Women Often Mute About Medication Use

Feb. 24, 2004 - Women often do not tell their doctors about the over-the-counter and herbal medications they take, a new study shows, and their health could suffer as a result.

Researchers found that the women were most likely to report taking a drug or herbal supplement if they were asked specifically about the medication or asked about the drugs they took for a specific medical condition.

"What we found very quickly was that just asking a single generic question about drug use did not get us much useful information at all," University of Minnesota pharmacy professor and study researcher Timothy Tracy, PhD, tells WebMD. "Health care providers need to dig deeper to get the answers they need."

OTC and Supplement Use High

In the survey of 567 non- pregnant women attending five rural gynecology clinics, researchers found the use of all medications to be higher than expected. Nine out of ten women reported taking one or more prescription drugs, while 96% took over-the-counter medicines and 59% took herbal supplements. The findings are reported in the Feb. 24 issue of the American Journal of Obstetrics and Gynecology.

Study participants were interviewed using a three-step process, starting with an open-ended question about general medication use, followed by questions about drug use for specifically named medical conditions, and ending with the women being asked about their use of specific medications and herbal supplements.

"With each question the women recalled more medications," Tracy says. "This was especially true of over-the-counter medications and herbal products. They either didn't think it was important to report the use of these drugs or they were apprehensive about mentioning them because they were self-medicating."

Potential Interactions

Herbal supplement use was slightly higher among the menopausal study participants than among younger women. Tracy says this finding is particularly significant because older women tend to take far more prescription drugs than younger ones.

Of particular concern is the use of St. John's wort. The herbal supplement is commonly used for depression and acts on the brain in a similar way to the most commonly prescribed class of prescription antidepressant. One out of four study participants took a prescription antidepressant and many also reported taking the herbal product.

Reports have also linked the use of St. John's wort with decreased effectiveness of oral contraceptives. The supplement has also been shown to interact with the heart medication Digitalis, certain immunosuppressive drugs, the commonly prescribed HIV drug Indinavir, and the anticoagulant drug Coumadin.

In an earlier study, researchers reported that at least 30 herbal supplements, including ginkgo biloba, danshen, garlic, and borage seed oil, may increase the risk of life-threatening bleeding among patients on Coumadin.

"Clearly there is interaction between Coumadin and many of these herbal medicines, but we are not really sure how big the problem is," University of Iowa cardiologist Brian Olshansky, MD, told WebMD in a previous interview. "It is true that most people don't tell their doctors exactly which herbal therapies they are on, but even when they do the doctor doesn't always know what to tell the patient."