Blog: Lloyd's Fatigue Clinic study asks “are women with CFS ovary-reacting?”

It may be better to play safe with this. That yellow headline bit with the "ovary reacting" quote looks not to be part of the original document. It appears to be merely pinned on, and possibly covering the original title. Presumably anyone could have done that as a joke in poor taste at the researchers' expense.

If it was placed there by the research team then they should really seek alternative employment.

 

i believe the yellow headline is on same piece of paper as the other words.

but yeah, offensive. poor selection criteria. psych questionnaires that may have ambiguous interpretations*. biomed samples (salivary samples, hormone testing) that might give the appearance of being sciency & objective, but the interpretation can be twisted to suit any purpose or belief. (eg symptoms get worse during ovulation - therefore ovulation causes ME).

and a research supervisor who benefits from ME research that increases stigma & neglect, and allows him to appropriate funds for more dodgy psych research. while the serious biomed researchers struggle to obtain research funds.

* an example is the Hospital Anxiety and Depression Scale: does your heart race ? do your fingers tremble ? you MUST be anxious, so we'll ignore the rest of your symptoms because obviously you're just anxious and misinterpreting normal signs. no attempt to differentiate between emotional anxiety VS orthostatic intolerance and/or POTS, where the body increases catecholamines to compensate for the low blood volume & reduced cardiac preload found in people with OI/POTS.

 

You may well be right, but there is what looks suspiciously like a shadow beneath the bottom edge of the yellow, and this would be appropriate given the apparent direction of the light source. It is clearly not a border to the yellow part, as it only appears at the bottom edge. It just looks a little odd to me. But I do have a suspicious mind. What's left of it.

 

i zoomed the photo - there's a blue-green (not black) line just below the yellow title box, the line has a consistent height, and left/right edges that match the text margins. the thumb-tack on the top left of the page, has a shadow inconsistent with that blue-green line being a shadow.

 

I don't like the sound of this bit

"The questionnaire will ask you questions about your fatigue symptoms, mood and thought processes"

so it's not how the hormones affect your physical health or mobility or ME symptoms at all

 

[Sarcasm]

Yeah, you see if you change the way you think you can sort your own hormone levels out! Keep them nice and even. Then of course that will improve your ME out. We understand this is difficult so we can generously allow you to completely waste your time and energy on a nice course of CBT.

 

Perhaps interesting to compare it to the Scandinavian hormone research - will show how things should be done ...

 

Ok, so this is a study of women with CFS who are ovary-reacting (I’ll apply benefit of doubt and go ahead and assume he is not talking female hysteria because that would be outrageous and is in fact examining the role of female hormones in ‘CFS’).

So far so good. I fit neatly into the ICC ME criteria but wait a minute, it is only a rare occasion where I manage a neat 30 day cycle. In other words, I have ME (or CFS as it’s called by the medical profession in Australia) and my hormones are a mess (what the study is supposedly exploring but apparently isn’t) meaning I shall never be the winner of a $50 Coles or Myers voucher (sad face) but someone with the symptom ‘chronic fatigue’ and normal menstrual cycles is in with a chance. It’s a crazy mixed up world we live in.

Actually, now that I think about it, the misogynistic headline in yellow, the entry criteria and the questionnaire are increasingly leading me to wonder if he is indeed studying the subjective influence normal female hormoney stuff has on tired lil lasses.

Pass the laudanum please someone, I feel a bout of nervousness approaching.

Edited typos

 

I hope you have practiced fainting prettily, and brought your smelling salts.

 

Given that most thought processes occur below the conscious level a questionnaire to elicit them seems... questionable. To say the least. Maybe they should ask patients to make puns instead. This appears to be a more accurate method as shown by the overreact/ovary-react pun on the poster headline which clearly displays the punner's subconscious view of women.

 

Edit: deleted post. Was trying to make a pun for a study with male cfs patients, but on second thought it wasn't working. Maybe someone brighter could bring one up.

 

The apparent lack of any controls is an important issue.

The most obvious control for an influence of female hormones on ME would be men with ME with matched levels of disability/impairment.

Any serious study would also have female controls with a different but comparably disabling condition and normal controls (ideally but probablely unachievable matched for overall activity levels)

 

@Hutan a great first letter.

Do keep us updated.

 

That poster with the "ovary-reacting" gag seems to have taken matters backwards by about 27 years.

David, later quoted with approval by Wessely, said "The term hysteria has been attacked on several counts, but survives. However a straw poll of colleagues uncovered not a single instance where a doctor has used the term "H-word" in front of a patient. Fortunately no serious researchers now claim that hysteria is relevant to discussions on chronic fatigue syndromes...." in
Postviral fatigue syndrome and psychiatry. British Medical Bulletin (1991) vol 4 no 4 @ p981

It may be that we have discovered an alternative term used by Australian researchers. I always thought it strange that David limited his enquiry to use of the term in front of patients. What they say amongst themselves would be far more interesting.

 

We should be applauding progress in the way women are considered by male doctors. They used to think our hormones controlled our thoughts but now they think our thoughts control our hormones.

 

Great letter. Thank you @Hutan.