Warning: Feminist, anti-patriarchal question on hormonal therapy

marijen

Here is the link on 50% failing to respond to anti-hormonal treatment. january 31, 201

https://academic.oup.com/jnci/advance-article/doi/10.1093/jnci/djx270/4780395

stephaniebc

Icietla I am not sure I understand your point about noncompliance. A woman who makes the informed choice of a higher risk of recurrence for herself in exchange for quality of life cannot really be compared to one who brings into the world a baby with birth defects because of her irresponsible use of Accutane, can she? After a long, grueling treatment, some of us prefer to let our bodies be, without further interference, even if that means a worse prognosis -- and yes, we have looked at the statistics. Some people bike without helmets because they like to feel the wind in their hair. Should they be shamed? Or should they be allowed to decide how they want to live? My cancer has taken enough of my youth and my womanhood and I want to live well for however long I live. It is extremely personal and I will never try to sway anyone toward my position but please respect other women's informed decisions.

runor

It is interesting, to get a different view of tamoxifen than the breast cancer view, to research the use of tamoxifen by bodybuilders, who take it ON PURPOSE for various reasons. There is debate in that community as to how safe or sane it is to take this drug. Blood clots, cataracts, liver damage and they don't fail to mention that tamoxifen is a known cancer causing agent. The article that I just read stated that you get all these wonderful side effects at JUST 10MG PER DAY ... imagine what you would experience on the dosage that bodybuilders take, which is 20mg !

Yet here we all are, taking a whopping 20mg, I KNEW there was a reason I can bench press 190!

I don't think more women in medicine is going to change anything about treatment. We need more women in banking. Because at the end of the day it's all about money. Drug companies do what's PROFITABLE. It does not matter who is cooking up what cure in the lunchroom microwave. If there is no money in it, if you bring your shareholders nothing ... it's all dead in the water. The person who says it's okay to have a year end report showing zero profit is the banker. And unless the banker is a breast cancer victim .. then it's not about doing the right thing, it's about doing the profitable thing. Drug companies now are one step off being sanctioned terrorists. The criminal markups they charge vulnerable people is unforgiveable. While all businesses should make a profit, there is a difference between profit and extortion and guess what the drug companies do? As my daddy used to say, there's a difference between screwing something and raping it all to hell. It is not a lack of women that dooms us, it is a lack of ethics.

Do I think the misery of tamoxifen is a feminist issue? This is a very interesting and provocative question. I love it! My answer: sort of. It was discovered, by accident, that tamox has an effect on breast cancer. Research began. Women quit the drug in droves (as already discussed). Why? Because it made them feel like shit. Now, a thinking person would have seen this problem and asked, what is the LOWEST dose we can give and still have an effect on cancer? But no one asked this question. Ever. Not once. Don't believe me? Research. Dig. Look up study after study. Look up new studies. Look up OLD studies. You will not find anything where researchers, reacting to the misery of women, reacted by finding the most effective, lowest dose. Didn't happen. And was that sexist? Well it was shitty ethical practice at the very least. Some research done by Italians on low dose had some promise, but it was small and seems not much has been done since.

Instead of going for the lowest, effective dose, researchers seemed to begin a bargaining process. What if we lower it from 60mg a day to 40. Would you stay on that? How about 30 mg? Would you keep taking it at that dosage? No? How about 20mg? Any takers at 20mgs a day? So the 20mg dose we have today is because it was the dose that allowed the most women to stay on the drug without throwing themselves in front of a bus. BUT IT WAS NEVER, EVER THE LOWEST MOST EFFECTIVE DOSE. It was just the most 'tolerated' dose. So we are taking a drug that was, in a way, not adequately researched at all. Maybe 5 mg a day would work just as well with reduced side effects. But we'll never know. Because no one will make more money by knowing this. Is that sexist? I don't know. But I think it's negligent and shoddy.

Icietla

7 hours ago stephaniebc wrote:

Icietla I am not sure I understand your point about noncompliance.

Icietla writes:

Again: "As we all know very well, as to any sort/s of medical advice, there is always a great deal of noncompliance among patients." In my first and second paragraphs, I was making two points about noncompliance – that as to any sort/s of medical advice, there is always some noncompliance among patients; and that as to noncompliance about recommended endocrine therapy, there are more explanations therefor than that all the noncompliant patients suffered terrible side effects from those medicines.

