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Good morning GFPs! Now, first things first: a GFP commented in the community area last week that my links were difficult to see in the post I sent out last week — are these better? And incidentally, thank you to the GFPs who have joined the community so far, I’ve so enjoyed chatting to you! If you’d like to get in on the GFP fun, you know what to do…!
In other news, as well as banning ads for feminist plays, I’m fairly sure that Meta is also throttling any post on their platform that has the temerity to draw attention to their speech-suppressing antics. Witness the difference in viewers between my post about the banned Facebook ad, versus my previous post:
And ok sure, the one on the right is a picture of my face and we all know how much instagram loves a middle-aged face, so let’s look at another recent non-face post…
Hmmmm….is it time for a social media platform that isn’t run by men with paper-thin skins?
The noisy menstrual cycle
This week I was struck by yet another study whose findings show why we might like to actually factor the menstrual cycle into medical research (you know, rather than the classic approach of using its existence as a reason to exclude fifty per cent of the global population from research altogether). This study is another one on how the menstrual cycle might interact with vaccines, but rather than studying how the vaccine might affect the menstrual cycle (previously in this newsletter we have looked at research on how the Covid vaccine might affect the timing/length/heaviness of a woman’s next period), this research considers the effect of the menstrual cycle on the vaccine. And, unsurprisingly given the interaction of the menstrual cycle with the immune system, it turns out that there may indeed be effects, with the “degree of protection” women get from vaccines potentially varying “depending on when in their menstrual cycle they receive them.”
“For too long, the menstrual cycle has been treated as background noise in health research,” says Poppy Cooper at the London School of Hygiene & Tropical Medicine. “This work is part of a growing shift in that thinking and a recognition that the menstrual cycle has impacts beyond reproductive health.”
Amen, sister.
In this study, “Cooper and her colleagues […] analysed data from 1474 women in the US, the UK, Canada and Australia who used the Clue period-tracking app in 2021. These women also self-reported their vaccine outcomes via an in-app survey.”
And they found something rather interesting: of the women who got infected with Covid shortly after receiving their vaccine, women who received their vaccine during the luteal phase of their menstrual cycle (that is, the bit that comes between ovulation and your period, when oestrogen is lower and progesterone is surging) were caught the virus over a month sooner than women who were vaccinated during the follicular phase (the first half of your cycle when oestrogen is high and your latest batch of eggs-to-be are competing to become the chosen one that gets released by the ovaries).
This may be because these hormones affect immune cell responses to vaccines, with a 2022 meta-analysis finding that many immune-related proteins, such as antibodies, are lower in the luteal phase. “Progesterone’s job, biologically, is to prepare the body to tolerate a potential pregnancy,” says Julia Craggs, a doctor who specialises in women’s health. “One way it does that is by turning down some of the more aggressive parts of the immune system, like T cell activity. That isn’t necessarily what you want at the precise moment you are trying to train the immune system to recognise a vaccine antigen [a substance that triggers the immune system to mount a response].”
The findings also made me think of a study I wrote about in Invisible Women, where researchers exposed male and female cells to oestrogen and then exposed them to a virus. The male cells didn’t respond to the oestrogen and they were unable to fight off the virus, but the female cells did respond to the oestrogen and did fight off the virus. I used this study as an example of a) why it matters that most cell stage research is still done in male cells (how many interventions that might work for women have we missed out on because they didn’t work on male cells) and b) why you must always sex disaggregate your data, but it now occurs to me it also perhaps function as an example of c) why you should not (at best) “control” for the menstrual cycle in your research but actually study it! And don’t get me started on the number of trials that require women to be on hormonal contraception to qualify as a trial participant. As Dr Julia Craggs, a doctor specialising in women’s health put it in an interview with New Scientist, “We may be sitting on a significant source of unexplained variation in how women respond to treatment and we have simply never looked in that direction.”
This study is not perfect. It relies on self-reports and it is observational, which means we can’t be definitive either about its findings or about cause and effect. But given no one bothered to collect data in the menstrual cycle in the actual vaccine trials, observational and self-reported is the best we’ve got, which is indeed frustrating. Still, another piece of the puzzle is always welcome, and perhaps one day there will be enough observational puzzle pieces to make enough of a jigsaw that we will actually start to analyse the menstrual cycle by default in medical research! Hey, a woman can dream….
