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Question:

I am 51, my period stopped about 6 months ago, and I have had debilitating hot flashes since then. I have had DVT and pulmonary embolism from HRT (birth control), due to a prothrombin II gene mutation, and so I cannot take hormones.

I am an RN, and my job involves doing sterile procedures that can sometimes take hours. I am dressed from head to toe, in gown, hat and gloves. I burn up on and off the whole time, and am constantly drenched. I am betatron bro dread the days that I have to do these procedures. My job is becoming almost intolerable due to the intense heat I experience.

What can I do to minimize the hot flashes? I take, evening primrose oil, black cohosh (vitex), calcium, and just started i-cool. They sometimes happen every 15 minutes with no rhyme or reason. I have heard that mistletoe tea can help. Is there any truth to this?

I don’t have any experience with misletoe for hot flashes and have not heard or read any scientific reports to support it. I do know it is used as a brewed tea three times daily for this indication and it should be safe for use at this level of intake.

I would talk with your doctor about some of the non hormonal prescription options to treat hot flashes. Those include neurontin (gabapentin) at doses of up to 900 mg daily (begun at 300mg daily and increased in stages for up to several weeks to prevent side effects) or one of the SSRI antidepressants used at lower dosages for hot flashes. In addition to i-cool, you can also try soy at dosages of up to 200 mg daily of isoflavones or up to 40 grams of the soy protein daily. My new book with Karen Giblin called Eat to Defeat Menopause offers recipes and tips to help as well. Be sure to drink plenty of water, and consider relaxation techniques as it sounds like your job is now really becoming stressful and stress is a big promoter of hot flashes.

Question:

Is there some natural dietary supplement to use for dry vagina – or some thing longer lasting than the inserts? I am not able to comfortably have sexual intercourse with out using some type of lubricant.

I am 55 and had stage I BC in 2005 (dx via mammogram) and had a lumpectomy and six wks radiation. BC returned (dx via mammogram) in 2008 where I had a double mastectomy and reconstruction. I am having hot flashes and was wondering if I could safely take i-cool for this? The i-cool box says the product is hormone-free and is also soy free. Do you have any additional info regarding this product and it’s safety for patients who should not take hormone products?

First for the vaginal dryness. The best solution is an over the counter product called Replens. Use it daily for 10 days then twice weekly. It contains no hormones and will add moisture. It’s important to realize that once you begin becoming sexually active again, there still might be some discomfort because you have not used those muscles very often for a while. However, by going slowly, taking plenty of time for foreplay, and increasing the frequency of intercourse, things should return to normal soon. If it becomes too uncomfortable in the beginning, just stop. Each time will improve and eventually the discomfort should become greatly reduced.

I cool is hormone free and soy free, but it does contain plant estrogens. The actual ingredient is genistein which is one of the isoflavones in soy. It is just that the iCool didn’t get its genistein from the soy plant. It is the same compound. Most medical experts feel that isoflavones are safe to use with a cancer history. But not all agree. Talk with your doctor about this and get their opinion. I have an entire book that goes into detail about this called The Soy Solution for Menopause. I know iCool doesn’t have soy in it, but it discusses genistein and other non-estrogen products.

Question:

I had been on Prempro for many years. I turned 60 and my doctor decided to change my therapy. He told me to take premarin 0.3 for 3 and one half months and on the 3 rd week of the 3 rd month to add provera 5 milligrams with the premarin for two weeks, then go back to the premarin for the 3 and one half months and do this again. I experienced hot flashes during this time. On the 14 th day of the combined premarin and provera I started to stain. I went back on the Prempro but am continuing to stain. How long should this staining last and should I be concerned?

It’s very unlikely you have to be concerned about the staining. But if there is a continued staining for more than 3 to 4 months, to be certain there is no problem, talk with your doctor about checking your uterine lining with a simple office procedure called an endometrial biopsy. The test removes a few cells from the lining of the uterus to look at under a microscope to be sure there is no cancer. The procedure usually causes only minor cramps for a few minutes and the risk for any complications is very low.

Question:

I am 44 yrs old. I started my period Thursday, June 30th as normal. Normally my period is for 7 full days…first 4-5 days are heavy, changing tampon at least every 1.5 hrs to 2 hrs even throughout the night. It is now Tuesday, July 12th and I am still spotting (red blood not brown). I exercise regularly (Curves Smart 5 days a week plus at least 45 minutes of walking 5 days + 1 hour 2 days a week) and have lost 25 lbs since January.

Do you think the exercising may be the issue or could I be going thru menopause?

Curves has a great exercise program and it is unlikely that your activity there is causing staining. But you might be at the beginning of perimenopause – just entering the change of life and on a journey that might last up to 10 years. Other things can also cause irregular or unexpected bleeding such as pregnancy, a significant change in weight, thyroid problems, increased stress levels, and low blood levels of iron to name a few.

Your doctor might want to check a few blood tests and test the lining of your uterus with a simple office procedure called an endometrial biopsy. The test removes a few cells from the lining of the uterus to look at under a microscope to be sure there is no cancer. The procedure usually causes only minor cramps for a few minutes and the risk for any complications is very low.

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