Spoiler alert: it’s absolutely bloody nothing.
Science has heard us, ladies.
Endometriosis awareness and diagnosis is at an all-time high, and it seems the burden of PMS and hormonal birth control may finally be receiving adequate recognition.
Perhaps the days of women’s menstrual pain and mental health being dismissed are finally coming to an end. Maybe, just maybe, we could be given options other than the pill or being told to get knocked up as the first line of treatment.
Lol, jokes, they want to give women sugar pills.
No, seriously. I mean literally being given a placebo which is identified to us as completely unmedicated and being told that it’ll stop our PMS.
A recent trial of 150 women in Switzerland aged 18 to 45 who had PMS or premenstrual dysphoric disorder were reeled in with advertisements for side effect-free intervention. Once they were on the hook, the minor detail that it was also treatment-free was revealed.
The researchers told a third of the cohort to keep doing whatever they were doing as a control and gave the rest open-label placebos twice a day for six weeks, which are described as “placebos that are provided with full transparency”.
Half of this “treatment” group were provided an explanation of how placebos work, while the other half were not.
Among those provided an explanation, researchers found a reduction in the intensity of PMS symptoms by nearly 74% and interference in their social, educational and working lives was reduced by almost 83%.
The placebo group with no explanation saw their symptom intensity and impact on their lives halve, while the control group reported a 33% reduction in symptom intensity and a roughly 46% reduction in interference in their lives.
I don’t know about you, but my biggest concern in the face of impending hormonal doom is whether I’m pleasant and trim. Luckily, I can lose the bloating and quit my incessant complaining about hormonal birth control by simply taking a nothing pill and wishing the symptoms away.
Perhaps this Back Page correspondent is just completely misunderstanding the concept of placebos. I was under the impression that in order for them to work, we require at least a small belief that we might be taking medication.
But no, the study cited a few other areas in which open-label placebos have been shown to be effective, including irritable bowel syndrome, chronic low back pain, and menopausal hot flushes. They can’t say how it works, only that some studies have shown a moderate effect of knowingly ingesting placebos to reduce symptoms.
I’m not dismissing the awe-inspiring power of self-talk (or in my case, straight denial), but I struggle to believe that if I were knowingly handed a sugar pill, I’d be able to think my way out of PMS.
But maybe I’m being unfair.
To their credit, the researchers did not downplay how serious PMS can be, discussing increased suicidality, depression, eating disorders and migraines. They described the distress and psychological symptoms, as well as the physical symptoms, as “significant”.
They really started to make me feel like they were on my side when they discussed the litany of debilitating side effects from treatments such as SSRIs and oral contraceptives.
Preach, sister.
But this all came crashing down when they concluded that open-label placebos had “very few and not serious side effects amongst women in both placebo groups”.
Wait, side effects? Seriously?!
Even after being advertised as side effect-free and recruiting women with that expectation, they simply couldn’t be fooled into thinking they could get benefits without side effects.
It seems that after a lifetime of treatments for their pesky little women’s troubles always coming with caveats, they just couldn’t convince themselves that this new nothing treatment wouldn’t also have drawbacks.
The study didn’t say what these side effects were but given what we experience from our other treatment options, I’m assuming it was only a moderate increase in the number of third nipples and bouts of explosive diarrhea.
Honestly, it might still be the better option for some.
Send story tips and mansplain placebos to penny@medicalrepublic.com.au.
