January, 2012
Rather than focus on individual nutrients, nutrition guidelines now encourage paying closer attention to the types and quantities of foods we eat.
More women are remaining sexually active after menopause, but concern about sexually transmitted infections has not been a priority, leading to an increase in such infections.
People with low back pain who are willing to try exercise are likely to find some relief with either yoga or a stretching program.
I have Dupuytren's contracture in both hands. I've had "needle" surgery in one hand, and the fingers straightened. But they seem to want to contract again. What can I do?
Ten years ago, I had uterine artery embolization to get rid of uterine fibroids. How long do the plastic particles they inject into the arteries stay in the body? Do they dissolve?
I'm 64 and have been diagnosed with uveitis in my right eye. What causes it, and what is the best treatment for it?
February, 2012
Disordered eating in midlife and beyond
Disordered eating later in life may be caused by life changes such as divorce or grief over the loss of a loved one, an illness, or the stress of dealing with mounting medical issues.
What to do about nonalcoholic fatty liver disease
Nonalcoholic fatty liver disease is characterized by the accumulation of fat inside liver cells. It is linked to obesity and type 2 diabetes, but other factors may influence who develops the condition.
Healing yourself after injury, illness, or surgery
Dr. Julie Silver discusses her book You can Heal Yourself, which offers research-based advice on healing physically and emotionally after surgery or a serious medical issue.
In the journals: Experts update guidelines for treating essential tremor
The American Academy of Neurology has issued updated treatment guidelines for essential tremor, deeming some medications ineffective and suggesting surgical procedures for severe cases.
Ask the doctor: Can getting rid of varicose veins cause venous insufficiency?
I have varicose veins and would like to get rid of them. Could that lead to venous insufficiency?
March, 2012
What to do about restless legs syndrome
People with this disorder experience an uncontrollable urge to move their legs, typically around bedtime. Lifestyle changes can help, and there are also medications that can provide some relief.
Why behavior change is hard - and why you should keep trying
Adopting healthier lifestlye habits doesn't happen at once, but is a process that happens in stages. Setbacks along the way are normal, but they provide opportunites for growth and learning.
In the journals: Certain dietary patterns are associated with long-term brain health
Researchers using brain imaging to track nutrient biomarkers found an association between higher levels of certain vitamins and better performace on mental tests in older people.
In the journals: Radiation for breast cancer is linked to narrowing of the coronary arteries
A Swedish study adds to the evidence that radiation therapy for breast cancer can lead to heart problems, particularly for women with left-sided breast cancer.
Ask the doctor: How do you treat a Baker's cyst?
I have a Baker's cyst in my right knee. It has been drained twice and recurred. Are there any other treatments for it?
April, 2012
Bone mineral density testing: How often?
Research on bone mineral density testing suggests that older women with good bone density test scores may need less frequent testing.
Treating pelvic organ prolapse
The muscles and ligaments that support the pelvic organs can stretch and weaken with age, allowing intrusion into the vagina. The condition may be exacerbated by obesity, vaginal childbirth, or other factors.
Peripheral artery disease
Women who develop peripheral artery disease tend to do so a decade later than men, by which time other conditions may mask the symptoms, delaying diagnosis.
In the journals: An emergency contraceptive pill helps treat fibroids
A medication currently prescribed as an emergency contraceptive helps women with fibroids by shrinking them and reducing bleeding.
In the journals: Spinal manipulation and exercise trump drugs for neck pain
A comparison of treatments for neck pain found that both spinal manipulation and a program of exercises were more effective than medication.
In the journals: Severe sleep apnea is linked to cardiovascular death in women
Research suggests that women with sleep apnea are more likely to die from a cardiovascular cause, which aligns with similar research done on men.
Ask the doctor: What can I do about an anal fissure?
I had pain and some bleeding during bowel movements. My doctor says it's an anal fissure. What is that, and what's the best way to treat it?
Ask the doctor: Are generic drugs the same as brand-name drugs?
I recently switched from Prilosec to its generic form, omeprazole, and it doesn't relieve my heartburn as well as Prilosec. Aren't generics supposed to be the same as the brand-name drugs?
May, 2012
When sex gives more pain than pleasure
Dyspareunia is a common problem for many postmenopausal women.
Managing osteoarthritis of the knee
There are many treatments for knee osteoarthritis short of surgical replacement that can help reduce pain and improve function.
In the journals: Compression stockings after deep-vein thrombosis: Knee-highs or thigh-highs?
Compression stockings after deep-vein thrombosis: Knee-highs or thigh-highs?
Ask the doctor: Does mangosteen have any health benefits?
I've seen advertisements for mangosteen juice claiming it has lots of antioxidants and health benefits, including anticancer effects. Is there any truth to this?
Ask the doctor: Are sunless tanning products safe?
I like to look tanned, but I'm somewhat fair-skinned and can't be in the sun much. Are self-tanning lotions and sprays a good idea? Are they safe?
Ask the doctor: Why should I limit my dairy intake to one to two servings a day?
In the January issue, you recommended the Harvard Healthy Eating Plate, which includes only one to two servings of dairy a day. Don't we need more than that to get enough calcium?
June, 2012
Do you need mammograms?
Before you get your next mammogram, learn the pros and cons of this controversial screening test.
Ask the doctor: What causes tingling hands at night?
Dr. Robb-Nicholson discusses what causes tingling hands at night.
Ask the doctor: Which are the healthiest fats for baking?
Dr. Robb-Nicholson discusses what are the healthiest fats for baking.
Statins and women
When it comes to heart disease, men and women aren't created equal. What you need to know if you take these cholesterol-lowering drugs.
Could a silent stroke erode your memory?
