Questions & Answers : HRT

Breast cancer and menopause relief

Editor — Mon, 23 Apr 2007 14:46:00 GMT

Question:

I had breast cancer 10 years ago. It was low grade, but I was told by my doctor that I was not able to take anything for my menopause. I have hot flashes bad. What can I do to help me with this?

Name withheld

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Answer:

Lifestyle changes may help. Make yourself aware of physical triggers, such as spicy foods. Make sure your bedroom is cool, and that you have layers during the day you can quickly remove. Regular exercise can help. And when a hot flash starts, practice keeping your breathing, slow, deep and controlled.

Question about Premarin in low doses

Editor — Mon, 23 Apr 2007 14:44:00 GMT

Question:

I am 67 and had been on premarin for at least 14 years when advised to go off by my doctor. I tried for six months, but had severe flushes, trouble sleeping and concentrating, and was tired most the time. Went back on premarin at a low dose which did the trick. I tried to go off again a year ago, and went back to feeling terrible again. My question is, have any studies been done on taking premarin in low doses for long periods of time and the dangers of it? I would like to go back on it; my doctor says he isn't concerned because of it being a low dosage. (I have tried herbal substitutes and creams but they didn’t help.

Name withheld

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Answer:

All HRTs have their risks and benefits. It sounds like you should follow your doctor’s advice. That said, no physician should ask you to be a blind follower. There are health risks associated with premarin and your doctor should explain what factors s/he’s weighing in determining that taking it is worth the risk. To do some research on your own, Google “women’s health initiative.”

Androgen treatments

Editor — Mon, 23 Apr 2007 14:33:00 GMT

Question:

I had a hysterectomy in 2000. I was 40 years old at the time. I have no sex drive at all, but I am also on opioids for back pain. Would that affect my sex drive? What kind of medication would you suggest to increase libido.

Jewels

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Answer:

There are androgen treatments that might help with your low libido, but they are not without side effects. You’ll need to talk to your doctor about these prescription medicines. Lifestyle changes may also help – getting more active (pursued cautiously, this avenue might help your back, too), improving eating or developing more intimacy with your partner.

Hot flashes and removal of ovaries

Editor — Mon, 23 Apr 2007 14:20:00 GMT

Question:

I recently had to stop taking Prempro because I was diagnosed with breast cancer. My hot flashes immediately returned, even though I was on a very low dose of it and was trying to wean myself by only taking it every other day. Meanwhile, a rather large ovarian cyst was discovered and I recently had that removed along with both ovaries. I noticed I have not had a hot flash since. Is this because I no longer have ovaries and have the hot flashes stopped on their own?

Name withheld

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Answer:

That’s entirely possible. Removing both ovaries will definitely have an effect on your hormones. One of those effects may have been the cessation of your hot flashes.

Vaginal Itch

Editor — Mon, 16 Apr 2007 19:44:00 GMT

Question:

I am 44. I began having menopause symptoms a couple of years ago. I just recently had my annual check up. Blood was drawn to see where my hormone levels were. I was told they were low and my doctor suggested hormone therapy. I am not ready to do that because I feel I can handle the symptoms that come with menopause. There is one thing that I am having difficulty handling, though, and that is vaginal itch. It seems to be at its worst at night. Please tell me what I can do to help this.

Name withheld

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Answer:

There are topical treatments and moisturizers that might help. With perimenopause, the environment of the vagina changes from acidic to alkaline, increasing susceptibility to some infections. Also, dryness is a common problem. Ask the pharmacist for a product specifically designed to increase vaginal moisture (don’t use an all-purpose moisturizer or petroleum jelly). If that doesn’t do the trick, you may find relief from a nonsystemic prescription estrogen therapy.

No menopause symptoms

Editor — Mon, 16 Apr 2007 19:07:00 GMT

Question:

I am 53 and have not had a period since 2001. I feel great and walk five miles, three times per week. I am five feet six inches tall and weigh one hundred five pounds. I am calling my condition amenorrhea because I do not believe that I have had any of the other symptoms of menopause. I have not seen a doctor in 30 years and am not currently on any hormone replacement supplements. I do take two vitamin supplements per day meant for senior citizens and have one martini per day, along with a sandwich and salad.

Name withheld

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Answer:

You haven’t asked any questions, so we’ll just offer a few comments. Given your age and the fact that you haven’t had a period in six years, menopause is probably a better description – some women have few, if any symptoms, when they reach menopause. Mind you, it also seems possible that you “skipped” experiencing perimenopause – or marking the passage of menopause – by inducing amenorrhea through low bodyweight and low calorie intake. Amenorrhea is not usually considered a good thing. We would tactfully suggest that you’re long overdue for a routine physical. Your activity level is great and you clearly feel well – good! But why not take the most basic precautions?

