Could a simple fertility treatment be right in front of us?

There might be a surprising — and inexpensive — treatment for couples who are “experiencing unexplained infertility”: good ol’ vaginal progesterone, used safely for decades.

British researchers who conducted a small study found that women who used the progesterone (400 milligrams twice a day for 14 days) conceived twice as often as the untreated women — 15.3% compared to 7.0%. (The researchers point out the small sample size, though, which means it could have happened by chance.)

Oh, and the miscarriage rate with the progesterone treatment was half that of the women who weren’t treated.

They don’t know what’s going on — “It could be that treating women with vaginal progesterone is helping the womb to become more receptive to a fertilized egg” — but the results are encouraging.

“We need to do further research to prove these results in a larger group of people, but this trial suggests a potential treatment for couples with unexplained fertility. Given its safety and low price, there is no harm in offering this treatment in the meantime.”

A pancreatic cancer double-punch

The hot new way to treat pancreatic cancer is by targeting a gene called KRAS, where mutations drive pancreatic cancer.

But there’s a problem. Inhibiting the KRAS gene actually comes back to bite — it turns on a different gene called ERBB, and that just undoes the drug’s hard work: “when KRAS goes down, ERBB goes up and drives KRAS and other related genes back up again.”

So the obvious plan: Target both KRAS and ERBB. Which is what UC San Diego researchers did. (There’s already an FDA-approved ERBB inhibitor called Afatinib.)

In the lab, that one-two combo worked a treat.

“[T]he benefits of using the two drugs together were even larger than the sum of each one’s individual effect. In other words, the drug pairing was greater than the sum of its parts.

Thus, the UCSD folks say, “[W]e strongly encourage the clinical testing of this drug combination for patients with pancreatic cancer.”

The Long(ish) Read: Keeping the hair?

Dutasteride, aka Avodart, is technically for treating an enlarged prostate, but it’s also (wink wink) sold as treatment to stop hair loss. But does it work? And if so, how? The folks at Healthline have all you need to know about dutasteride. (Spoiler: Yes, it does seem to work, but “it may be best to manage your expectations.”)

Why statins cause muscle pain

It’s an old question: Why do some statin users get muscle pain and weakness? Now there’s an answer. It’s about an obscure enzyme called HMG-CoA reductase. Two facts about it:

1. It’s what statins target in order to lower cholesterol.
2. Researchers just discovered that, when a genetic mutation causes lower production of HMG-CoA reductase, it leads to a rare disease called limb girdle muscle dystrophy, where limb muscles weaken.

As you might imagine, “This connection between a rare disease and a common drug stunned the researchers.”

Happy twist: The Israeli team that discovered that it was the cause of limb girdle muscle dystrophy also found a treatment. It’s a drug called mevalonolactone that “allows muscle cells to function more normally even without the HMG-CoA reductase enzyme.”

That could mean a treatment for people for whom statins cause severe muscle pain. Sad twist: mevalonolactone may also increase cholesterol, so it would only be for the worst-off patients.

Less smell, more depression

This is the kind of interesting connection that might come into play later as we tease out what’s causing what. Johns Hopkins researchers have found a connection between the sense of smell as people age, and the chance of their suffering from depression.

Or, put more science-y: “[R]esearchers found that individuals with decreased or significant loss of smell had increased risk of developing significant depressive symptoms at longitudinal follow-up than those in the normal olfaction group.” And the worse the loss of smell, the greater the depression.

But which way does the connection go? Is the same factor causing both (e.g., altered serotonin levels, brain volume changes)? Or does one lead to the other — maybe less smell means less appetite means less socializing?

“Losing your sense of smell influences many aspects of our health and behavior, such as sensing spoiled food or noxious gas, and eating enjoyment. Now we can see that it may also be an important vulnerability indicator of something in your health gone awry.

“Smell is an important way to engage with the world around us, and this study shows it may be a warning sign for late-life depression.”

Short Takes

When opioids are outlawed, people become outlaws

This actually makes logical sense, but it’s good to have a study to prove it: When people have better access to prescription opioids, opioid-overdose deaths go down because “When access to prescription opioids is heavily restricted, people will seek out opioids that are unregulated,” as the lead author of a Rutgers paper explained.

And the latest long-Covid effect…

Add hypertension to the possible effects of long Covid — in women, at least. A small study (23 women) out of the University of Texas found that…

… while only one participant with long Covid had been diagnosed with hypertension prior to contracting Covid-19, “two patients had received a new diagnosis of hypertension post-Covid-19, two had resting [blood pressure] values classified as Stage II hypertension, one as Stage I hypertension and two with high [blood pressure] based on the current guidelines.” The elevation in resting blood pressure was consistent.