Could you have a stroke and not realize it? Learn how these hard-to-detect strokes could put your memory at risk.
Stomach bug
Find out why one pesky virus could ruin your summer vacation- -if you're not careful.
In the journals: Prolonging your life with seven healthy habits
Prolonging your life with seven healthy habits.
In the journals: Menopause group reassures women about hormone therapy
Menopause group reassures women about hormone therapy
In the journals: Goodbye to yearly pap smears for some women over 65
Goodbye to yearly pap smears for some women over 65.
In the journals: Botox can help with overactive bladder
Botox can help with overactive bladder.
January, 2011
A number of basic tests and screenings done at regular intervals will provide information that can help your health care providers keep you healthier.
Many women experience abnormal uterine bleeding in the years leading to menopause, as hormone levels fluctuate. After menopause, any uterine bleeding is considered abnormal and should be investigated.
For women with pelvic organ prolapse, pelvic floor strengthening exercises may prevent the condition from worsening, and may even reverse the condition in some women.
With reports of bedbug infestations on the rise, it's important to know about the creatures and steps you can take to keep them away.
I have osteoporosis and a recent spine fracture. I hear there's a minor surgical procedure that can fix the fracture. Can you tell me anything about it?
February, 2011
Job strain and heart disease risk in women
Three separate studies from the United States, Denmark, and China found evidence that job stress contributes to higher risk of heart disease in women.
Strange bedfellows: Polymyalgia rheumatica and temporal arteritis
Polymyalgia rheumatica is an inflammatory disorder of the joints and connective tissues. Temporal arteritis is an inflammation of large blood vessels, such as in the head. These conditions often occur together, though the reasons for this are unknown.
Diverticular disease prevention and treatment
By age 60, about 40% of people have diverticular disease, a condition characterized by protruding pouches on the colon. It's thought that a low-fiber diet, obesity, and lack of exercise contribute to the disease.
What to do about dry skin in winter
Lack of moisture in the air during the winter months tends to dry out skin. Dry skin is also a common adjunct to aging. Keeping your skin properly moisturized can help prevent conditions like eczema.
In the news: Report sets new dietary intake levels for vitamin D and calcium
An Institute of Medicine panel evaluating more than a decade of research concluded that the evidence for vitamin D's contribution to bone health is clear, and set its recommended daily intake levels on this basis.
Ask the doctor: Does folic acid improve immunity?
What do you know about taking extra folic acid to boost the immune system?
Ask the doctor: How should I remove eye makeup if I have blepharitis?
In your article about blepharitis, you didn't say anything about the best way to remove eye makeup. Are oil-based products bad for this condition?
March, 2011
Hormone therapy: The next chapter
In the span of ten years, the attitude within the medical community regarding hormone replacement therapy for postmenopausal women has shifted from optimism about its benefits to caution about its risks.
Prolonged illness and grieving
A new book examines how patterns of grieving are changing as people and families endure terminal illnesses for longer periods of time.
What to do about gallstones
Women under 40 are at much greater risk of developing gallstones than men, due to the actions of the hormones estrogen and progesterone.
In the journals: Heart failure risk is lower in women who regularly eat modest amounts of chocolate
An observational study of 31,000 older women in Sweden found that those who ate one to two servings a week of chocolate had a lower risk of heart failure.
Ask the doctor: How do I use a cane?
I recently had a right hip replacement and my doctor says I'm now ready to use a cane. Do you have any recommendations about the best way to use it?
April, 2011
FDA limits prescription acetaminophen
The danger of liver failure caused by an overdose of acetaminophen has led the FDA to require prescription drug manufacturers to limit the amount of the pain reliever in their products.
Keeping up with your vaccinations
The Centers for Disease Control and Prevention revises its immunization guidelines every year, and there are some changes for 2011, in particular ones that apply to people at middle age or older.
Minimally invasive treatments for bothersome leg veins
The common treatment for varicose veins used to be surgery, but it has largely been replaced by less invasive procedures like injections or laser therapy.
In the journals: Mindfulness meditation practice changes the brain
A small study of people who practiced regular mindfulness meditation found changes in several areas of their brains.
In the journals: Timing of hormone therapy influences breast cancer risk
Researchers in the United Kingdom surveyed more than a million women about their use of hormone therapy, and found that the timing of hormone use after menopause affected their risk of breast cancer.
Ask the doctor: Do I need an HPV test?
I'm 50 years old and have never had an HPV test. Do I need one as part of my health screening?
Ask the doctor: What causes a craving for ice?
I recently developed a craving to chew on several ice cubes a day. What causes this? Is it unhealthy?
May, 2011
When patients suddenly become confused
Many people, especially those over 65, experience delirium during illness or hospitalization. In its more common form a person is likely to act withdrawn or appear drowsy, making diagnosis more difficult.
Food allergies and food intolerances
Incidence of food allergy and food intolerance is increasing, though they are distinct conditions. Food allergies typically begin in infancy, and can be life-threatening if not outgrown. Food intolerance can cause discomfort but is generally less serious.
In the journals: Culturally appropriate storytelling may help control blood pressure in African Americans
People with uncontrolled high blood pressure who viewed DVDs of others from a similar cultural background talking about living with hypertension showed a reduction in blood pressure after six to nine months.
In the journals: A device to prevent heart failure is twice as effective in women
Women who received an implantable device that helps the heart maintain its rhythm had a much larger reduction in serious cardiac events, and greater improvement in cardiac function, than the men in the study.
Ask the doctor: Is hair straightening safe?
I had my hair straightened six months ago. Is there any danger in getting these treatments twice a year? I hear they may contain formalin or formaldehyde.
June, 2011
Soy may be okay for breast cancer survivors
Research now suggests that breast cancer survivors can eat soy foods in moderation.
