm sure there are more.

BUT - this particular treatment is not unequal - it is appropriately controlling for side effects of the medication that are harmful to the next generation in a way that is uniquely tied to having a uterus.

[AllyCat]

4. I do not deny that other treatments are not also unequal

What makes no sense is this number of days rule that puts someone out of compliance with the law. What reason can there be to be on 2 forms of birth control AND still need a pregnancy test every month? At what cost?

[Ms. Toad]

5. Let me introduce you to thalidomide.

https://www.standard.co.uk/lifestyle/books/the-thalidomide-catastrophe-by-martin-johnson-raymond-g-stokes-and-tobias-arndt-review-a3880221.html

No doctor in her right mind would prescribe a drug that is known to cause birth defects without ensuring, to the best of her ability, that there is no possibility of pregnancy.

2 forms of birth control are required because no single form of birth control is 100%.
33 days permits a first trimester abortion in the event both forms of birth control fail.

Acne is not a life-threatening condition - so there is no compelling reason to make it easy to obtain accutane - at the potentially significant (and potentially life-threatening) impact on a fetus.

It's also not so hot for the person taking it to treat accutane:

· depression
· psychosis (see
· suicide.
· increased brain pressure
· tinnitus
· night vision
· diabetes
· high cholesterol
· decreased red & white blood cells

It is the doctor who would be sued by a child born with birth defects, not the parent.

This is not unequal treatment - it is recognizing the potentially catastrophic consequences of allowing a pregnant woman to take accutane, and creating restrictions that permit people of child-bearing age wtih uteri a means to take medication that would otherwise have to be banned. It's a small price to pay to ensure that the person being treated for acne, who can intelligently consent to the risks, is the only one exposed to them.

That said, it looks to me as if the information can be entered electronically from wherever the person taking accutane is, as long as they have internet access.

[TexasBushwhacker]

6. She should have timed her vacation differently n/t