NOTE: I’m also, as you can see, experimenting with trying ads out in this newsletter…we will see how that goes, I’m not expecting it to be a huge money-spinner (it’s one of those per-click things) and I may not do it again…but given I myself pay for email to avoid google scraping and selling my data I felt this one made sense. I personally use fastmail which I’ve been very happy with — I had originally been with hey email but then the founder started harping on about London being a no-go area for white people and I felt that while living in the 21st century inevitably involves certain compromises I do draw the line at giving my money to someone who thinks Tommy Robinson is our saviour. Hence, fastmail. I haven’t tried protonmail, but I’ve heard good things from people who have. It’s run by a Swiss non-profit with “a legal obligation to serve the community” which makes it less likely to be taken over by a Tommy Robinson fanboy — and in general I am pro moving away from Big Silicon Valley tech (I mean Google not hey whose co-founder is Danish, proving that you don’t have to a US-based tech bro to have your brain rotted by Elon Musk) wherever we can (if GFPs are interested I might make an on-going list in the GFP Community area of the alternatives I’ve found to date? Let me know in the comments if this is something you’d like!) and unlike fastmail protonmail has a free service so it’s worth at least giving it a go!
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Another piece of the puzzle
And in fact, we already have some other pieces of the puzzle! Earlier this year, new research published in a journal called Genomic Psychiatry found that not only did a drug affect participants by sex, it was also affected by hormones. And here’s what was particularly interesting about this research: it was on a previously promising-seeming drug for brain degeneration (davunetide) that had been abandoned ten years earlier by the pharmaceutical company that had been developing it, thanks to a late-stage trial that appeared to show davunetide had no effect.
But one of the researchers, Professor Illana Gozes, who I cannot help noticing is a woman, we not happy to let the story end there, and she wondered if sex could be having an effect here. So she analysed the data by sex and found that in fact women did seem to respond to davunetide, while men didn’t. Intriguing, but since the study had not been set up to study sex differences, this was inconclusive. More research was needed.
But first! Professor Gozes decided “to look back at studies that had differences between the sexes in their results,” which any GFP could have told her wouldn’t get her very far, since as we have discussed previously, most research into such conditions is not sex disaggregated. And, indeed, she found that on the whole
“the overall findings were mixed together.”
But still! Professor Gozes persisted, and decided to run a trial using male and female mice, in which not only did they sex disaggregate their data, but they actively tracked where in its estrous cycle each female mouse was. And a clear pattern emerged, one which GFPs may recognise from the previous segment:
During proestrus and estrus, the phases when estrogen runs highest, female mice took up significantly more drug in the head region than males did. […] As the cycle moved into metestrus, when estrogen falls toward its minimum, the difference between the sexes faded toward nothing. The hormone was not incidental. It tracked the drug.
Now, as we all know, while women are not small men, neither are female mice small, furry female humans with a tail. Still, I am sure that GFPs won’t be able to help noting the overlap with the previous segment on the interaction of the menstrual cycle with vaccine efficacy — and in any case, the researchers didn’t stop there, turning to a small earlier, but crucially, human study of davunetide, and they found that the same sex differences.
Again, this is not definitive research. It is small and early stage. Still, it is suggestive, and surely worthy of further study. As the write-up from Genomic Psychiatry put it:
A field that designs trials and doses without accounting for sex and hormonal state may keep producing flat averages that conceal living effects, and may keep shelving drugs that work for someone, just not for everyone at once. […] We have spent a long time pretending the body is one body. This peer-reviewed work, modest in scale and careful in its claims, suggests something the clinic has been slow to absorb. A drug can be right for a person and wrong for the week. The woman in the trial and the man beside her were never taking the same medicine. They only thought they were.
And again I say Amen.
The incredible shrinking menopausal brain
And so to the menopause, which is, as we know, the beginning of the end for the female human, and in particular the beginning of the end for her brain. OR IS IT?