Tonight: abortion bans are changing miscarriage care, how biology might play a role in PMDD and psychiatric conditions, and more.
— Meghan McCarthy
WHAT ABORTION BANS ARE DOING TO MISCARRIAGE CARE
States with abortion bans at or before six weeks have also changed how miscarriages get treated, a JAMA study of tens of thousands of privately insured patients found. Women in ban states were less likely to receive the gold standard mifepristone-misoprostol regimen and 14 points more likely to be given misoprostol alone, a less effective option with greater side effects. The study, the first national look at this connection, excludes Medicaid patients, which means the actual scope is likely larger. The broader point: abortion bans are no longer just shaping abortion access; they’re reshaping routine pregnancy care for women who very much wanted to stay pregnant.
YOUR PMDD AND YOUR ANXIETY ARE DRIVING EACH OTHER
Women with premenstrual disorders face roughly double the lifetime risk of developing depression, anxiety, ADHD, or bipolar disorder, and the relationship runs both ways: prior psychiatric diagnoses roughly double the risk of later developing PMDD or PMS, a JAMA Network Open analysis of 3.6 million Swedish women found. Researchers tracked records from 2001 to 2022. The two-way pattern suggests the conditions share underlying biology rather than merely co-occurring by chance. The bigger implication is that PMDD still gets treated culturally as “bad PMS” when the data increasingly points to it being deeply intertwined with serious psychiatric and neurodevelopmental conditions.
THE MENOPAUSE SLEEP SYMPTOM THAT MISSES SCREENING
A nationally representative survey of 1,200 U.S. women, presented at the ACOG annual meeting, found that 75 percent of those with menopausal symptoms reported sleep problems, compared with about half of women without symptoms. Sleep disorders rarely come up at menopause appointments, even though untreated sleep disruption compounds other menopausal health risks, including cardiovascular disease and depression.
FOR THE HIGHEST-RISK C-SECTIONS, A DRUG THAT CUTS HEMORRHAGE RATES
A multicenter Chinese randomized trial of around 1,700 women with placenta previa found that giving tranexamic acid at the time of cesarean delivery cut postpartum hemorrhage rates from 35 to 30 percent, a statistically significant though modest reduction, per the BMJ study. Placenta previa, in which the placenta partially or fully covers the cervix, puts women at elevated hemorrhage risk; postpartum hemorrhage is the leading cause of maternal death worldwide.
THE FDA DOOR NOW WIDE OPEN FOR ABORTION OPPONENTS
Anti-abortion groups spent months calling for FDA Commissioner Marty Makary's firing over his slow-walking a mifepristone “safety” review, and his exit this week gives them a new shot at a successor willing to restrict the drug's telehealth approval. His departure is also a loss for menopause advocates. Makary championed expanded hormone therapy access, and the FDA removed black box warnings from estrogen treatments during his tenure.