Conditions: When sweating is too much
Excessive sweating is uncomfortable and unpleasant, but the condition can be managed with products such as prescription-strength antiperspirants, Botox injections, or treatments like iontophoresis.
What to do about bunions
A bunion is a deformity of the foot that causes the big toe to turn inward toward the other toes. This can result in damage to the other toes, calluses, and trouble walking.
In the journals: Major depression more likely during perimenopause than during premenopause
In a study, approximately one-third of women in perimenopause had at least one episode of major depression.
Ask the doctor: How should I be screened for cardiovascular disease?
I have a family history of cardiovascular disease. Although I don't have any risk factors, I'm concerned about how my cardiologist is screening me, because women can have small-vessel disease and not necessarily arterial disease. How should I be screened?
Ask the doctor: What are the differences between soluble and insoluble fiber?
I enjoyed your article on diverticular disease and the fiber content of various foods. However, could you make some distinctions between soluble and insoluble fiber? Some fiber makes me feel very bloated.
July, 2011
New Alzheimer's guidelines define early stages of the disease
New guidelines for diagnosing Alzheimer's disease are intended to support the emerging theory that the disease is present in the body long before it manifests in diminished cognitive capacity.
Experts urge intensive lifestyle measures for lowering triglycerides
The American Heart Association is recommending that people with high triglyceride readings undertake an intensive program of diet, exercise, and weight loss.
Are there limits to laser refractive surgery after midlife?
Freedom from corrective lenses makes laser eye surgery seem attractive, but having the procedure may affect the treatment of eye conditions that can arise in midlife and later.
In the journals: Cognitive behavioral therapy and exercise therapy help ease chronic fatigue symptoms
Researchers studying chronic fatigue syndrome found that adding either cognitive behavioral therapy or a specially formulated exercise program to medical care achieved better results than an adaptive program that conserves energy.
Ask the doctor: Is thermography a good screening tool for breast cancer?
When you talk about breast cancer screening, why don't you mention thermography? I've been using it for several years instead of mammography, which uses radiation.
Ask the doctor: Do statins cause hair loss?
My hair's been thinning. Could it be due to simvastatin, which I started taking several months ago?
August, 2011
Psychotherapy at midlife
The challenges of midlife may prompt some women to conside psychotherapy.
Diagnosing and treating interstitial cystitis
Interstitial cystitis is a painful, chronic bladder condition. There are several theories regarding its origin, but the exact cause is not known.
In the journals: Another drug prevents breast cancer in postmenopausal women
A drug already in use for breast cancer treatment may have the potential to prevent the disease in some women.
In the journals: Fibroid embolization and surgery have similar five-year outcomes
A comparison of two treatments for fibroids has found that long-term results are about the same for both methods.
Ask the doctor: What can I do about xanthelasma on my eyelids?
I'm 70 and in good health. My cholesterol levels are normal. Lately, I've started to get little yellow deposits on my eyelids, which I'm told are xanthelasma. What causes these, and how can I get rid of them?
September, 2011
Bioidentical hormones: Help or hype?
Bioidentical hormones are promoted as being safer than FDA-approved hormones, but their production is not regulated and their claims of effectiveness have not yet been substantiated by long-term clinical trials.
Tinnitus: Ringing in the ears and what to do about it
Yhough ringing or other noise in the ears is bothersome, it is rarely indicative of a more serious health issue. There are ways to manage the condition or minimize its impact.
In the journals: Napping boosts sleep and cognitive function in healthy older adults
A study of older adults who took daytime naps found that their total sleep time increased without causing daytime drowsiness.
In the journals: Large trial finds annual screening doesn't reduce deaths from ovarian cancer
In a trial, annual screening for ovarian cancer did not result in fewer cases or fewer deaths.
Ask the doctor: Does creatine improve strength in postmenopausal women?
Could you discuss the benefits of creatine supplements for older, postmenopausal women? Are there any drawbacks?
October, 2011
The breast density-breast cancer connection
Women with dense breast tissue may be at higher risk for more aggressive types of breast cancer.
How to get rid of warts
Warts are an unsightly nuisance that can take a year or more to go away on their own. Several effective, noninvasive treatments are available.
Update on vibration therapy for bone health
Low-intensity vibration therapy attempts to strengthen muscle and bone through gentle stimulation, which could help postmenopausal women at risk for osteoporosis.
In the journals: Novel foot-health program reduces falls in older people
A program aimed at improving the foot health of older people through examinations, exercises, advice, and orthotic shoe inserts may help prevent falls.
In the journals: Regular exercise may ward off cognitive decline in women with vascular disease
Vascular disease increases the risk of age-related cognitive decline, but women who already have vascular problems can still gain cognitive benefits from daily exercise.
Ask the doctor: How does hot pepper cream work to relieve pain?
I have pain from osteoarthritis in both knees. I'm curious about the cream made from a substance in hot peppers. How does it relieve pain?
Ask the doctor: Do I need a Pap test at age 75?
I'm 75 years old and healthy. My doctor is still recommending annual Pap tests for me. I have no history of any problems in this area and have had normal Pap tests for years. Is this necessary at my age?
November, 2011
Screening after age 75
The question of whether or not to have certain screening tests after age 75 varies depending on a woman's overall health, risk factors, and treatment preferences.
When keeping stuff gets out of hand
Compulsive hoarders accumulate unneeded items beyond reason. While hoarding is sometimes a symptom of obsessive-compulsive disorder, most hoarders do not exhibit the characteristics of OCD.
In the journals: Even a little exercise is good for the heart - especially a woman's
More physical activity is clearly better for health, but even small amounts of daily exercise can lower the risk of heart disease.