See that ridiculous spin in the first line of the Original Post?

>>Some people bike without helmets because they like to feel the wind in their hair. <<

Yep. It is one thing to acknowledge that some cyclists – for whatever their reasons -- do not wear helmets. It would be something else to make the absurd leap to claiming that the only possible reason for any/all of the cyclists not wearing a helmet is that they had suffered terrible side effects from helmet use.

>>please respect other women's informed decisions.<<

I do respect others' informed treatment decisions. I want everyone as well and happy as they can be.

I do not respect the decisions of some never-takers and nearly-never-takers to abuse this forum section to try to make others afraid to avail themselves of what might be easy treatment capable of saving or extending their lives. They are literally scaring people to death. It grieves me very much to read of their successes that way.

>>If one of the major side effects of this drug was unrelenting penis pain so severe that it prevented intimacy would the words "well tolerated" be used to describe it and would it continue to be advocated as "the gold standard"?<<

Your five days on an aromatase inhibitor caused you to suffer severe, unrelenting penis pain? Think there is any possibility that it might have been delusional? Well, you cannot fairly blame the medicine for that. Delusions are not listed among the known possible side effects of that medicine.

>>So the 20mg dose we have today is because it was the dose that allowed the most women to stay on the drug without throwing themselves in front of a bus. <<

Names? Cites? News items about those who did that because they were taking Tamoxifen? Police blotters, surely? Or is this from your personal knowledge? Names? Please.

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>>Note: Please remember that there are good experiences and bad with ALL treatments and this is a safe place to share YOUR experience, not to be influenced or influence others.<<

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

That illusory statement there should be replaced with a conspicuous warning banner.

Peace.

GKL

StephanieBC I literally just got off the phone with my MO's office. I had called earlier to tell her that I was planning on going off the anastrozole I've been taking for almost 9 months.Don't remember if my diagnosis will appear when I post this but I was diagnosed with very early stage DCIS. My 1st oncologist said that mine was not really cancer. It was caught so early that it was pre cancer which is fine with me. I am happy that I went for a second opinion when the radiologist at the first facility said ( after I insisted on a sonogram and face-to-face with a Dr.after 3 visits without either) that he "thought" it was benign.. I changed oncongologists because the first one put me on the " suck-it-up-cupcake " health care plan. Nothing that happened was a side effect and nothing was ever suggested to help. My nurse navigator is the one who told me to try taking my meds at night instead of in the morning. I did and it didn't work long term but I then "had a clue" and tried adjusting the time and 3pm worked great. My problem now is that I have a rash that is only on my arms and legs. My MO doesn't think it's from the anastrozole but has agreed I can go off it until my appointment in early May.. Sorry but I got side tracked with TMI. My point was to share what my new MO said on my first visit. I'm 96% estrogen positive so I thought I had an extremely high chance of recurrence. She said for me, my chance of recurrence would be only in my left breast where the pure DCIS was found and that with the meds the chance was 2% and without the meds, the chance was 4% which translates to a 50% better chance of recurrence. She also said that this cancer would not recur in the right breast and that the meds didn't change my chances of getting cancer in the right breast, which is 15% just like any other woman who has never had cancer.. With my stats, I have decided that if the issues don't resolve, I have such low risk that i could easily walk away from the meds and not worry as much as I do on them.

pupmom

I've reached the point where I am indifferent to whether people choose to take cancer treatment or not. I did everything my doctors recommended, and am alive and kicking 7 1/2 years after diagnosis. I also have had very few SEs, so maybe that's why I'm still on Tamoxifen. I think it's important not to paint a ridiculous picture that life is intolerable under various cancer treatments. Most of us know that's not correct, and it unjustifiably scares newbies.

mustlovepoodles

pupmom, I am in agreement with you. I care not one fig what others choose to do. I just keep my head down and continue talking my medicine. I've been fortunate--2yrs on letrozole with very few SEs. I asked my MO just yesterday out of curiosity what my risk would be if I decided to stop taking it. He immediately looked up my oncotype and other stats--35% risk of recurrence without the AI, 15% with it. Gulp! That's enough incentive for me!

Hopeful82014

I have to say that I agree with both Pupmom & Icietla's comments above.

