We have to take gender bias in medicine more seriously

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There has been little panic over the contraceptive pill, a medicine that has a higher risk of causing blood clots than the AstraZeneca-Oxford vaccine (Getty Images/iStockphoto)

Emma Flint raises a number of important points in her piece about thrombosis and the combined oral contraceptive pill (The pill has a higher risk of causing blood clots, but nobody is banning that, 17 March).

A very large amount of information exists about this risk collected since introduction in the early 1960s. It is part of the initial assessment for prescription to assess these known risks and advise the patient so that she can decide whether to take the pill or not. It is a matter of concern if that is not happening.

Her second point about gender bias in medicine is very important. There is a growing awareness that a “one size fits all” approach is not valid and special rules may apply to the different biological genders, children, the elderly, and even different ethnicities.

Of these subgroups, women have been recognised most recently as needing different consideration. A good example is that of the blood test Troponin to evaluate heart attacks where the level of significance for women is different compared to men.

Dr E A Bayton

Warrington

Global Britain

The “Global Britain” declaration by Boris Johnson is tantamount to a “MBGA” – Make Britain Great Again – policy.

The ambition to become a centre and world leader in technological development is laudable even if in a highly competitive market, well funded by national governments, it will be very challenging. However, sending the pride of our fleet to Indochina is redolent of gun-boat diplomacy and just how Britain will benefit is baffling. Certainly China is unlikely to make any changes to policy.

But it is the ambition to increase our nuclear deterrent that is both unfathomable and highly worrying. It breaks an international agreement on nuclear arms reduction and will send a strong message that if you want to exert influence then nuclear weapons are essential. Do we really believe that regimes that are prepared to make a cyber assault or launch a chemical weapons attack will be deterred by our nuclear arsenal when it is abundantly clear it is innocent civilians that will suffer and that fall-out cannot be contained?

Boris Johnson is too young to remember the palpable fear during the Cuban missile crisis, but for those of us who do remember, the steady reduction in nuclear weapons and the non-proliferation treaty has brought peace of mind. The announcement to increase our nuclear arsenal is a blatant threat not just to world peace but also to our standing in the world.

We are already diminished as a nation by the actions and policies pursued by Boris Johnson and this latest attempt to portray Britain as a major world power will only serve to bolster the widespread opinion that he is a buffoon and not to be trusted.

Andrew Erskine

Abergavenny

Sir Keir Starmer asks why we must increase the UK’s nuclear stockpile. The new UK Trident warheads will need to fit within the US-designed warhead aeroshell and need to be compliant with all the other US non-nuclear components. The US can share design information for the warhead but not sell it.

Read more:

• Britain’s nuclear weapon plan makes little sense at home or abroad
• Key points: What is in the government’s integrated review of defence and foreign policy
• Unsafe and unfair: The truth about covering football as a female journalist

UK taxpayers are told by HMG that they cannot afford to pay NHS workers what they sorely deserve, nor keep the cross-party commitment to overseas aid, but they can afford to subsidise the heavy costs of US nuclear research and development. Would that be to sweeten the much-vaunted post-Brexit US/UK trade deal?

Christopher Hall

Banbury

Cumbria coal mine

By all means let us debate whether the proposed coal mine in Cumbria should go ahead or not but can we have the debate based on logic and fact, not on knee jerk reaction and prejudice?

This is coking coal destined for steel works. If steel works cannot buy it from Cumbria, they will buy it from the US or Australia for as long as there is demand for steel. Coal is heavy stuff and transporting it halfway round the world in fossil fuel burning ships will add significantly to the carbon footprint of the steel produced. So the impact of this mine will be to lower CO₂ emissions.

Dr Doug Parr is quite right to say (UK accused of ‘rank hypocrisy’ over Cumbria mine as it hosts coal phase-out summit, 2 March) that it would signal an increase in planet-heating emissions from the UK – but only by exporting the emissions elsewhere. As CO₂ knows no boundaries, this is hardly a green response.

The emphasis on coal as the ultimate baddie, whose production we must stop at all costs, misses the real point. If there is no market for coal then coal will not be produced, so the real target should be users of coal. Sixty years ago, coal heated people’s homes, powered the railways, produced gas and produced electricity. These markets have since moved almost completely away from coal on to other fuels and coal production has plummeted accordingly.

Among the few remaining users of coal are heavy industry – particularly steel and cement. If we are to reach net-zero carbon by 2050, then we need to reduce the demand for coal from steel and cement works. If we do that, coal production will fall automatically.

Clive Rix

West Bridgford

EU’s vaccine mess

The European Union’s self-inflicted vaccine catastrophe will hardly be eased by Ursula von der Leyen’s threat to invoke Article 122 of the EU Treaty, allowing confiscation of factories, suspension of patents and export bans.

Is she trying to make Brexit look respectable?

Dr John Doherty

Stratford-upon-Avon

Too clever by half

Kudos to the government for coming up with a plan so cunning the great Baldrick himself would be proud.

As vaccine centres report cancellations from folk who want the Pfizer vaccine not the Oxford one due to scare stories, the government has claimed there is a vaccine shortage. Creating a shortage creates demand and folk are now desperately rebooking for any vaccine while stocks last. Brilliant!

Barry Tighe

Woodford Green

See you up north, Tim

It’s good news to hear that the BBC has plans to relocate some services out of London. I wonder to which northern city Tim Davie will be moving?

Dr Anthony Ingleton

Sheffield