In the journals: Sleep apnea increases dementia risk in older women
Older women with sleep apnea may be at higher risk of developing cognitive problems and dementia.
In the journals: Cholesterol-lowering foods outdo low-saturated-fat diet
Adding certain cholesterol-lowering foods to a low-fat diet may be more effective at lowering long-range heart disease risk.
Ask the doctor: What do you know about Prolia and Reclast for osteoporosis?
I'm looking for information on Prolia and Reclast as alternatives to Boniva.
December, 2011
Depression and cardiovascular risk in women
There is growing evidence of a link between depression and increased risk of heart disease and stroke.
The overlooked hazards of holiday eating
Holiday meals present an increased risk for food-borne illnesses, but a few simple precautions can prevent illness.
Staying active despite osteoporosis
People with osteoporosis may be reluctant to exercise, but it's important to prevent bones from weakening further. Consult a health-care provider to find the right exercises for your condition.
In the journals: Vaginal estrogen ring helps relieve overactive bladder
Postmenopausal women with overactive bladder may benefit from a low-dose vaginal estrogen ring.
In the journals: Study elucidates health risks for DES daughters
The health risks of women whose mothers were given the drug DES have been documented in a follow-up study.
Ask the doctor: Should I have my magnesium level checked?
Should I have my magnesium level checked regularly to make sure I'm getting enough for my bones?
Ask the doctor: Does vaginal estrogen have the same risks as oral or patch estrogen?
Do vaginal estrogens that are used for vaginal dryness have the same risks as estrogens taken orally or by skin patch?
January, 2010
10 for 2010: 10 things you should know about heart disease
Women's heart disease risk is different from men's, due to differences in anatomy and the protective effect of estrogen. This article summarizes what women need to know about heart disease and prevention.
In the journals: Cognitive behavioral therapy more effective than light therapy for relieving seasonal depression
A small study found that cognitive behavioral therapy was a more effective treatment for seasonal affective disorder than light therapy.
What to do about Bell's palsy
Bell's palsy is an inflammation of the facial nerve, believed to be caused by a viral infection, that results in paralysis of one side of the face. It can take several weeks to return to normal, and treatment is typically a corticosteroid medication.
Time for tooth whitening?
Tooth whitening procedures can be done at a dentist's office, or there are many over-the-counter products that can be used at home, but regardless of the method, the result is temporary.
By the way, doctor: What can I do about chronic leukorrhea?
I'm a healthy 62-year-old and have developed a vaginal discharge and discomfort. Tests for vaginal infections have been negative. Nothing helps. I'd appreciate your thoughts on this problem, which my gynecologist calls "chronic leukorrhea."
By the way, doctor: Is it safe to take high doses of vitamin D?
On the basis of a blood test, my doctor wants me to take high doses of vitamin D for three months. I hear there are wide variations among laboratories performing these tests. Should I trust my first results, or take the test again? What are the risks?
By the way, doctor: Does carbonated water harm bones?
I've heard that club soda, seltzer water, and sparkling mineral waters rob the bones of calcium. Is this true?
February, 2010
Preserving and improving memory as we age
As people age, it is normal to have concerns about maintaining good memory function. Practicing good general health habits and keeping the mind active can help preserve and protect memory.
A doctor talks about: Screening mammography
The editor in chief of Harvard Women's Health Watch discusses the recommended changes in breast cancer screening guidelines and suggests that women should discuss their risk level with their doctors and weigh the benefits against the potential harms.
Essential tremor and how to manage it
Essential tremor is a condition that causes involuntary movement of the hands, and sometimes the head. It can be managed with certain medications and lifestyle adjustments.
In the journals: Cocoa reduces inflammation associated with heart disease
A study from Spain found that daily consumption of unsweetened cocoa powder led to a reduction in inflammatory molecules linked to heart disease.
By the way, doctor: What can I do about vulvodynia?
I've had pain and burning near the entrance to my vagina for a long time. My doctor says it's probably vulvodynia. What can you tell me about this condition? How is it treated?
March, 2010
Calcium beyond the bones
Though calcium is essential for bones and muscles, it can accumulate in the body in unwanted places. There is concern that calcium intake via food or supplements may be to blame for these buildups, but it is generally unwarranted.
Managing postmenopausal vaginal atrophy
After menopause, many women experience vaginal dryness and discomfort. There are a variety of products available to treat this condition, including vaginal moisturizers and estrogen medications.
In the journals: Some antidepressants interfere with tamoxifen more than others
Women who take tamoxifen to prevent a recurrence or first occurrence of breast cancer should avoid certain antidepressants that interfere with tamoxifen's action in the body.
Update: Thighbone fractures in women taking bisphosphonate drugs
A few women taking a bisphosphonate medication for osteoporosis for several years experienced unusual thighbone fractures, but a large Danish study did not find sufficient evidence to support a connection.
By the way, doctor: What's the right amount of vitamin C for me?
I'm 79 years old and have been taking 3,000 mg of vitamin C a day for years. I'm now uneasy about taking this amount and plan to cut back to 1,000 mg daily. Is this the right dose? Will my body be startled by the abrupt change?
April, 2010
Progress report on ovarian cancer screening
Ovarian cancer has a high survival rate if detected early, but early detection is difficult due to the absence of precancerous lesions, the lack of a reliable biomarker, and the uncertainty of results of transvaginal ultrasound screening.
Tendon trouble in the hands: de Quervain's tenosynovitis and trigger finger
Painful conditions like de Quervain's tenosynovitis, inflammation of the tendons that move the thumb, and stenosing tenosynovitis, or trigger finger, when a digit becomes locked, can develop due to overuse or repetitive movement.