As to the OP - I can think of several diseases that are tougher to deal with, in terms of undesirable SE of treatment. And for some of them a great deal of the professional emphasis IS on education of patients as to the absolute necessity of staying on medications, despite SE and costs (sometimes substantial) not just for 5-10 years but for LIFE.

I understand that OP is angry that we don't have better treatment options - I was, too, when first diagnosed. Now I'm simply resigned. But I don't think we have it worse than everyone else simply because we're women. Not that I expect to change anyone's mind...

Meow13

We should never stop demanding better treatments. Many of us suffer in silence.

Traveltext

Consider this. More money is poured into bc research than to any other type of cancer. And well-funded researchers around the world have been working for very many years now to find a cure. Understandably, nearly all the research on this disease is aimed at helping women with this disease. Because men are so few in numbers, we get excluded from trials, and very little of the research funding goes to better understand our situation. I read a lot of research papers, and I see that female scientists are up there with the men in equal or greater numbers publishing papers, talking at conferences, putting in long hours in the lab, etc. In fact, the world authority on male breast cancer is a woman.

The treatment options available to us, however much we think they might need improving, are the best available to date. Whether we choose to avail ourselves of any, or all, the treatments is up to individual choice and these choices should surely be respected. Individual biology, cancer type and stage, your genes, environmental factors, your age,your race, your income, along with how well you can follow diets and exercise regamins, and care to stick with post treatment meds, are all contributing factors to warding of the dreaded recurrence. On top of all this, and you hear this all the time around these forums, this disease is a crap shoot.

So, take your pick of the options available to you, do your best, enjoy life, even move on as most people here end up doing, in fact do whatever suits your disposition and predilections. As to the feminist aspect to hormonal therapy, I'm having trouble making the link. I'm very involved in BCO but I'm also on major prostate cancer sites, and I daily mix with so many interesting and thoughtful people who are really generous with their time, and, regardless of gender, just want to stay well. Ironically, hormone treatment is a great point of discussion for both bc and pc, and the similarities in concerns are pretty identical.

bluepearl

Men do have drugs that create bad side effects, and there are quite the range of them...including heart meds, pain meds, anti-hormonal meds, chemotherapy etc.

stephaniebc

Icietla,

Maybe I don't patronize these forums frequently enough, but I have never seen anyone proselytize about forgoing hormone blockers so far. Women do rightly vent about their own side effects, which as we all know (newbies included) vary greatly from person to person.

Where is this anger toward the "never takers" and the "non takers" coming from?

Outfield

It's definitely odd for me to be in disagreement with a post identifying as feminist and anti-patriarchal, but I am.

My work day is spent with people suffering from (and yes, I do mean "suffering from" not as a vague way of saying they've got a disease but as in they are truly suffering) a whole host of chronic diseases. Heart failure, cirrhosis, COPD, diabetic neuropathy, dementia among others, and of course different types of cancers. Most of them have some gender predilection, but not strong enough that we think of them as a diseases of men or women. The diseases are bad, but so are the treatments. Loop diuretics anyone? It's hard to leave the house. Aldosterone antagonists? Painful gynecomastia. Don't like giving yourself shots? Too bad. Grogginess? Well, would you rather have the pain? It makes your hands shake? Tough it out. Can't breathe? Well beats me, you don't qualify for a lung transplant so just grin and bear it.

I really disagree that women taking tamoxifen or AI's shoulder some disproportionate degree of suffering due to gender. Even in the cancer world, I don't think women suffer disproportionately. Side effects caused by AI's or tamoxifen are often reversible. Side effects of treatment for "male" cancers often are not: ED and urinary incontinence from radiation or prostatectomy. And why do we never hear about the bowel problems from radiation for prostate cancer? Given one of those choices that nobody ever actually gets, I"d choose my lymphedema plus my AI side effects over radiation proctitis any and every day for eternity. Finally, as others have mentioned, men of course DO undergo hormonal blockade for prostate cancer and suffer many of the same or analogous side effects. Lastly, there's concern now that a hormonally-acting medication that has been marketed to and very commonly used in men for BPH (big prostate that blocks urine flow), finasteride, causes permanent ED. How ticked would I be if I were a man who had a condition not considered life-threatening, and a medication I took to relieve my symptoms wrecked my erections forever? I don't think any matriarchal thoughtlessness has been part of that story, it's just a drug that's been pushed by a drug company and men the age for BPH are also an age where ED is common.

