Women in the military, by and large, are of child-bearing age, so you're concerned about things like pregnancy and breastfeeding. We have a little bit of data that the use of mefloquine causes a higher rate of miscarriage in Somalia veterans. Women who are deployed are not supposed to be pregnant, but sometimes they're pregnant before they go and they don't pick it up in time, and sometimes they get pregnant when they're there. I think it's inherently very risky. Then there's the question about the expression of mefloquine through breast milk.
The other thing is that women tend to have a higher lipid concentration, so again, one would hypothesize that you might have more of it that goes through the blood-brain barrier. We know that in traumatic brain injury or others, women have different reproductive cycles. Obviously, you've got the estrogen and other hormones, so how could that influence it? There are a lot of questions about passing on mefloquine. There are a lot of medications we try not to use in pregnancy because there's the risk of fetal abnormalities. All of those I would be concerned about.
For better or worse, so far, we don't have that much data because not many women, to the best of my knowledge, have been deployed on mefloquine and have been pregnant.