In the journals: New analysis supports expanded use of statins in women
The Food and Drug Administration has approved the use of a statin in people with normal cholesterol levels, in part because of evidence that taking the drug can reduce vascular inflammation.
In the journals: More studies find that regular exercise helps protect aging brains
Several studies add to the growing evidence that regular exercise offers a measure of protection to the aging mind, along with the benefits of keeping the body physically healthy and fit.
In the journals: Yoga may help improve women's sexual function
Researchers in India found that women who participated in a daily yoga program experienced improvement in several aspects of sexual function.
By the way, doctor: Does laser treatment work for toenail fungus?
I've tried a lot of things for a fungal infection in one of my toenails, but it just won't go away. What do you know about a new treatment that uses laser?
May, 2010
Advances in breast imaging
Mammography has been an essential tool in the early detection and treatment of breast cancer for decades. New imaging technologies such as MRI and ultrasound are augmenting diagnosis.
Easing aching kneecaps
Patellofemoral (kneecap) pain can be caused by stress from overuse, tendinitis, misalignment, arthritis, or injury. Strengthening the surrounding muscles, especially the quadriceps, is the best way to ease or prevent kneecap pain.
In the journals: Study confirms link between certain diabetes drugs and fractures
Research has confirmed concerns that a certain class of diabetes drugs increases the risk of fractures in women, especially those over 65.
By the way, doctor: What are the health risks for DES daughters and their children?
My mother took DES when she was pregnant with me. I'm now 69, my daughter is 41, and we've both had gynecological problems. What particular risks do we have because of our DES exposure, and what can we do about them?
By the way, doctor: What do you know about the HCG diet?
I've been trying to lose weight for a long time and nothing seems to work. What do you know about the HCG diet?
By the way, doctor: What can I do about twitching eyelids?
From time to time, my eyelids twitch. What causes this, and is there anything I can do about it?
June, 2010
Getting help through couples therapy
Changes in life circumstances may cause tensions in a relationship, even between people who have been together for a long time. A couples therapist can help partners or spouses deal with such problems and issues.
Bringing psoriasis under control
The cause of the skin condition psoriasis is not known, but may be a combination of heredity and immune system response. It is not curable, but can often be managed with various treatment methods.
In the journals: Exercise limits weight gain in normal-weight but not heavier women
Physical activity can help prevent weight gain in women who are not overweight, but for those who are already overweight or obese, exercise alone is not enough to prevent weight gain.
Urine color and odor changes
The color and smell of a person's urine can be affected by foods, vitamins, or medications, but there are also medical conditions that can cause changes in urine.
By the way, doctor: Is krill oil better for the heart than fish oil?
A relative in Australia was told to take krill oil capsules, which are advertised as better for heart health than fish oil. What's your opinion?
By the way, doctor: Does platelet-rich plasma therapy work for tennis elbow?
You wrote about platelet-rich plasma therapy for chronic tendon problems. Has there been any news? I ask because I'm thinking about it for my tennis elbow.
July, 2010
Too early to get up, too late to get back to sleep
Sleep-maintenance insomnia, the inability to remain asleep during the night, may be caused by health problems, depression, or stress. Maintaining good sleep habits and practicing relaxation techniques may lead to a better night's sleep.
Progress in treating multiple myeloma
The cause of the blood disease multiple myeloma is unknown, but advances in treatment, including new medications and stem-cell transplants, are giving patients longer periods of remission.
In the journals: Study finds no link between bone drugs and unusual thigh fractures
After recent concerns about the possibility that bisphosphonate drugs taken for osteoporisis could cause thigh fractures, an analysis of three studies found incidence of this injury to be extremely rare.
In the journals: Unequal leg length may be a risk for osteoarthritis of the knee
Researchers found an association between unequal leg length and a higher likelihood of developing osteoarthritis of the knee.
Update: Home phototherapy for psoriasis is cost-effective
A Dutch study found that in-home phototherapy treatment for psoriasis was as effective as receiving the treatment in a hospital, and cost about the same.
By the way, doctor: What can I do to prevent cataracts?
Is it true that cataracts are made of calcium? Can I do anything to avoid getting a cataract? What about diet?
August, 2010
Taking aim at belly fat
Though the visceral fat that lies behind the abdominal wall makes up only a small percentage of the body's fat, a growing body of research indicates that it is linked to a number of diseases and conditions.
Living wills and health care proxies
Specifying a health care proxy or preparing a living will, or both, can help ensure that your wishes regarding medical treatment are followed in the event you are unable to express them yourself.
In the journals: Studies find ways to reduce falls in older multifocal lens wearers
People who need multifocal eyeglasses are at higher risk of falling. Some of this risk may be lowered by being more selective about when to use multifocal lenses.
In the journals: More happiness, less worry after age 50, study finds
A survey of more than 300,000 Americans finds that after age 50, people feel happier and worry less.
By the way, doctor: Should I get the shingles vaccine?
I'm 79 and had chickenpox as a child. Should I get the shingles vaccine? What are the risks?
September, 2010
Direct-to-consumer genetic testing kits
Several companies are offering genetic testing kits for sale to the public, but they are expensive and may not offer any useful information beyond what people can already learn from their own doctors.
Midurethral sling surgery for stress incontinence
Women who experience urinary stress incontinence may want to consider midurethral sling surgery, a minimally invasive procedure in which a mesh support is inserted to relieve pressure on the urethra.
In the journals: The antidepressant citalopram cuts hot flash severity and frequency
Women who take an antidepressant to reduce the frequency and severity of hot flashes have another option in citalopram, and it does not block the effectiveness of tamoxifen like some other antidepressants do.
