According to a report from Reuters, taking ginkgo biloba, St. John’s wort and several other widely used herbal medications may impede the potency of prescription drugs, making them more or less effective.

Experts at the Journal of the American College of Cardiology found that mixing herbs and drugs also may cause serious heart rhythm problems and bleeding.

“We can see the effect of some of these herb-drug interactions — some of which can be life-threatening — on tests for blood clotting, liver enzymes and, with some medications, on electrocardiogram,” Dr. Arshad Jahangir of the Mayo Clinic in Arizona said in a telephone interview.

Many patients fail to disclose their use of herbal remedies so healthcare providers should be more probing, Jahangir said in a telephone interview.

“We need to be actively ask about alternative or complementary medicine patients may be seeking on their own to assess these potential interactions or side affects,” said Jahangir, a cardiologist.

“They don’t even consider that herbs could have a negative effect,” he said. “Their impression is that ‘natural’ is safe,”

So whether you use an ACE inhibitor like Vasotec or Monopril, alpha agonists like Zanaflex, or angiotensin II receptor blockers like Avapro or Atacand, it is a good idea to check with you doctor and make sure there won’t be an interaction with any of the additional supplements you may be taking.

Remember, whenever dealing with potential interactions between medicines and supplements, it is always better to error on the side of caution.

Better safe than sorry.

A new paper in the scholarly journal Trends in Ecology and Evolution suggests that oral contraceptives may influence women’s choice of mates, with potentially enormous effects on their quality of life and their ultimate reproductive success.

Commonly used hormonal birth control methods such as Yasmin, Seasonale, Ortho Tri Cyclen, and Loestrin, while extremely effective at preventing unwanted pregnancy, may well have previously unsuspected effects on a woman’s choices of both long-term and short-term partners. This is of interest to the more than 100 million women around the globe who use oral contraceptives, and their sexual partners, too.

The paper, published October 9th, was authored by biologists Dr. Alexandra Alvergne and Dr. Virpi Lummaa at the University of Sheffield in England. It analyzed a large body of research that had gone before. Writes Dr. Alvergne, lead author of the study, “The use of the pill by women, by changing her mate preferences, might induce women to mate with otherwise less-preferred partners, which might have important consequences for mate choice and reproductive outcomes.”

Researchers have long known that women make different sexual choices during their most fertile phase than they do during the rest of the month. This is called “cycling mate preferences,” and quite simply, it means that most women choose more masculine and symmetrical faces when they are ovulating or close to ovulation. They are also uncharacteristically attracted to dominant males, and most likely to engage in infidelity at this time in their cycle. During the rest of their cycle — periods when the women are more likely to be infertile — they are more attracted to less masculine faces, and men who are better choices as long-term partners.

Oral contraceptives work by mimicking pregnancy and stifling ovulation, which flattens out the hormonal cycles usually experienced by a fertile woman. Why is this a concern? Says the paper:

New evidence suggests that the pill, by eliminating oestrus, changes the natural cycling preferences in women for markers of both genetic quality and compatibility in mates as well as natural cycling attractiveness to men. As compared with normally cycling women, pill users show no or weaker preferences for facial and vocal masculinity. For instance, the preferred face shape is more masculine during the high conception-probability phase of the menstrual cycle in non-pill users, but pill users do not show similar preference.

The possibility is that a woman could make a choice influenced by birth control that is perhaps not in her best reproductive interests. Even worse, with our cultural customs of lifelong mating and marriage, a woman could change her contraceptive practices and find that she is not attracted to her mate in the same fashion as she was when she was under the influence of prescribed hormones. Either of these outcomes could be devastating to a paired couple.

Oral contraceptives are still regarded as one of most effective forms of birth control available to women (they trail the intra-uterine device by a fraction of a percentage point, but the IUD is appropriate for fewer patients, and is rarely prescribed for women who have not already gone through childbirth). Birth control pills are affordable, simple to obtain, and work extremely well. However, this paper has given us all something to think about: the possibility that altering the hormonal cycles of the human female en masse could have significant reproductive effects for individual women, and the entire species, too.

More research is forthcoming in this arena, and the results are sure to be fascinating.

Earlier this month, a closely-watched trial over the osteoporosis drug Fosamax ended in mistrial, to the frustration of nearly everyone involved. The trial was marked by great tension, with a deadlocked jury, reports of threats of physical violence, and a judge-ordered cooling-down period.