New medications hit the market almost always because a drug company - not a doctor - spends the time and effort to get therm through the FDA so that it can make more money. It's not in their interest to produce drugs that have horrible side effects, unless the disease is worse. Even then, if Bayer produces drug A and it does a great job but causes side effects, then Pfizer and Merck and Novartis are going to be keenly interested in producing something with less side effects. It's all $, and I honestly don't think they give a crap if the $ are coming from men or women. Money is money. Breast cancer has the potential for blockbuster drug after blockbuster drug, and I am confident we'll see better things out on the market down the road. The disease is a drug company dream: common, potentially life-threatening, and we're getting somewhere in figuring out disease-specific targets.

The truth is, we've been fed a diet of mass-media medical fiction that most medical crises end well, that most diseases are curable, and that people walk out of the hospital cheerful and thankful. "But doctor, I'm sure that in this day and age . . . " when the truth is that no, in this day and age we are only beginning to scratch the surface of how we might be able to alter the course of the so many ways the body can go wrong. You can look at that as the glass half-full, or the glass half-empty. At least we're scratching. Had I been diagnosed 100 years earlier than I was, I would not have lived to see my older child turn 5, but I'm here for her 11th birthday at a price. Most of the time my glass is half-full, but sure, I wish it were simply full and I hope for women in 50 years things will be much better.

exbrnxgrl

"It's definitely odd for me to be in disagreement with a post identifying as feminist and anti-patriarchal, but I do"

Outfield,

I share this sentiment and thank you for expressing why you feel this way so very eloquently.

Artista964

i agree outfield. On this bored it's easy to feel we have the worst of everything because majority of people still posting are people who are having ses. But there are other diseases too and men have just as many shitty ses some of which as women may not know. Yes we have shitty txs, but long ago we'd all be dead in no time. Now even stage IV cancer people can live longer. So progress has been made thanks to the drug companies. Someday immunotherapy will be the choice for all cancers and chemo and rads will only be in the history books. But for now as much as ses suck and they do for me too, I am grateful that there is this as an option vs nothing.

I'd rather have what I have, in remission, than in my dad's shoes who had a stroke and his walk and hand function are compromised. Everything takes a lot of effort and time when he used to be active just last year. He works then his time is spent doing exercises and activities of daily living then sleep. There is no remission for him and stroke people have a high chance of stroking worse again. I'll take my ses over that life any day.

tlfrank

I'm sorry, but I've been watching the hostility of this post escalate and I have to say that I think the OPs intent was solely to express frustration. Pointing out that serious research dollars are spent on things like the "little blue pill" for men, and the importance of maintaining an erection for 4 hours, when it seems that markedly less dollars are spent on this type of women's medicine - (unless we have a little blue pill that I'm unaware of).

I don't see where she implied that men don't suffer horrible side effects from some of their treatments, and slamming her for expressing frustration is not the point of these boards - or is it? If so, count me out.

exbrnxgrl

IMO, no one is slamming the op, simply expressing their points of view, which may or may not be the same. I'll re-read, but I didn't notice hostility or slamming, just different POV's.

Traveltext

I also don't agree that there's hostility in this thread, just lots of interesting posts. In fact, it's is one of the best debates for ages on BCO, and I hope it has a long life.

pupmom

Outfield, that was a righteous rant! You spoke for me!

Outfield

As there's been a question about the erection for 4 hours thing: I've seen the devastation of that side effect from the drug most commonly known to cause it, an old antidpressant, trazodone, which is now mainly used for sleep. I've seen this. Once I had 2 guys at the same time on a 10 bed unit who had permanent ED as a result. They were both bitter. No drug company wants to create a drug that purposely prolongs erections like that since there's a major risk of ischemic (lack of fresh oxygenated blood) damage to the penis, and therefore a major risk of lawsuits.

The "little blue pill" wasn't developed for erectile dysfunction. Pfizer thought nitric oxide was a good target to explore for the treatment of angina, since NO is a vasodilator. NO's lifespan in a blood vessel is very short - it's not stable. Sildenafil was an attempt to prolong its action by inhibiting the phosphodiesterase that breaks down a step past the NO itself. SIldenafil didn't end up being used for angina, but the type of medication is also used to treat arterial spasm in the lungs (pulmonary hypertension). The discovery of the fortuitous "side effect" is basically the same story as how a TB treatments] led to the development of early antidepressants: non-specific drugs do a lot, and sometimes the "side effects" are actually good.

