TO YOUR GOOD HEALTH
Low-dose estrogen eases hot flashes
PAUL G. DONOHUE
Q: Is there something I can take to get rid of hot flashes? I am 74 and have them all the time. I have tried Estrace (a female hormone), Estroblend (a dietary supplement) and black cohosh (an herbal remedy).
A: It has been said that 8 percent of women still have hot flashes into their 70s. Most women stop having them in six months to five years after menopause. The drop in estrogen production that occurs with menopause affects a part of the brain that regulates body temperature. The brain’s thermostat is thrown out of whack, causing spells of sudden, uncomfortable warming. To deal with hot flashes, dress in layers so that outer garments can be shed at the first inkling of a hot flash. Keep ice water on hand and drink it at the start of a flash. Cut back on caffeine. Slow, deep breathing at the onset of a flash is said to minimize the discomfort. Estrogen, which you have tried, is the most effective treatment for hot flashes. It should be taken in as low a dose as possible for the shortest time possible. Maybe a different estrogen preparation would work. Effexor and Lexapro, two antidepressants, have met with success in suppressing hot flashes for some women. Neurontin (gabapentin) is a seizure-control medicine that is also used for control of hot flashes. Hot flashes that have lasted as long as yours call for a consideration of conditions other than estrogen deprivation. An overactive thyroid gland, a hidden infection and two unusual tumors — carcinoid and pheochromocytoma — are examples of illnesses that produce symptoms similar to a hot flash.
Jan’s Comment on this Q: So often I can respond from personal experience- – but not much on this one. In California, sometime in my 40′s, my doctor whom I totally trusted said I needed to have my uterus removed. It had turned mushy he said, had fibroid tumors and I didn’t need it anymore. Ugh, I guess! Had it done; quick recovery and back to usual routine in no time. Took no meds of any kind. During my 50′s I was aware of getting extra warm, but seemed to quickly pass and was no problem. I did become fairly bitchy however and co-workers seemed to clear a path away from me. Figured this was menopause and thought I was getting away pretty easy – at least according to my mothers experience.
Mother had her ovaries and uterus removed (without consent) after having collapsed on a street in Oklahoma. When she awoke in a hospital and learned what had happened to her (late 1930′s ) when she was pretty young, she of course was distraught and traumatized. She had a totally different exposure to the need for HRT. Premarin was being used then (from horses). She was still taking it in her 70′s, but after her Alzheimers started, she became less aware and it was stopped. In early 1950′s, she nearly died from cancer – vaginal, a piece of the uterus was still there. She continued HRT after recuperating – could not cope with her “symptoms.”
No doubt Mother’s near-death cancer experience was in fact brought about by those long years of taking these drugs.
For the past 30 years or so, Bio-identical Hormones have been available according to what I have recently learned about Dr Jonathan Wright of the Tahoma Clinic in Washington. He wrote a book about it in 1997 and if I had this problem, I would probably get the book and/or contact the Tahoma Clinic for information and direction. It seems they are deeply interested in tailoring it to the individual after certain tests have been done. One is dealing with three different estrogen types including Esterol and estrodiol as well as progesterone and testosterone. One does not take this type of med orally. Taking a pill by mouth is not how nature provides it to us. One must always try to copy the way of Nature. Not to be swallowed.
They had tried transdermal application, but it was good for only a few years, then quits. The ideal solution turned out to be copying nature as closely as possible and using prescription compound directly to the labia or inserted into the vagina and rubbing gently in according to a timed concept (again, according to nature’s rhythm) turned out to be ideal.
Similar testing and treatment is done for men as well who have a whole set of particulars involved therein. And as with the women, where the ointment is applied is specific – either on the scrotal skin or the annal-rectal area.
As I said, I have no personal experience and what I have detailed here is pretty much all I am able to convey.
Q: My son is 56 and has a problem with bruises. He gets one whenever his arm hits anything. He has talked to his family doctor and company doctor, but they can’t find a cause. He doesn’t take aspirin or blood thinners. Do you have an answer?
A: Easy bruising in someone your son’s age could be an indication of clotting problems, such as the existence of too-few blood platelets (the blood cells that form clots); a defect in producing blood proteins called clotting factors; a fragility of blood vessels; or a deficiency of vitamin K, an almost-unheard-of condition these days. I don’t know whether he was checked for these things, but he should be. In older people, easy bruising is common because blood vessels have become fragile and have lost the cushioning material that protects them. By the way, your son is too young to have fragile blood vessels.
Dr. Donohue answers letters only in his North America Syndicate column but provides an order form of available health newsletters. Write him at P.O. Box 536475, Orlando, FL 32853-6475.
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