What could cause such intense drama? Well, this was just one of approximately 900 state and federal cases pending against Fosamax, alleging that that medication causes osteonecrosis of the jaw (the death of jawbone tissue). In large part, the tension in the Manhattan courtroom was that this trial — the first — was supposed to be an indicator of how these hundreds of similar cases might proceed. The other major factor is that it is notoriously difficult to “prove” drug-related injuries, and this difficulty was definitely shown in the frustration and tension among jury members.

Millions of women have taken Fosamax (alendronate), a Merck drug that was approved in 1995 to treat osteoporosis associated with menopause, and in 1997 to prevent osteoporosis itself. Until the recent introduction of some competing medications, it was one of the most popular drugs in the U.S. It is still prescribed millions of times per year to women suffering from bone loss.

In short, Merck’s defense on this topic is that there is no definitive evidence that Fosamax causes the death of jaw tissue, while plaintiffs and their lawyers insist that Merck overpromoted Fosamax without warning doctors about the potential for jaw injury. Obviously, no conclusions were reached.

Of course, this is of great interest to women who may have taken, or are considering taking, Fosamax. Only your doctor can decide what is the right choice for you, but we thought we would enumerate the other medications available for treating osteoporosis for those doing research on Fosamax alternatives. One very important thing to be aware of it is that Fosamax is not the only osteoporosis drug in this class (the bisphosphonates), which all have a similar mode of action. Fosamax is being talked about most in the media, but all are associated with some amount of risk of damaging the jaw.

If you do choose to take a bisphophonate, know these facts:

• A high proportion of jaw injuries occur following high-dose intravenous administration, so that is a particularly risky way to take the medication.
• As many as 60% of the cases are preceded by a dental surgical procedure involving the jaw. In short, women who are expecting major dental work should consider delaying treatment with Fosamax, Boniva, Actonel or similar drugs until after their dental surgery.

Here are the main alternatives on the market for Fosamax:

1. Actonel (risedronate) is a bisphosphonate manufactured and marketed by Procter & Gamble and Sanofi-Aventis. It belongs to the same family of drugs as Fosamax, and may be associated with the same jaw side effects.
2. Boniva (ibandronate) is also a bisphosphonate, manufactured and marketed by GlaxoSmithKline and Roche Laboratories. It is a competitor to Fosamax, and may also affect the jaw tissue.
3. Evista (raloxifene) is NOT a bisphosphonate , but rather an oral selective estrogen receptor modulator from Eli Lilly and Company that affects bones through estrogen. Evista may be an interesting alternative for women concerned about their jaw health or planning oral surgery.

Also this month, The Wall Street Journal published an article called “From the Osteoporosis Front, Updates on Potential New Drugs.” These are the up-and-comers in clinical trials and going before the FDA. The story covers the latest news about Wyeth’s Viviant, Pfizer’s Fablyn, Amgen’s denosumab, and other upcoming treatments for osteoporosis.

If you are interested in following the Fosamax case that ended in a mistrial, it is expected to be re-tried in the spring. The name of the case is “In re Fosamax Products Liability Litigation, U.S. District Court, Southern District of New York (Manhattan), No. 06-1789.”

Erectile Dysfunction drugs such as Viagra, Cialis, and Levitra have made huge strides in treating male sexual dysfunction — but have women been left behind? At this writing (September 2009), no treatment has been approved by the FDA for Female Sexual Dysfunctions (FSD), which are estimated by the Journal of the American Medical Association to affect 43% of American women (about 40 million) at some point in their lives.

It’s not for lack of trying. Pharmaceutical makers would love to tap into a market that’s the other 50% of the population. They are assertively researching the problem. So why has a result not come forward?

One issue is that, with men, “sexual dysfunction,” no matter whether the cause is mental or physical, is likely to respond as a pretty straightforward plumbing problem: Viagra and its counterparts, the Phosphodiesterase Type 5 Inhibitors, are vasodilators, meaning that they open up blood flow to the area, allowing an erection to be achieved and retained more easily. (More information on the effects of these vasodilators on women is below.)

But women’s sexuality is more complex and less understood, often caused by a range of physical, emotional, and psychological conditions. Simple manipulation of bloodflow only goes so far. Another element is that women have unique hormone issues, which often cause low libido, as they age. Finally, some researchers are experimenting with methods that place sexuality in the mind.

