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Those scary “ask your doctor” commercials

Friday, May 22nd, 2009

You know the ones. The narrator tells you that, if such and such happens to you, say, you get two eyelashes caught in your eye per week, you may have eyelash-balding disease (okay, I’m making this up but, you know what I mean). Often, the commercial is about some disease you’ve never heard of before. Or maybe, it tells you about a new medicine for a health concern you already have.

Should you “ask your doctor” to write a prescription for the “medicine-of-the-month”?

Maybe a few other questions should be answered first. Has the narrator of the commercial examined you? Factored in whether the trade-off between symptomatic relief and side-effects is worth it? Compared it to your current prescription and determined, based on your health history, that this is a superior choice?

Well, of course not. The narrator is an actor, paid to convincingly read a script that is meant to do one thing only: sell stuff.

So, think twice before responding to direct-to-consumer advertising about prescription medications. When it comes to marketing these new drugs, the “consumer” should be the physician, who has knowledge of your health history and needs, as well as specialized training and understanding about the potential benefits and risks of drugs. The drug company has a vested interest in selling you their product. And remember that we’ve seen significant consequences with former “medicines-of-the-month,” such as Vioxx or Phen-fen.

If you’re concerned about a symptom, or if your current medication isn’t working as well as you’d hoped, make an appointment with your doctor. Ask your doctor about side-effects including how a medicine interacts with other prescriptions or nutritional supplements you are taking or if your medical history precludes its use.

Remember, you can’t diagnose yourself based on a commercial or an article in a magazine (or a blog post, even one written by a doctor).

So, go ahead, ask your doctor. Just be sure to ask the right questions. Don’t simply ask for a prescription based on what you saw on TV.

– Yvonne S. Thornton, MD, MPH

Can you use the “morning after” pill as your main form of contraception?

Wednesday, May 20th, 2009

Some women wonder whether, since the morning after pill (a.k.a. “Plan B”) can prevent pregnancy, they can take it whenever they have intercourse and skip other forms of contraception.

Here’s the short answer: No.

Okay, now for the longer answer. Plan B delivers a wallop of hormones – at least twice the amount that you’d get in a high dose birth control pill. We doctors just don’t know what effect such a massive dose of hormones might have on a woman’s body over time, including an increase in the risk for blood clots and strokes. That’s because there have been no studies done on using the morning after pill as anything but a one-shot emergency contraceptive.

If you try to use Plan B as ordinary contraception, you will be, in effect, going into the “do-it-yourself” research business, with yourself as chief guinea pig. You’ll be risking your health while not developing a responsible approach to birth control. There are plenty of effective, tested contraceptives on the market. Use this medicine only for the purpose it was intended to serve.

– Yvonne S. Thornton, MD, MPH