Intended for healthcare professionals

Minerva Minerva


BMJ 2000; 320 doi: (Published 11 March 2000) Cite this as: BMJ 2000;320:724

Regular sex can be an alternative to vaginal surgery for young women with vaginal agenesis, writes a gynaecologist from the Netherlands (Acta Obstetricia et Gynecologica Scandinavica 2000;79:149-50). Three of his teenage patients—one of them only 15—ignored advice to consult a gynaecologist before starting a sexual relationship. After a year or more of regular intercourse all had an acceptable vagina. This approach is not new, however. Italian doctors wrote up the first case series in 1972.

After drinking a large mug of coffee, Minerva learned from the American Journal of Clinical Nutrition(2000;71:480-4) that unfiltered coffee increases the plasma homocysteine concentration by about 10%. The researchers are cagey about whether or not 10% more homocysteine matters, but it surely matters less than the accompanying increase in serum caffeine concentration which gets many of us out of bed.

Extensive research has yet to provide any firm conclusions about the significance of homocysteine to cardiovascular disease. A systematic review in the Archives of Internal Medicine finds that the strongest associations have come out of the weakest study designs (2000;160:422-34). Prospective data are unconvincing, say the authors. Only a large randomised trial of treatments to lower plasma homocysteine concentration will settle the debate one way …

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