The good news is that research IS progressing. Here’s an update on where the various methods are:

THE BIG THREE (Viagra, Cialis, Levitra)

Researchers are looking into using male ED drugs on women suffering from FSD. In April of this year, a study by the American Physiological Society was described that compared the effects of three drugs used for erectile dysfunction (Viagra (sildenafil), Levitra (vardenafil), and Cialis (tadalafil)) on female rats. The researchers discovered that these drugs significantly increased blood flow to female sexual organs, and show promise for treating similar conditions in human women. Another study has shown that Viagra can help with orgasms in women who are taking SSRIs and suffering sexual dysfunction as a side effect.

There is promise here, but it is all forward-looking. The FDA has not approved these medications for use by women. We will be closely following the progress of this research.

HORMONAL TREATMENTS

The hormone testosterone drives sexual desire, and as women age, they typically lose some of both. There are some doctors that prescribe testosterone off-label to women to help with low desire, but this process is not approved by the FDA. There have been flops along the way to a hormonal treatment. Intrinsa, a testosterone patch for women, was turned down by the FDA in 2004 due to worries about long-term safety, and PT-141 was a nasal spray that was being tested to raise desire in both men and women when it was quashed by the FDA for having possible blood-pressure-related side effects.

In upcoming news, though, BioSante Pharmaceuticals of Illinois is in late-stage studies of a testosterone gel intended to remedy libido loss after menopause. The product, called LibiGel, is smeared on the upper arm and promotes a long, slow build-up of testosterone in women. We’ll be eagerly watching to see if LibiGel is approved by the FDA.

NEUROTRANSMITTER ADJUSTMENTS

A nonhormonal treatment for FSD is in late-stage testing. Boehringer Ingelheim’s Flibanserin, a pill to be taken daily, acts on serotonin receptors in the brain. Early reports suggest that the medication was not useful for treating depression (its intended use), but had the curious side effect of increasing desire in females. The company is now researching the drug’s effects directly in younger, premenopausal women who are suffering from low desire.

The reality is that there is no approved pharmaceutical treatment on the market for a condition that troubles millions of women. The good news is that there are a few promising treatments on the horizon, and we encourage women to follow issues like this in the news so that they will know when relief becomes available. Some of the companies mentioned in this article are conducting clinical trials of these medications, so if you are deeply interested and want to participate, that is a possibility, too. We should see some major changes in the field in the next few years.

Are you one of millions of people battling some type of hair loss? More than half of males experience some degree of male pattern baldness by age 50, but even women and children can experience unwanted hair loss. There are more options than ever before to treat hair loss — such as herbal treatments, scalp massage, lasers, and surgery — but one of the most popular options is the safe and effective pharmaceuticals on the market.

There are two main medications approved by the FDA for treatment of hair loss — and they’re very different. For starters, Rogaine is a topical solution applied to the scalp, while Propecia is an orally administered pill. One medication is better than the other at treating a receding hairline. Men can use either medication, or even both, but women are restricted to just one. Because of these distinctions, it is important to choose the right hair-loss medication for you.

Let’s take a closer look at each one.

Rogaine (minoxidil) was first on the scene. Its ability to fight hair loss was discovered accidentally. The drug, a vasodilator, was originally used exclusively to treat high blood pressure, when some patients began reporting that it re-grew hair as a side effect. It was approved by the FDA in 1988 to treat male pattern baldness. Rogaine, by Pfizer, is primarily effective at stopping hair loss, but in some patients, it can increase protein blocks, which can promote new hair growth. It is said to be effective both on the hairline and vertex of scalp. Rogaine can be used by both men and women, in a 2% or 5% solution.

Propecia (finasteride), made by Merck, is an orally administered medication approved by the FDA in 1997 to treat hair loss. Unlike Rogaine, which is a vasodilator, Propecia acts on hair loss through hormonal means. (Because of this, Propecia should NOT be used by women or children; it could be very dangerous.) Propecia is an anti-androgen, which decreases the conversion of testosterone to dihydrotestosterone (DHT), a chemical responsible for balding. With DHT inhibited, existing hair is better maintained, and the body can put more energy into thinning follicles so that they become thicker. Propecia has high effectiveness with early to moderate hair loss, and works best on the crown of the head, but not as well with a receding hairline.

Neither Rogaine nor Propecia is a quick fix for hair loss. They both need to be taken for long periods. It can take anywhere from 6 to 24 months to see initial results, and patients may need to take their chosen medication indefinitely keep treating the condition.

Knowing all this, which factors should guide your choice between Rogaine and Propecia?

