Paracetamol, Aspirin, Fashion and Changing Disease Patterns.

I remember the last days of  “A cup of tea, a Bex, and a good lie down.”  I also remember the reports that kidney failure  was related to Bex’s phenacetin and digestive tract ulcers were  linked to its aspirin, and  the start of the emphasis on paracetamol (AKAacetaminophen  in the USA)  as a safe alternative.

Now there is research suggesting that aspirin use has many useful side effects.  This has hit the popular press – compare http://www.womenshealthmag.com/health/aspirin and  http://www.medicalnewstoday.com/articles/243265.php

There are also problems with overuse of paracetamol having its own risks, and (unlike aspirin) it does not much reduce inflammation, so will not provide the same range of beneficial side effects as aspirin.  (As an aside,  it has great value for those who cannot risk aspirin’s blood-thinning properties, and for those young enough to be at risk of Reye’s syndrome.)  Other new painkillers (e.g. ibuprofen, naproxen) are selling well, and will no doubt be found to have a range of unexpected good and bad side effects.  There is a lot unknown about analgesics – for example, they don’t yet know why some people don’t respond to some analgesics, but some genes (e.g. melanocortin 1 receptor (MC1R)) seem to play a role.

The statistics on western women’s life expectancies in the seventies were based on generations of women who used aspirin-based medicines to keep going when family needs meant they had to keep going – no sick leave for Mothers.   (Well, not until they got bleeding bowels or failed kidneys from other things in the painkillers.)  They also had generations of  men who soldiered on bravely – painkillers were for softies.  And generations where women got heart problems and the diseases of aging later than the men.

Now we have a generation who changed from aspirin to paracetamol and other analgesics, and  under 40s who grew up with paracetamol for both genders.  Here is one more  public health change among the thousands of deliberate improvements in our lives.

And look, the gap between the genders’ life expectancies has shrunk while both genders have greater life expectancies.

Ten years ago I said that there would be a decline in the gap between the genders’ life expectancies.  I would now bet that there will be a continued decline in the gap between male and female  life expectancies, possibly a reversal of the gap, and that the change will have many causes.  I expect that most of the talk will be about the social changes such as mothers working outside the home – but I hope someone does some research on the outcomes by preferred general painkiller.

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