In the journals: Indoor tanning is strongly linked to melanoma risk
Researchers found that people who used indoor tanning equipment had a much higher likelihood of developing melanoma.
By the way, doctor: What can I do about blepharitis?
I suffer from blepharitis and have tried many medications, but the condition always returns. How can I cure it?
October, 2010
What's new in early breast cancer treatment?
Studies of breast cancer survivors have provided information that may lead to changes in the practice of lymph node removal and the use of radiation.
Workout for aching hands
Exercises that stretch and strengthen the muscles and joints of the hands can help ease pain and prevent injury.
A doctor talks about: Radiation risk from medical imaging
Given the huge increase in the use of CT scans, concern about radiation exposure is warranted. Patients should try to keep track of their cumulative radiation exposure, and only have tests when necessary.
In the journals: Link between calcium supplements and heart attack risk unclear
Research regarding a link between calcium supplements and increased risk of a heart attack is contradictory, but getting most of the body's daily calcium requirement from food is preferable.
In the journals: Sitting can shorten your life
While it's well known that a sedentary lifestyle is unhealthy, some newer research suggests that people who spend more time sitting are more likely to die.
By the way, doctor: Is it okay to drink grapefruit juice, as long as I don't take my statin at the same time?
I've been advised not to take my statin drug, simvastatin, with grapefruit juice. But is it safe to take the medication at night and then drink grapefruit juice in the morning?
November, 2010
Going off antidepressants
People who have been taking antidepressants for some time may wish to stop taking them due to unpleasant side effects. This can be accomplished, but it is best to taper the dosage slowly and be aware of the potential for discontinuation symptoms.
How to release a frozen shoulder
Frozen shoulder is caused by an injury or inflammation, which limits movement and causes the tissue around the joint to thicken and contract. Physical therapy will aim to restore flexibility to the joint capsule, then to strengthen it.
Takotsubo cardiomyopathy (broken-heart syndrome)
Takotsubo cardiomyopathy, also called broken-heart syndrome, is a weakening of the left ventricle that is usually the result of severe stress. Its symptoms resemble those of a heart attack, and treatment is usually the same as that for heart failure.
In the journals: Early palliative care extends life in lung cancer study
A study of lung cancer patients found that those who received early palliative care along with standard medical care lived longer and felt their quality of life was better than those receiving only standard medical care.
By the way, doctor: How much protein should I eat?
How much protein do I need every day? Does it matter what kind I eat?
December, 2010
The health benefits of strong relationships
Strong connections and regular social interaction with friends and family members helps alleviate stress and enhance longevity.
How to put your smartphone "on call"
Health and fitness apps for smartphones help users lose weight, track their exercise goals, find information about personal health concerns, and receive updates about public health issues.
In the journals: Grip strength and other physical measures predict lifespan
Older people who are able to perform better on measures of physical strength such as grip strength and walking speed are likely to live longer than those whose performance was poorer.
In the news: FDA approves the first oral drug for reducing multiple sclerosis relapses
The FDA has approved the first oral medication for treating relapses of multiple sclerosis.
What to make of the new warning on bisphosphonates
There is growing evidence that long-term use of bisphosphonate drugs, commonly prescribed for osteoporosis, can increase the risk of fractures of the thighbone.
By the way, doctor: How much aspirin should I take to reduce my risk for colon cancer?
I keep hearing that aspirin can help prevent colon cancer, but I have no idea how much I should take. Can you help? I've had adenomatous polyps in the past.
By the way, doctor: What can I do about chilblains?
I've been diagnosed as having chilblains in the fingers on both hands. What causes chilblains? Is there a cure?
January, 2009
Nine for 2009: Nine ways to healthier eating, Mediterranean style
Over decades of study, evidence shows that following a Mediterranean diet can help protect against heart disease, stroke, diabetes, and perhaps even cancer and Alzheimer's disease.
Exercise as medicine
Even as people become more sedentary, evidence continues to accumulate showing that regular exercise is crucial to staying healthy. Getting started on a regular routine is often the most difficult step.
In the journals: Some side effects of breast cancer treatment may be a good sign
Women who experienced a combination of certain side effects while undergoing breast cancer treatment were less likely to see a recurrence of the disease.
By the way, doctor: How often should I have a colonoscopy?
How often should a healthy 55-year-old woman have a colonoscopy? Do the benefits outweigh the risk of complications, such as bowel perforation?
February, 2009
Should women with normal cholesterol be taking a statin?
The results of the JUPITER trial suggested that people with normal cholesterol should take a statin, but questions remain about long-term effectiveness. One's level of cardiovascular risk should be the primary factor in deciding whether to take a statin.
In brief: Hypnosis helps reduce hot flashes in breast cancer survivors
Breast cancer survivors suffering from hot flashes who underwent hypnosis therapy for a study experienced a significant decrease in the frequency and intensity of their hot flashes.
In the journals: Research finds that many older people can't get up from a fall
As people get older, they are at greater risk of falling, and it also becomes more difficult for them to get up after a fall, which may complicate injuries.
Foot conditions: Recognizing and treating Morton's neuroma
Morton's neuroma is a painful thickening of a nerve in the foot typically caused by tight, high-heeled shoes. Conservative treatment (low, roomy shoes, pain relievers, ice) is recommended before surgery is considered.
Prevention: Have your vaccinations had a check-up lately?
Although most people receive vaccinations in childhood, over time some vaccines lose their potency, new ones are introduced, and foreign travel may require certain vaccinations, depending on the destination.
By the way, doctor: Can I have endometriosis even after a hysterectomy?
I had a hysterectomy a year ago. Six months ago, I started having severe pelvic pain a few days before I would have had a period. Is it possible to experience symptoms of endometriosis after a hysterectomy? I also wonder if I might have pelvic adhesions.
