Menopause

What can I take to ease my hot flashes?

DEAR DOCTOR K: I have terrible hot flashes. My doctor no longer recommends hormone replacement therapy because he says it has heart risks. Is there anything else I can take?

DEAR READER: Hot flashes are a common symptom of menopause. They probably result from changing hormone levels. My patients describe them as a sudden, intensely uncomfortable onslaught of heat. They are often accompanied by a rapid heartbeat, headache, nausea or dizziness.

I had a period after 5 years of menopause– is this normal?

DEAR DOCTOR K: I thought I entered menopause five years ago, but now I seem to be having a period again. Is this normal?

DEAR READER: A woman is considered to be in menopause once it has been one year since her last period. Once menopause begins, vaginal bleeding is not normal. Post-menopausal bleeding (PMB) can happen for many reasons. It may result from infection or injury. Non-cancerous growths such as polyps and fibroids can cause PMB. So can bleeding disorders or use of blood thinners.

Does vaginal estrogen cream carry the same risks as systemic hormone therapy?

DEAR DOCTOR K: I use a vaginal estrogen cream for vaginal dryness. Does it have the same risks as hormones taken orally or by skin patch?

DEAR READER: Hormone therapy (HT) is estrogen taken alone or with other female hormones to treat the symptoms of menopause. "Systemic" HT involves hormones that enter the blood and travel throughout the body. It is the most effective treatment for postmenopausal hot flashes and vaginal symptoms, including vaginal dryness.

Are there natural remedies for hot flashes?

DEAR DOCTOR K: I'm having menopausal hot flashes, but I don't want to take hormone therapy. Can you tell me about natural remedies?

DEAR READER: Natural remedies can help for hot flashes, but hormone therapy is helpful more often. For that reason, I'll come back to the pluses and minuses of hormone therapy after answering your question.