No attempt to slam anybody here, but an attempt to keep things grounded in fact.

Lea7777

I have read and appreciated all the responses, whether serious or in jest, whether in agreement or rebuttal. Thanks for the education and for taking time to express your thoughts, feelings and rants of your own. For those of you who are suffering I wish solace. And I wish you were not suffering at all.

>>If one of the major side effects of this drug was unrelenting penis pain so severe that it prevented intimacy would the words "well tolerated" be used to describe it and would it continue to be advocated as "the gold standard"?<<

Your five days on an aromatase inhibitor caused you to suffer severe, unrelenting penis pain?

^^^^^^^^^^I was the one on the AI for 5 days. No penis pain, as I am female and was suggesting that unrelenting penis pain would not be considered "well tolerated" or a "gold standard" whereas unrelenting vaginal pain can still earn those words of accolade. After 5 days on Exemastane my entire "undercarriage" was in burning pain, radiating out to my limbs. Walking, sitting, sleeping, urinating was painful every moment. Among other things.^^^^^^^^^^^^^^^

Think there is any possibility that it might have been delusional? ^^^^^^^^^^^No, I was and am completely in charge of my mental faculties, though not of my penis, as I do not possess one.^^^^^^^^^^^^^^^^^^^^^^^^^^

Peace, Health, Contentment to you all.

MO-Beth

runor,

I didn't even read your entire post, but I am replying, "You're right. It's all about the money. FOLLOW THE MONEY," because, at the risk of sounding like an extremist, which I am NOT...it's just the plain and simple, gosh darned truth.

Artista964

very enlightening posts, outfield.

Icietla

>>anger<<

Disappointment.

>>[...] side effects, which as we all know (newbies included) vary greatly from person to person.<<

Some newbies seem not to know that. Some seem to be under the misapprehension that the possible side effects are universal. Some state assumptions that they would have those side effects if they were to use the medicine/s.

>>Women do rightly vent about their own side effects [...]<<

Yes. I have no issue with that. Readers from all over the World look to BCO for information, including information as to what they might fairly expect in their treatment experience. They hope and expect to learn from others sharing their own experiences of breast cancer and its treatment. We want -- and want to reach others with -- understanding, support, and connection.

>>I have never seen anyone proselytize about forgoing hormone blockers so far.<<

Perhaps you have seen posts complaining of "the" dreadful side effects "we" suffer from endocrine therapy -- or that "most of us" have suffered and been unable to tolerate. Think posting content of that nature might make some misleading impressions? [No response required.]

>>the "never takers" and the "non takers"<<

Not all of them.

>>[...] side effects [...] vary greatly from person to person.<<

Those who take or have taken the medicine/s may have side effects therefrom.

Peace.

Icietla

Lea7777-- Oh dear! I am so sorry you suffered all that. I hope you are feeling better now.

That medicine you were taking is the one my MO says would be the next choice for me if I should ever have intolerable side effects from the Letrozole.

Are you going to try another medicine? There might be other medicines to help about bothersome side effects (?).

Michelle_in_cornland

ICE, thank you, thank you, thank you.....YOU SPEAK MY LANGUAGE

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>>anger<<

Disappointment.

>>[...] side effects, which as we all know (newbies included) vary greatly from person to person.<< YES.

Some newbies seem not to know that. Some seem to be under the misapprehension that the possible side effects are universal. Some state assumptions that they would have those side effects if they were to use the medicine/s. YES

>>Women do rightly vent about their own side effects [...]<< IF THEY ARE TAKING THE MEDICATION, IT IS JUSTIFIED.

Yes. I have no issue with that. Readers from all over the World look to BCO for information, including information as to what they might fairly expect in their treatment experience. They hope and expect to learn from others sharing their own experiences of breast cancer and its treatment. We want -- and want to reach others with -- understanding, support, and connection. DITTO

>>I have never seen anyone proselytize about forgoing hormone blockers so far.<<

Perhaps you have seen posts complaining of "the" dreadful side effects "we" suffer from endocrine therapy -- or that "most of us" have suffered and been unable to tolerate. Think posting content of that nature might make some misleading impressions? [No response required.]