Do I need supplements?

Editor — Mon, 16 Apr 2007 17:38:00 GMT

Question:

My doctor said I am going through menopause. Do I need a supplement to get through this? I feel really tired after I eat lunch and when I am driving home from work. I feel really run down once I get home. I need a cup of coffee just to keep me going I was never much of a coffee drinker until the last couple of years. I am 44.

Lexie

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Answer:

You will want to ensure that you are eating a well-balanced diet, which includes sufficient calcium and vitamin D. You should also minimize alcohol and caffeine – try decaf? If you smoke, quit. Finally, assess how well you’re sleeping. Hot flashes and night sweats can degrade sleep quality, leading to fatigue.

Estrace and promethium

Editor — Mon, 16 Apr 2007 17:11:00 GMT

Question:

I am trying to get off of estrace and promethium. For two weeks, I take estace – half a milligram every other day – then, for the next two weeks, I take it every three days. When I get off of that, I am supposed to ease off of Prometrium. I am taking 100 mg every night. When I am off of estrace, can I take a one-a-day weight control without causing any problems? I have been in menopause for the last four years. When will I be completely through menopause? I have not had a period for a year.

Deb

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Answer:

We’re not qualified to make recommendations about prescription drugs. However, we can clear up a few things for you. Given that you haven’t had a period in 12 months, you should assume you’ve reached menopause. Perimenopause symptoms can continue for up to a year after reaching menopause. As for weight control pills, we’re not aware of any over-the-counter pill that is safe and effective – so don’t take them. Eat healthy foods and get lots of exercise. It will keep your weight manageable, help alleviate unpleasant side effects of menopause, and improve your health in subsequent decades.

Menopause and Muscular Dystrophy

Editor — Mon, 16 Apr 2007 16:58:00 GMT

Question:

I'm 32 years. Last spring, I began having symptoms of menopause. A series of blood tests confirmed it, and I made an appointment with an ob/gyn. At the time, the symptoms were minimal so no hormones were prescribed. Over time, [the symptoms] have gotten worse. I've also had severe memory loss. There are times when I feel like I've fainted and my family says that during these episodes I'm very disoriented. Can menopause cause this? My mom thinks it's seizures, but I only had these episodes going through the change. I've taken Dilantin since 1992. I also have muscular dystrophy.

Jennifer

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Answer:

Honestly, Jennifer, given the complicating factors, we’re not comfortable dispensing advice on this. It’s time to pay another visit to your doctor.

I want off HRT

Editor — Mon, 16 Apr 2007 15:35:00 GMT

Question:

I am 64years old. I have been on HRT for 18 years. I have tried to stop taking the hormones, but the hot flashes come back. Sometimes, I even have them while I steadily take the hormones. I've been to three doctors and they all say that “about 20-percent of women have hot flashes forever and the only thing to do is to take the hormones." I've tried soy, herbs, but nothing is helping. Can you please direct me on where I can go for help? I want off of these hormones, but all three doctors keep me on them.

Joyce Carpenter

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Answer:

We’re going to have to disappoint you, Joyce. We’re not going to offer advice that flies in the face of a unanimous opinion offered by three physicians who have examined you. But by all means, go to a fourth physician, express in the strongest terms possible your dislike of hormones, and demand that the doctor spell out other alternatives – even if s/he doesn’t recommend them! You should also look at your own lifestyle and recognize that changes to diet, activity level and use of recreational substances, such as smoking or drinking, might make a difference. Also, have you looked into finding a menopause support group in your area?

Castleman's Disease and Menopause

Editor — Mon, 16 Apr 2007 15:25:00 GMT

Question:

I am a 43 year old who had a complete hysterectomy last September. I have a rare disease called castleman’s. Because of it, and an associated high risk of cancer, I cannot take HRTs, even natural remedies. I cannot have any soy products. I don't even know what I am going thru half the time. I need some help! Help! Help! I can't sleep at night. I feel nauseous all the time and sweat profusely. I am frustrated because of my rare disease, which I am having a hard time finding info on.

Name withheld

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Answer:

Our suggestion is that you get in touch with the folks at the Castleman’s Disease Organization. They can be reached at castlemans.org. You could also contact the national Organization for Rare Disorders at rarediseases.org, or the American Autoimmune Related Diseases Association, at aarda.org.