Spotlight Interview with Ema from The Well-Timed Period

Blog: The Well Time Period
Blogging Since: 2003
Occupation: OB/GYN

What prompted you to start your blog?
Correcting mainstream-media misinformation about reproductive health issues, in particular contraception and menstrual management (my areas of interest) is was started it all.

Helping women make informed medical decisions, by disseminating complete and correct repro health information, debunking the noxious propaganda targeted at female patients of repro age, and combating the relentless politicization of women’s healthcare followed in short order .

To this day I remember, way back in ’03, coming across a deeply misinformed article-cum-propaganda piece about Seasonale in an online newspaper article and my reaction to it. The idea that, just because the topic is female reproductive health, it’s acceptable to throw science and accuracy out the window, and lie, cheat, and play political games with medical information, and, ultimately, patients’ lives was shocking to me. [Yes, it’s fair to say I had been living in a bubble.]

I just had to do something about it and I realized, slowly but surely, that blogging would be a most effective way to do just that. Reaching millions of people from all over, establishing a reference site, and the ability to educate 24/7 are invaluable tools.

How did you become interested in women’s health?
Professional bias, I guess.

What are the three questions people ask you most frequently? And what do you tell them?

  1. Practical questions about menstrual management, like what regimen to use, what pills to consider, side effects like breakthrough bleeding/spotting
  2. Medical analysis of various reproductive health legislation.
  3. Factchecking mainstreammedia articles.

What do you wish people would *stop* asking you?
Frankly, I never tire of repro health questions. The way I see it, the more accurate information you have, the better positioned you are to make a medical decision that’s best suited for your unique circumstances and needs. In this age of information (frequently, of questionable accuracy) overload and journalistic laxity it’s ever more important to insure women have access to reputable, practical resources.

Bottom line: Since I have the knowledge, I am best positioned to disseminate the information. Having people ask me questions and look to me for guidance is a privilege, not a chore.

Your site is really well organized and you track an impressive number of birth control and menstrual products. How do you keep track of all the research you post on your site?
Mostly by reading specialty journals (listed on my sidebar). They’re excellent resources; unfortunately they require a subscription and are heavy on “medspeak”. So what I try to do is to bridge the gap by presenting the information in a more accessible/practical format for my readers. (I’ve deliberately targeted my blog to laypeople.)

What birth control/menstrual management research has you most excited/encouraged right now?
A few things. First, the on-going research into developing better IUDs (like GyneFix, the frameless IUD), and efforts to educate the US public about using this excellent method of birth control (there’s even a Mirena TV ad!). I, like The American College of Obstetricians and Gynecologists (ACOG) and the specialty journals, just can’t say enough good things about the IUD. It is a very effective, safe, easy to use method, one that, unfortunately, is underutilized in this country. It’s very important that we do everything we can to educate the public about this method and encourage its use.

Second, better emergency contraception pill methods (like the one dose [10 mg] RU-486/mifepristone), with improved efficacy and side-effects profile (less nausea/vomiting, less disruption of the menstrual cycle).

Last, but not least, I’m also cautiously optimistic about research into microbicidal spermicides. Although there’ve been some setbacks, developing a contraceptive that could also broadly prevent STIs (sexually transmitted infections) would be a very beneficial step.

What are the biggest trends you see right now in the women’s health community?
One encouraging trend I’ve noticed is the increase integration of women’s health into the mainstream arena, combined with a move towards encouraging a more active role for women in managing their repro health-from direct-to-consumer ads about menstrual management and contraceptive methods, to companies like Goldman Sachs and drugstore chains like Duane Reade staring to offer in-house health care with a focus on women’s health, to the so-called contraceptive convenience movement (somewhat of a misnomer in my opinion, but that’s a discussion for another time).

Related to the above, I also see more of a willingness from the Ob/Gyn establishment to stand up for patients and go on the offensive. Clearly, when it’s acceptable public discourse to ponder what degree of trauma and/or mortality risk a female patient should present with before she may be allowed to receive medical care, and when laws have been passed in some states that 1) force physicians to subject women to unnecessary tests before they’re allowed to render care, and 2) ban women from suing physicians who lie to them and commit malpractice, the time to stay on the defensive and hope for the best has passed. (Oklahoma SB 1878)

I mean, when you have ACOG openly calling HHS Secretary Leavitt a liar and ABOG challenging him to produce some evidence, you know something’s afoot.

Granted, much remains to be done, and finding the right balance between the patients’ well-being and commercial and political/regulatory interests is a work in progress. (Hence, my blog!)

What is your favorite health-related website or resource?
I don’t have just one; I tend to aggregate, everything from Yahoo, AP, etc. health news feeds, to Medical News Today, emedicine, to ARHP‘s Contraception, to name but a few.

And speaking of resources, to give you an example of what lay people in search of medical information are up against, just today I caught Medical News Today doing something improper. They posted an article that’s nothing but a PR release from an interest group, without 1) making it clear that the source and the material are nothing but propaganda, and, most importantly, 2) informing their readers what the actual medical evidence is. \

How exactly are people without a medical background or those who aren’t up-to-date on the literature supposed to figure out that there even is a problem with the information, and, more importantly, know where to search for accurate data? Factor in that normal people have busy lives and that not everybody finds the minutia of medical data engrossing (imagine that!), and you begin to see the magnitude of the problem.

What has most surprised you about blogging?
If I had to distill it down to just a couple of things, first being exposed to the sheer amount of misinformation, often deliberate, that’s out there. For example, to this day, I continue to be shocked by the fact that politicians are allowed to lie about, and misrepresent, medical information on the record when enacting reproductive health legislation.

Where it not for blogging, I don’t think I could’ve fully realized what an uphill battle female patients of reproductive age face in getting proper medical care, and how dependent their health is, literally, on the kindness of assorted strangers.

Second, having the opportunity to expand my horizon and to meet and interact with so many great people.

From correcting errors on the NIH site, to learning about cephalopods on Pharyngula or reading about naval history on LGM (who knew that’s something I was even interested in?), to playing a role in protecting women in Virginia who miscarry from being considered criminals until politicians and the police decree that they are innocent, blogging has allowed me to learn something new every time I go online, and, most importantly, it’s allowed me to take an active role and have an impact. (You know, just like Mighty Mouse, who sees injustice and suffering far and wide and rushes to help, but with Ob/Gyn powers.)

What are you long-term goals regarding your blog?
Heh, just like any self-respecting blogger, world domination and untold riches through blogging!

Seriously now, the main goal of my blog has always been, and remains, to help female patients make their own medical decisions (in consultation with their Ob/Gyn and their loved ones, of course), and make the decisions best suited for their particular circumstances.

Any final thoughts?
These were very good questions and I appreciate that. It’s good, from time to time, to have to stop and reflect on why you’re putting all this time and effort into blogging. And speaking of motivation, just in case there was any doubt, and this disclaimer was needed. This blog is a personal undertaking; strictly my time and my money. I have no ties with or funding from any Pharma, HMO, politicians, interest groups, etc. whatsoever.

Thanks for sharing your thoughts with us, Ema!

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