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Why The Five & One?
Health care doesn't fail women because we lack information. It fails because systems are slow to change and rarely built around women's bodies, lives, or timelines.
The Five & One exists to make those systems visible. Each week, we share five signals shaping women's health across care, policy, research, and access, plus one thing just for you.
This week
From a Supreme Court ruling and a new cancer drug to microplastics, ultra-processed foods, and oral health, this issue explores how systems, environments, and everyday behaviors intersect to shape women's health — often in ways that are overlooked or hard to avoid.
01. When a Court Ruling Affects Your Prescriptions
The Supreme Court recently issued a temporary ruling affecting how a commonly prescribed medication can be dispensed — and the ripple effects go beyond one drug.
The case centers on mifepristone, a medication with multiple clinical uses including miscarriage management, uterine fibroids, and Cushing's Syndrome but is most commonly associated with abortion. . The ruling puts restrictions on how and whether it can be prescribed remotely — and that has implications for how all time-sensitive medications reach patients.
The Breakdown
Many women rely on telehealth and mail-order pharmacies to access medications, especially in areas with severe OB-GYN shortages
Restrictions on remote prescribing for one drug set a precedent for others
Rural and low-income patients are disproportionately affected when in-person dispensing is required
The Breakthrough
This ruling puts telehealth as a healthcare access point — not just a convenience — squarely in the national conversation
It creates momentum to address provider shortages and geographic gaps in care
It raises important questions about who gets to decide how medications reach patients
Source: NBC News
02. FDA Approval Expands Options for Hormone-Driven Breast Cancer
Breast cancer outcomes have improved significantly over the past few decades, driven by better screening, earlier detection, and targeted therapies. But that progress hasn't reached every patient equally — especially those with advanced or treatment-resistant forms of the disease.
The FDA recently approved a new drug from Pfizer and Arvinas for patients with hormone receptor–positive, HER2-negative metastatic breast cancer — a form of the disease where cancer has spread and stopped responding to earlier treatments. It's the first approved therapy to work by targeting and breaking down a specific protein, called ERα, that fuels tumor growth in this subtype.
The Breakdown
Patients with advanced or metastatic disease often run out of effective options as treatments stop working
Hormone receptor–positive breast cancer is the most common subtype, but later-stage patients have had fewer next-line therapies available
Treatment at this stage can become a long, exhausting sequence of trying what's left
The Breakthrough
This drug works differently than existing therapies — it degrades the protein driving tumor growth rather than just blocking it
It gives patients with treatment-resistant disease a new option when others have stopped working
It's a concrete example of innovation reaching the patients who need it most: those furthest along and with the fewest alternatives
Source: US News
03. Microplastics, Exposure, and What We’re Still Figuring Out
Microplastics have become one of those topics that seems to be everywhere. A recent update from Harvard T.H. Chan School of Public Health highlights what researchers are beginning to understand about how these particles may affect women's health. We know exposure is real. We don't yet fully understand the long-term consequences.
The Breakdown
Public conversation has moved faster than clinical guidance
Women may have unique exposure pathways through cosmetics and personal care products, and because microplastics may interact with hormones in ways that affect women differently
Early research suggests potential links to inflammation, hormone disruption, and reproductive health
Microplastics are now detectable in human tissue, including blood and reproductive organs
The Breakthrough
Research is shifting from "are they there?" to "what are they doing?"
Scientists are focusing specifically on women's health outcomes, including fertility and hormone regulation
Better measurement tools are improving our ability to track exposure in the body
The conversation is moving toward systems-level solutions — materials, regulation, and manufacturing — rather than putting the burden on individuals
Source: Harvard
04. Ultra-processed Foods and the Limits of “Just Make Better Choices”
Ultra-processed foods (UPFs) are another area where concern is growing faster than clarity. A recent study links higher consumption of these foods to shorter attention spans, adding to a broader body of research connecting UPFs to metabolic, cardiovascular, and cognitive health. Like microplastics, this is a story about exposure that's hard to avoid — and a system that makes the default choice the harder one to resist.
The Breakdown
Ultra-processed foods make up a large share of the American diet
Many UPFs contain additives and ingredients with unclear long-term effects on the brain and body
Time constraints, caregiving responsibilities, and work demands disproportionately shape what women eat — and when
Public messaging usually reduces this to personal discipline, not system design
The Breakthrough
Research is expanding beyond physical health to include cognitive and behavioral effects like attention
The conversation is shifting from "what you eat" to "what the food system produces"
There's growing recognition that reducing exposure requires systemic change, not just willpower
Nutrition science is increasingly focused on how food is processed, not just what's in it
Source: Women’s Health Magazine
05. The Health Habit Hiding in Plain Sight
Flossing rarely makes the list of longevity strategies. It's framed as cosmetic, optional, or something to feel guilty about skipping — not something that meaningfully affects your overall health. But emerging research suggests that oral health may be far more connected to long-term outcomes than most people realize — linking gum disease to cardiovascular health, inflammation, and even lifespan.
We treat the mouth as separate. The body doesn't.
The Breakdown
Oral health is routinely siloed from the rest of healthcare
Dental care is frequently excluded from standard insurance coverage
Gum disease is common and often goes untreated
Chronic oral inflammation is linked to cardiovascular disease
Bacteria from the mouth can enter the bloodstream and affect other organs
The Breakthrough
Research is reinforcing the connection between oral health and systemic inflammation
Flossing and gum care are being reframed as part of cardiovascular prevention, not just hygiene
More clinicians are recognizing oral health as a signal of overall health
Prevention is shifting toward small, consistent behaviors with long-term impact
Source: Self
Your+1: When the Internet Outpaces Science
There's a growing conversation online about using a combination of Allegra (an antihistamine) and Pepcid (an H2 blocker) to manage perimenopause and menopause symptoms.
Women are sharing anecdotal reports of relief from brain fog, itchy ears, and frozen shoulder — symptoms that are real, frustrating, and often poorly addressed in traditional care models.
It's understandable why this is gaining traction. When symptoms are dismissed, under-treated, or therapies are in short supply — as we're seeing with HRT — people look for answers wherever they can find them.
What's worth knowing
This combination is sometimes used clinically for mast cell–related conditions, which has led to speculation about histamine's role in menopause symptoms
There is no strong clinical evidence supporting this protocol for perimenopause or menopause
Anecdotal reports can signal areas worth studying, but they are not the same as proven treatment
Both medications are available over the counter, which can create a false sense of safety when used long-term or off-label
Where to be cautious if you're thinking about this combo
Long-term antihistamine use may have side effects, including sedation or cognitive effects
Pepcid (famotidine) reduces stomach acid, which can affect digestion and nutrient absorption
Symptoms like brain fog or joint issues may have multiple underlying causes that need proper evaluation
Self-treating can delay diagnosis of other conditions
The bigger signal
This moment points to something larger: women are actively experimenting because the system isn’t meeting their needs. When care gaps exist, communities fill them, sometimes faster than science can.
The opportunity isn’t to outright dismiss these conversations. Though if you are in the mood to be even more frustrated by the tendency to do so, here’s some extra reading.
It’s to study them rigorously, understand what’s happening biologically, and translate that into safe, evidence-based care with an understanding of benefits and trade-offs.
. . .
P.S. Floss tonight. Consider it a cardiovascular intervention.