Is there a drug-free way to relieve PMS symptoms?

DEAR DOCTOR K: Every month I have awful PMS. Can you suggest drug-free ways to relieve my symptoms?

DEAR READER: Premenstrual syndrome (PMS) is a collection of symptoms that occur just before and during menstruation. The most common symptom is unusual mood swings. In addition, women with PMS also experience irritability, anxiety, depression, headaches, hot flashes, bloating, abdominal cramping, breast tenderness and food cravings.

What are treatments for chronic neuropathic pain?

DEAR DOCTOR K: I suffer from what my doctor calls "chronic neuropathic pain." What are my treatment options?

DEAR READER: There are two main types of pain. Nociceptive pain results from an injury to tissues outside your nervous system. Burns, sprains and broken bones are all examples of nociceptive pain. Tiny nerve fibers are always present in tissues. When the tissue gets injured, the nerve fibers detect it. The signal they send the brain is nociceptive pain. The signal says to the brain: "Do something to avoid further injury!"

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.

Is it possible to go off blood pressure medication through diet and exercise?

DEAR DOCTOR K: Is it possible to get off blood pressure-lowering medication through diet and exercise?

DEAR READER: Yes, it is. I've seen many patients commit to lifestyle changes and get off blood-pressure medicines entirely. More often, I've seen that a commitment to a healthier lifestyle allows people to greatly reduce how much medication they take, even though they still need some medicines to control their blood pressure. While many people, myself included, would like to not have to take medicines at all, being able to reduce the dose is a big deal. Many of the side effects of medicines are reduced or eliminated by reducing the dose.

What fish should I avoid while pregnant?

DEAR DOCTOR K: I recently found out that I'm pregnant. I'd like to continue eating fish, but I understand some fish contain mercury, which could be harmful to my baby. What fish should I avoid?

DEAR READER: Fish are a great source of lean protein, and many types are rich in heart-healthy omega-3 fatty acids, which help brain and nerve development and protect the heart. In fact, current dietary guidelines recommend that women who are pregnant eat 12 ounces of seafood a week. But as you noted, some species of fish do contain worrisome amounts of methylmercury. This toxin is especially dangerous to developing brains. High-mercury fish you should avoid during pregnancy include swordfish, shark, king mackerel and tilefish.

Is too much sleep harmful to your memory?

DEAR DOCTOR K: I read about a new study on sleep and memory. I understand why too little sleep could affect memory. But why would too much sleep be harmful?

DEAR READER: When it comes to memory, sleep is a Goldilocks issue: Neither too much nor too little is good.Aim for "just right," says Dr. Elizabeth Devore, an instructor in medicine at Harvard-affiliated Brigham and Women's Hospital. Dr. Devore led a new study that suggests getting an "average" amount of sleep -- seven hours per day -- may help maintain memory in later life.

When should I go back on a bisphosphonate drug?

DEAR DOCTOR K: I am currently on a bisphosphonate "drug holiday." How will I know if, or when, I should go back on the drug?

DEAR READER: After menopause, loss of bone (osteoporosis) can lead to crippling bone fractures. Drugs called bisphosphonates slow bone loss. Below, I've put a table with detailed information about these drugs. But bisphosphonates can cause troubling side effects. The pills can cause burning in the esophagus. And a small number of users have developed bone loss in the jaw and in the large bone in the upper legs (the femur), causing the femur to break.

Do you suggest HPV testing or Pap smears for cervical cancer screenings?

DEAR DOCTOR K: I am 31 years old and have always had normal Pap smears. I just read that HPV testing might be better. What do you suggest?

DEAR READER: Screening for cervical cancer has led to a dramatic decrease in the disease. Until fairly recently, all cervical cancer screening was done by Pap smear. But the FDA recently approved the use of a new screening tool -- the HPV DNA test -- that may eventually take its place.

What are the differences in erectile dysfunction drugs?

DEAR DOCTOR K: Is there a difference between the drugs that are available for erectile dysfunction?

DEAR READER: Erectile dysfunction (ED) is a problem faced, to one degree or another, by many middle-aged and older men. Since sildenafil (Viagra) was launched in 1998, men have been turning to medication to help address this problem. There are currently four ED drugs on the market: sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) and avanafil (Stendra).

Am I getting enough iodine in my diet?

DEAR DOCTOR K: I cook with kosher salt, which doesn't contain iodine. Am I getting enough iodine in my diet? Can I get iodine from other foods?

DEAR READER: Before I answer your question, I'll need to explain a little about the thyroid gland and how it works. The thyroid is a small, butterfly-shaped gland that perches with its wings wrapped around the front of your windpipe, below your voice box. This gland influences the rate at which every cell, tissue and organ in your body functions. It does this primarily by secreting thyroid hormones.