>>the "never takers" and the "non takers"<< YES.

Not all of them.

>>[...] side effects [...] vary greatly from person to person.<< YES. AND SOME PEOPLE ONLY HAVE SLIGHT SIDE EFFECTS.

Those who take or have taken the medicine/s may have side effects therefrom. AS WITH EVERYTHING IN LIFE, AN ACTION CAUSES A REACTION. THE DEGREE OF REACTION IS SUBJECTIVE.

Peace.

tlfrank

Your five days on an aromatase inhibitor caused you to suffer severe, unrelenting penis pain?

^^^^^^^^^^I was the one on the AI for 5 days. No penis pain, as I am female and was suggesting that unrelenting penis pain would not be considered "well tolerated" or a "gold standard" whereas unrelenting vaginal pain can still earn those words of accolade. After 5 days on Exemastane my entire "undercarriage" was in burning pain, radiating out to my limbs. Walking, sitting, sleeping, urinating was painful every moment. Among other things.^^^^^^^^^^^^^^^

Think there is any possibility that it might have been delusional? ^^^^^^^^^^^No, I was and am completely in charge of my mental faculties, though not of my penis, as I do not possess one.^^^^^^^^^^^^^^^^^^^^^^^^^^

Lea777 - I'm on Tamoxifen and have the same discomfort. People who don't experience it, just can't understand. I don't post horror stories about it because I was one of those people who read some of the posts and was terrified to take it. In my case it turns out they were right and no I'm not delusional.

Meow13

I have seen people say they need to take a break from these boards because they can be toxic. I understand what they mean.

stephaniebc

Meow13 ditto. what is being euphemistically described as disappointment looks like seething hostility to me.

runor

I am completely confused!

In my time on this forum I have seen what can be roughly categorized as two different camps. Those who want their pill with a spoonful of sugar and those who want it straight up. To put it another way, there are those who want information manipulated, edited, mollified, sweetened up or down to make it easier, less scary, more encouraging to swallow. Drink the Kool-Aid and we'll all go see Jesus, and that's a GOOD thing. Then there are those who want YOUR truth, as it happened to you, no holds barred, spit it out, tell it like it is, lay it on the line so I have some frame of reference.

When the Tell It Like It Is (to me) people speak up they are quickly slapped by the Spoonful Of Sugar group who accuse them of scaring newbies. NEWS FLASH by the time you arrive on this forum you have already had the shit scared out of you! If you have been diagnosed with breast cancer or going through that trauma, and you are NOT scared, you are the happy recipient of a lobotomy or your meds are too high, dial back that antidepressant so reality can get to you!

I resent, mightily, the self appointed righteous who get to determine that the purpose of this forum is to soft sell the breast cancer experience because that is the only way to 'support' someone. By feeding them carefully worded reality. By not getting too real. By not pointing out that sometimes things go right and sometimes they go wrong. By the way, if you are here, you have already fallen into the Things Gone Wrong category.

I was scared to take tamoxifen. I took it anyway. I read the happy, joy-joy posts saying I'm so lucky to have this drug and it's giving me a fighting chance and I dance and sing every time I take my pill, weeee! I also read the posts by people so miserable they quit. I read it all. ALL OF IT. And using my own brain, my own judgement and my own decision I took the pill.

I am not loving it. And to anyone who says NOT taking the pill is the same as choosing death I say piss off. That is the response of someone who very much wants to NOT know the truth of their situation. Breast cancer showed up randomly and if you survive it until death by other means, lucky you. If it kills you, unlucky you. And the bullshit we go through in between is all cards stacked in our favour - or not - no guarantees, so no one EVER ought to connect treatment obedience with survival because those two things, ultimately, are not connected. Short term in some cases, yes. In some cases, no. Long term in some cases, yes, in some cases, no. So what ONE HARD TRUTH can be concluded from this? We're all just flapping in the breeze.

BUT .... it is not my job to assume very new person here is too stupid, too weak to accept the TRUTH OF MY EXPERIENCE. That is insult to someone to add to injury. If you love taking your tamoxifen and dance in the street every time you pop a pill, SAY SO. If your hair is falling out, your joints ache and your vagina is a useless shrivelled prune SAY SO. That is the most valuable thing this site ha to offer, the REAL, unvarnished experiences of everyone. Good or bad. Equally.