March, 2009
What to do about sinusitis
Sinusitis occurs when blocked sinuses cannot drain and the backed-up mucus gets infected. The simplest and often most effective treatment is daily nasal irrigation. It can also help to drink a lot of water, inhale steam, and sleep with the head elevated.
Conditions: Cold fingers, cold toes? Could be Raynaud's
In Raynaud's phenomenon, even a slight decrease in temperature can cause a pronounced loss of blood flow to the hands. It can often be treated by protecting against exposure to cold, avoiding medications that constrict blood vessels, and exercising.
In the journals: Experts revise guidelines for irritable bowel syndrome
A panel of gastroenterology experts has revised the guidelines for irritable bowel syndrome, simplifying the definition of the disorder and the tests typically required for a diagnosis.
In the journals: Exercise, especially treadmill, eases peripheral artery trouble
Researchers studying people with peripheral artery disease found that an exercise program focused on treadmill walking reduced leg pain in those who suffered from it, and improved overall blood flow and artery function as well.
By the way, doctor: I have a joint replacement - should I take antibiotics before procedures?
Do I need to take antibiotics before dental cleanings and other procedures to prevent infection in my hip prosthesis?
By the way, doctor: Why is it unhealthy to have high triglycerides?
I have healthy cholesterol levels, but a high triglyceride level. What are triglycerides, and how dangerous is it to have high levels?
April, 2009
Mindfulness in a hectic world
Practicing mindfulness can help you learn to focus your attention and energy and reduce distractions, and can lead to reduced stress and improved health.
So you have primary hyperparathyroidism
In primary hyperparathyroidism, one or more of the parathyroid glands produces too much of a hormone that regulates blood calcium levels. If the imbalance becomes serious enough, it can lead to bone or kidney disease and require removal of the gland.
Alzheimer's caregiving: Day-to-day challenges
Beyond the broader issues of caring for a loved one with Alzheimer's disease, many caregivers find daily tasks such as bathing, dressing, and eating challenging. Keeping things simple and eliminating unnecessary choices may help prevent confusion.
In the journals: Heart experts recognize the benefits of daily omega-6s
The American Heart Association examined a number of studies involving omega-6 fatty acids and concluded that earlier concerns about their role in inflammation were unwarranted, and that omega-6s are beneficial in reducing the risk of heart disease.
In the journals: Weight loss reduces urinary incontinence in heavy women
A study of overweight women who committed to a six-month program of diet and exercise found that, in addition to weight loss, nearly half of them experienced a decrease in episodes of urinary incontinence.
In the journals: Alcohol can increase the risk of heart rhythm problems in middle-aged women
A study found that middle-aged women who had more than two drinks per day had a slightly higher risk of developing atrial fibrillation.
By the way, doctor: What causes Beau's lines?
You wrote about weak, brittle fingernails with longitudinal ridges. I have strong nails with horizontal ridges. What causes this, and what can I do about it?
By the way, doctor: Is vaginal estrogen safe for breast cancer survivors?
I'm 78. I had breast cancer nine years ago and have been taking Arimidex for six years. I have pain and some bleeding after intercourse, despite using Astroglide. My gynecologist prescribed vaginal estrogen cream. Is that safe for me?
May, 2009
Experts recommend low-dose aspirin to prevent stroke in women
A number of studies support the advice that women ages 55 to 79 should take a low-dose aspirin daily to reduce their risk of stroke. Aspirin does increase the risk of gastrointestinal bleeding, so this should be factored into the decision.
The health benefits of tai chi
Tai chi is gentle and not strenuous, but it has been shown to have a positive effect on muscle strength, flexibility, and balance, and it can be practiced by people in nearly any state of health or physical condition.
Foot health: What to do about an ingrown toenail
Most people can treat an occasional ingrown toenail by soaking it in warm water and applying antibiotic ointment, but if the problem occurs frequently, part of the toenail may need to be removed.
In the journals: High resting heart rate predicts heart risk in women at midlife
A study based on data from the Women's Health Initiative suggests that a high resting heart rate is an indicator of risk of heart attack in middle-aged women.
In the journals: B vitamins may protect against macular degeneration
Taking a daily supplement of B vitamins could reduce the risk of developing macular degeneration.
In the journals: Exercise eases nighttime leg twitches
People who suffer from periodic leg movement disorder, which disrupts sleep, may find that intense exercise during the day results in fewer leg movements during sleep and improved sleep quality.
By the way, doctor: Do I need CTX testing during a Fosamax "holiday"?
I'm 69 and have been taking Fosamax for 10 years. My doctor has approved a "drug holiday," provided we use a CTX test to monitor my bones. Can you explain?
June, 2009
Treating female pattern hair loss
Hair loss is a surprisingly common problem for women, particularly after menopause. This condition is typically treated with a medication such as minoxidil, though other options are available, including hair transplant surgery.
Recognizing and avoiding tick-borne illness
Tick-borne illnesses, once rare, are becoming more common. Insect repellent and treated clothing can help protect you, but if you do find a tick on your skin, it is very important to seek treatment as quickly as possible.
In the journals: Scientists discover how shift work may threaten health
People who work night shifts experience a misalignment in their circadian rhythms that can result in higher risk of obesity, diabetes, and cardiovascular disease.
In the journals: Triple-negative breast cancer rate is triply high in black women
Researchers found that a particularly aggressive form of breast cancer is three times as likely to occur in black women as in white women.
By the way, doctor: What can I do about strep B vaginitis?
I'm 61 and recently began to have a vaginal discharge. It's not itchy, but sexual intercourse is painful. My doctor diagnosed it as strep B vaginitis and prescribed amoxicillin, which helped. But the discharge returned within a week. What do you recommend?
