2023-10-25 04:00:09
BSIP / Getty Images/Collection Mix: Sub “”
BSIP / Getty Images/Collection Mix: Sub
“It’s a bit like making people believe in the existence of Santa Claus, but in adult women and on the scale of an entire country” explains Juliette Ferry-Danini
HEALTH – “The Spasfon?” It never worked on me. » This sentence, uttered by a colleague during a conversation, is banal: for stomach aches, painful periods or pregnancy contractions, most French people have already seen the name of this famous pink pill on a prescription – or Phloroglucinol, for its generic version.
In 2021, its sales amounted to 25 million boxes, the vast majority prescribed to women, and partially reimbursed by social security. However, despite its strong popularity in French pharmacies, the scientific evidence of the effectiveness of Spasfon is very weak – at least for the pain for which it is most widely prescribed.
In Pink Pills, Ignorance in medicinepublished this Wednesday, October 25 by Stock editions, researcher Juliette Ferry-Danini explains that “ the addition of the indication of menstrual pain to the marketing authorization for Spasfon was the result of particular nonchalance […]. The mention of 10 patients was enough. »
This teacher-researcher at the University of Namurs and specialist in the philosophy of medicine has produced an edifying investigation into the antispasmodic. Between medical ignorance, insufficient clinical data and sexism, the philosopher retraces with rigor and education the history of Spasfon in France and its consequences on women’s health.
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Le HuffPost. What intuition led you to do this research on Spasfon?
Juliette Ferry-Danini. I am a woman and I grew up in France. Like everyone else, I was prescribed Spasfon when I had a stomach ache, particularly for period pain. After several doses, I concluded that the medication had no effect on me. Later, when I had an IUD inserted, I was prescribed a Spasfon before insertion to “protect” me from pain. When I saw how much the medical procedure had hurt me, I was challenged.
This experience met my interests as a researcher in the philosophy of medicine, and I decided to delve into the subject. As I began my research, I learned that Spasfon was only marketed in France and a few other countries around the world. For me, it was a first point of alert.
So what your work demonstrates is that one of the best-selling drugs in France has no recognized proof of effectiveness?
In 2021, 25 million boxes of Spasfon or its generic, phloroglucinol, were sold, and 72% of these prescriptions were given to women. However, there is a real lack of convincing, relevant and quality data on the effectiveness of phloroglucinol in its indications (period pain, contractions during pregnancy, stomach aches, etc.) in France.
One of the starting points of my research are two systematic reviewss (practice which consists of evaluating and summarizing the clinical studies that exist on the use of a drug in the context of a given use, editor’s note) published by researcher Clara Blanchard and her colleagues.
The reviews are clear: in the case of gynecological or abdominal pain, there is not enough data to conclude that Spasfon is effective, and the research does not allow us to attest that it is indicated. prescribe. For certain indications – including painful periods, a frequent reason for prescription – there is no published clinical trial, period.
How is it possible that there are so few studies on a drug on the market for more than 60 years in France? This is the question that I try to answer in my work.
You hypothesize that ignorance around this medication and sexism are closely linked. How do you explain it?
The administrative archives that I was able to consult demonstrate that for indications which concern women (in gynecology then, later, in obstetrics) the scientific criteria used to evaluate Spasfon were even weaker than for “general” indications.
Not applying the same scientific requirement for male and female indications is the very definition of discrimination. But this is not the only manifestation of sexism. When women express their pain and are given a medication that has no scientific proof of effectiveness to soothe them, this is also discrimination, and their testimony is systematically ignored. My observation is that we are not interested in one of the drugs most used to treat women’s pain in France.
On X (Twitter), you have also received numerous reactions from women who have been prescribed Spasfon.
I have received many testimonials from women who shared times in their lives when they were prescribed Spasfon, to no avail. Many people said “I’ve known for a long time that it doesn’t work, and I’m still prescribed it.” And then, there is this feeling of being “crazy” which often comes back. We tell ourselves : “I have the impression that it has no relieving effect on me, but it is not possible that the whole of society is wrong about this medicine. Am I the problem? »
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In one of your chapters, you present the lack of effectiveness of Spasfon as an “open secret”.
For this book, I was not able to conduct a sociological study among doctors, but I was able to consult the medical thesis of Justine Clochey, who was interested in the management of women’s pain during inserting an IUD.
In the interviews she conducted with the medical profession, we can read doctors saying: “When I prescribe an IUD, I always prescribe ibuprofen, and Spasfon as a placebo. » We understand that it is almost an open secret: the lack of effectiveness of Spasfon is obvious to many doctors, but rarely explicitly announced to patients. It’s a bit like making people believe in the existence of Santa Claus, but in adult women and on the scale of an entire country. It’s a lie and it doesn’t respect the autonomy of patients.
Please note, I am not saying that all doctors are aware of this lack of evidence of the effectiveness of Spasfon. Many also have to prescribe it because they have been taught to do so, because it is common…
In France, nearly one in two women suffer from painful periods. These are all women who are potentially prescribed an ineffective medication…
Imagine it all put together. You have had painful periods since you were 16, you were given a Spasfon, and you have pain for hours when if you had been given something else, you would have had less pain. Accumulate these periods of pain in all French women, every month, over years and years until menopause.
Since finishing my work, I have been angry. What I analyze in it is the establishment of this medical “factory of ignorance”. And the harm caused by this ignorance is enormous.
Also see on Le HuffPost :
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