• Your gender: if you are male, you can be prescribed either (or both), but if you are a woman, you can only use Rogaine.
• Your goals: Rogaine is slightly more useful for retaining existing hair, while Propecia is said to be more effective at promoting new hair growth.
• Your area of hair loss: Propecia has good results mainly on the crown, while Rogaine has documented success on the hairline and the crown.
• Medical interactions: Consult your physician to determine which drug is a better fit for your personal health conditions and other medications.
• Side effects: With Propecia, you may experience decreased libido or gynecomastia. Rogaine may trigger allergic effects, chest pain, dizziness, or irregular heartbeat.
• Ease of use: Some people feel that a daily pill is simpler than a twice-daily application to the scalp, but others prefer to pick their medication based on its mode of action.

Whichever method you select, be patient, and remember to keep feeling good about yourself, your hair, and your overall health. As with any drug, please consult your physician before you begin any medication.

Long-term sufferers of insomnia who have not found lasting relief from such sleep aids as Ambien or Sonata should consider researching Rozerem, the only medication of its type approved in the treatment of sleeplessness.

Rozerem (ramelteon) is the first of a new class of insomnia drugs: melatonin receptor agonists. These are similar to the naturally-produced sleep hormone melatonin, which your body needs for healthy sleep cycles. Rozerem, manufactured by Takeda Industries North America, was approved by the FDA in July 2005 for the treatment of delayed-onset insomnia. It emerged against a backdrop of other classes of drugs to treat the condition — and it has some important differences.

Insomnia was historically treated with barbiturates, which were extremely strong and frighteningly addictive. In the Sixties, the benzodiazepines appeared. These drugs (such as Halcion) helped treat insomnia with a much lower rate of serious side effects and addiction, but still had moderate side effects such as dizziness and a hangover effect. In the Nineties, there emerged a new class of non-benzodiazepine sleep aids, including Sonata and Lunesta, which have safely helped many people combat insomnia. Still, as they target several broad areas of the brain that are involved in sleep, they still have considerable side effects on memory and clarity.

In 2005, Rozerem was approved as a treatment for insomnia. It is said to have a different, more precise mechanism than other sleep aids, with an ability to target the “master clock” of the human body, affecting the sleep-wake cycle without unduly interfering with nearby brain functions.

Because it is in a different class than Lunesta and Ambien, Rozerem may be an effective treatment for patients who have not found lasting results on these medications. If you have not reconsidered your insomnia treatment since this important new class of drugs appeared in 2005, it is worth researching these new developments, as they may cure your insomnia more effectively, or do so with fewer side effects.

Side effects: Common side effects on this medication are dizziness, drowsiness, and daytime sleepiness. Sometimes people using this drug sleep-walk or perform other actions in their sleep. More serious side effects involve hormonal changes such as missed periods, nipple discharge, or difficulty becoming pregnant. It is important to tell your doctor immediately if you experience depressed or suicidal thoughts while taking this medication. Finally, be aware of any symptoms of a very serious allergic reaction to Rozerem such as a rash or swelling. Call your doctor immediately if this occurs.

Cautions and contra-indications: Rozerem is not suitable for patients with liver disease. You should not take it if you are also taking fluvoxamine, rifampin, or certain antifungal antibiotics. You should advise your doctor if you suffer from any breathing disorders such as sleep apnea or chronic obstructive pulmonary disease. You should also tell your doctor if you have a history of mental illness, depression, or suicidal thinking. And of these factors might mean that you cannot take Rozerem, or that you might have an adjusted dose. Rozerem is a pregnancy category C drug, so it may be harmful to an unborn baby, or in breast milk. Finally, Rozerem may affect hormonal levels in men and women, with possible effects to the desire and fertility. Talk with your doctor about your reproductive plans if you are considering Rozerem.

As with any drug, please consult your doctor before taking.

The Internet is fast becoming the digital equivalent of the Physician’s Desk Reference. An average of 55.3 million people per month, or 31% of US Internet users, visited a Web site in the health information category in the first quarter of 2007, according to comScore data. That traffic represents a healthy 12% increase over the same period in 2006…

Most of the traffic went to category leader WebMD (17.1 million average monthly visitors), followed by the National Institutes of Health site (9.8 million) and MSN Health (nearly 8.1 million) … MSN Health leaked the fewest visitors to other sites — only 16.8% of the audience went elsewhere, compared with 28.5% of visitors to WebMD…

Many visits were sparked by seeing direct-to-consumer (DTC) ads in other media … After seeing a DTC ad, 27% of respondents talked to their doctor about the drug or condition mentioned, and 89% went online to look for more information on the specific condition or illness. Over six in 10 searched for the prescription medicine itself.

Watch out, WebMD. We’re coming after you…