Archive for July, 2016

Does hormone replacement therapy increase heart disease risk or not?

DEAR DOCTOR K: I'm in my third year of menopause, and my doctor won't prescribe hormone therapy. He says it increases the risk of heart disease. I think I recall that you told another reader that this is not true. Is my doctor right, or are you?

DEAR READER: You won't be surprised to learn that I think I'm right. But in the previous column you refer to, I didn't say exactly what you remember. I said that the effect of hormone therapy (HT) on heart disease depends on a woman's age and how recently she entered menopause. In younger women, in their first six to 10 years after menopause, HT protects against heart disease. In contrast, in older women, HT increases the risk of heart disease. It's called the "age effect."

Could my daughter have anorexia?

DEAR DOCTOR K: I'm worried about my 15-year-old daughter. She eats like a bird. She is very thin, but thinks she is fat. I'd like to think this is just a phase some teenagers go through, but could she have anorexia nervosa?

DEAR READER: As with most illnesses, there is not a magic dividing line between having anorexia and not. In fact, there's a big gray zone where people don't meet the criteria for a disease, yet they're not normal, either. An example is "pre-diabetes." Tens of millions of people in the United States have blood sugar levels that are not high enough to be called diabetes, but also aren't normal. It's important to recognize them, because such people have a higher risk for developing diabetes in the future.

What’s considered normal aging when it comes to sex?

DEAR DOCTOR K: My wife and I are in our 70s. Sex is not what it once was. Is there anything "natural" I can do to improve sex? I don't want to take pills. What's normal aging when it comes to sex?

DEAR READER: As a man in the last half of his life, I would like to be able to tell you that nothing changes. However, even in healthy men, sexuality changes over time. It's often a gradual, almost unnoticeable process that usually begins in a man's 40s.

Are there any new treatments on the horizon for Alzheimer’s disease?

DEAR DOCTOR K: Is there anything new on the horizon for treatment of Alzheimer's disease?

DEAR READER: Alzheimer's disease affects more than 5 million people in the United States, alone. And that number is expected to more than double by 2050. I spoke to my colleague Dr. Gad Marshall about advances in Alzheimer's treatment. He is an assistant professor of neurology at Harvard Medical School.

Why do women tend to live longer than men?

DEAR DOCTOR K: I've heard that women tend to live longer than men. Why is that?

DEAR READER: On average, women do live about five years longer than men. In the United States, 57 percent of all who are ages 65 and older are female. By age 85, 67 percent are women. You can see this for yourself in most nursing homes or assisted living facilities in the United States: Women usually outnumber men, and the magnitude of the difference is often striking.

Can you give me specific advice to help control my allergies?

DEAR DOCTOR K: The weather's warming up. For me, that means one thing: allergies. Can you give me some specific advice to help keep my allergies under control?

DEAR READER: Inhaled pollen, from trees, grass and weeds, is responsible for hay fever. These allergens get into the air -- and into our noses, eyes and lungs --causing the symptoms that allergy sufferers dread.

What is a POLST form?

DEAR DOCTOR K: My husband has terminal cancer. He has already signed a do-not-resuscitate order. His doctor recently suggested that he also complete a new form called a "POLST." Can you explain what this is?

DEAR READER: As you know (but other readers might not), a Durable Do Not Resuscitate Order (DDNR) lets your husband's medical team know that he does not want CPR if his heart stops beating or he stops breathing. It's usually for people who are near the end of their lives or have an illness that won't improve. It takes the burden of decision-making off family members.

Is there anything I can do about excessive sweating?

DEAR DOCTOR K: I'm a woman in her 70s. My problem is that I sweat heavily, day and night. Of course, it's worse in the summer. I'm way past menopause. What can I do?

DEAR READER: Doctors call excessive sweating "hyperhidrosis." It is not a rare problem; I've treated many patients for it. In every case, they waited a long time before talking about the problem. That's because they thought it was such a trivial issue that they didn't want to waste the doctor's time.

Is jogging or brisk walking better for my health?

DEAR DOCTOR K: I'm a 42-year-old couch potato. Gentle pressure from my wife and doctor have "convinced" me to start exercising regularly. What's better for my health: jogging or brisk walking?

DEAR READER: If you're a couch potato, you're in the majority. A recent study found that nearly 60 percent of adults in the United States do not get enough exercise.

What are the treatment options for uterine fibroids?

DEAR DOCTOR K: I have fibroids that cause heavy menstrual bleeding and painful cramping. What are my treatment options?

DEAR READER: As I'll explain shortly, the first question you need to ask yourself is whether you want to have children in the future. That's because some of the most effective treatments for fibroids make becoming pregnant more difficult, or impossible.