IW #261: Being stubbornly female

This excerpt is from the Invisible Women Newsletter. Click here to join the 60k+ subscribers and read the full article.

In this newsletter, I emerge from my book-writing hermitage and demonstrate some proof of life as well as proving that it is actually possible to include women in medical device trials.

But first, a quick little update from the world of using menstrual blood as a diagnostic tool / to secretly murder your husband…and for those of you who have no idea what I’m talking about, let me take you back to August 2021, when I wrote this newsletter in response to a tweet from a from a biomedical researcher called Federica Helena Marinaro.

Marinaro had just submitted a paper about the benefits of stem cell therapy using cells taken from menstrual blood, and she shared one of the peer review responses online. Unfortunately, the original tweet has been deleted, a loss to comedy for which I am holding Elon Musk personally responsible, but thankfully I have a record of what the response was because I read it out on a podcast episode I made the following year; you can of course listen (you should listen!) but because I’m extremely kind, I’ve screen grabbed the transcript of the relevant section for your reading delight:

The good news is, researchers have found an alternative use for menstrual blood and that is to diagnose endometriosis, an extremely painful disorder that can have serious ramifications for women’s fertility and their health more broadly. As GFPs will be aware from both my book and several newsletters on the topic, despite the fact that it is as common in women as diabetes, we remain terrible at diagnosing endometriosis, with women waiting up to a decade for any answers, let alone any treatment.

Existing diagnostic approaches involve intravenous blood tests and laboratory analyses coupled with imaging studies and extensive patient history collection for clinicians to make a definitive diagnosis. Such challenges contribute to delays in diagnosing endometriosis, with one study of 218 women revealing a delay of up to 12 years in the United States.

Enter: your period. Well, ok, your period has already entered the room, since this is of course not the first time we’ve spoken about using your period blood to diagnose a range of diseases, including endometriosis (IIRC we went into this in some detail in the podcast). What’s new here is the test that researchers have developed, which can detect endometriosis-linked proteins in your menstrual blood at much lower levels than in traditional tests, which could make early diagnosis much more feasible. Even better: since the test uses menstrual blood as opposed to intravenous blood, this is a test you could theoretically do at home on your own, rather like a pregnancy test — it could even be integrated into a menstrual pad, meaning you could be getting your endo diagnosis as you simply go about your day.

So far, this study just delivers proof of concept. Next up are clinical trials — and, (and this bit made me particularly excited) expanding the test “to detect additional disease biomarkers such as HPV and cervical cancer.” No more smears AND no more swabs? Please, you’re spoiling us! Future us, anyway. And specifically future us who haven’t yet reached menopause and still have periods. BUT STILL. This would be a major step forward for millions of women and overall, I am declaring it OFFICIALLY MORE GOOD NEWS.

For more good news and evidence that it is actually possible to include all women in medical device trials, read the full newsletter here.