July, 2009
Getting your vitamins and minerals through diet
With the effectiveness of multivitamins in question, it is possible to get the required amounts of vitamins and minerals through diet alone, even for those watching calories, by focusing on nutrient-dense foods.
Left behind after suicide
Those left behind after the suicide of a family member or friend struggle with a particularly difficult grief. Support groups, individual counseling, and online assistance may make the process easier to handle.
In the journals: Routine ovary removal during hysterectomy ill-advised for most women
Women who have their ovaries removed during hysterectomy procedures may be at greater risk of heart disease, lung cancer, or other illnesses as they age.
In the journals: Average duration of hot flashes may be longer than previously thought
A study of menopausal women found that they experienced hot flashes for an average of more than five years, much longer than had been previously thought.
By the way, doctor: Is taking calcium a problem if you have pseudogout?
I've been diagnosed with pseudogout, which I understand is caused by a buildup of calcium crystals in the joints. Should I be concerned about taking a calcium supplement?
By the way, doctor: What can you tell me about peppermint oil?
What are the pros and cons of taking peppermint oil?
August, 2009
Staying attuned to blood pressure
Blood pressure tends to increase with age as arteries stiffen. From midlife onward, the focus should be on the systolic number, which tends to rise more sharply in women after menopause than in men of similar age.
Exercise to go
This set of strength and flexibility exercises can be done anywhere without any special equipment, making them a good substitute routine to use while traveling.
In the journals: Radio wave treatment is effective against Barrett's esophagus
Barrett's esophagus occurs when cells lining the lower esophagus are replaced by intestinal cells brought up by acid reflux. A new technique uses radio waves from an electromagnetic coil to kill the affected cells while leaving healthy cells undamaged.
In the journals: Pelvic organ prolapse: Vaginal delivery is not the only cause
Pelvic organ prolapse is more common in women who have given birth vaginally, but a study of Swedish women who had prolapse identified several other potential causes related to lifestyle and other health conditions.
In the journals: Perimenopausal mental lags are real but temporary
A study of women in several stages of menopause found that a slight cognitive lag occurs in late perimenopause, but it is temporary.
By the way, doctor: What causes ice-cream headache?
What exactly happens when I eat something cold and get an ice-cream headache? Is it harmful in any way?
By the way, doctor: What do you think of platelet-rich plasma therapy?
What's your professional opinion of platelet-rich plasma therapy for soft tissue injuries? Is it safe for older adults?
September, 2009
Botox: Beyond cosmetic fixes
Most people are familiar with botulinum toxin (Botox) as a treatment to lessen the appearance of facial wrinkles, but it has other medical uses, such as treating uncontrollable muscle spasms and anal fissures.
Anaphylaxis: An overwhelming allergic reaction
Anaphylaxis is a serious and potentially fatal reaction to an allergen. People at risk must carry injectable epinephrine and know how to use it in the event of an attack.
In the journals: Link found between migraines with aura and late-life brain lesions in women
Women who experience migraine headaches with aura may be at higher risk of developing brain lesions later in life.
In the journals: Soy extracts don't improve bone density in older women
Adding a soy protein or isoflavone supplement did not prevent bone loss or encourage bone growth in postmenopausal women.
In the journals: Endometrial ablation is shown to be safe and effective
Women who are considering having a hysterectomy to relieve heavy menstrual bleeding may find microwave endometrial ablation a less invasive option.
By the way, doctor: Is a tanning bed safer than sunlight?
Does tanning in a tanning bed cause less damage than natural sunlight?
October, 2009
Molecular advances in early breast cancer
Advances in understanding the molecular biology of breast cancer have led to a new tumor classification system that can help clinicians determine which treatments are most likely to be effective.
Becoming a vegetarian
A vegetarian diet can meet all a person's nutritional needs if planned thoughtfully. Eat a variety of fruits, vegetables, whole grains, and nuts, avoid saturated fats, watch calories and portions, and be physically active.
In the journals: Study shows that a new type of osteoporosis drug reduces fracture risk
Testing of a new type of drug for the treatment of osteoporosis found that it reduced fracture risk, though it has not yet been compared to the other osteoporosis medications already available.
In the journals: Psychodynamic therapy is effective in treating chronic worry
A study comparing two types of therapy treatment for generalized anxiety disorder found that both therapies produced persistent positive results.
By the way, doctor: Should I try Renessa for urinary incontinence?
I have stress urinary incontinence and don't want to have surgery. What can you tell me about Renessa?
By the way, doctor: Should I have my knee replaced?
Fifteen years ago, I had surgery for a torn meniscus and was told I had arthritis. I'm now 79, and my knee hurts most days, though I still exercise daily on a stationary bike. I hate to take pills. Should I consider a knee replacement?
November, 2009
Sodium, salt, and you
Public health officials and agencies contend that most people should reduce their sodium intake to 1,500 milligrams per day or less. The average American tends to consume more than twice this amount per day.
In the journals: Yoga therapy helps relieve chronic lower back pain
A study of people with chronic low back pain found that those who participated in a particular form of yoga therapy had less pain after six months.
In the journals: Weight lifting eases lymphedema symptoms in breast cancer survivors
Breast cancer survivors who followed a strength training workout program had fewer problems with lymphedema, a common side effect of breast cancer treatment.
In the journals: Nonsurgical approach unlocks contracted fingers
Dupuytren's contracture is a condition in which one or more fingers is chronically bent. A nonsurgical treatment uses an injection of an enzyme solution that allows the contracture to be released.
Flu update: This year, reducing your risk for the flu will require two kinds of shots
The emergence of the 2009 H1N1 flu virus means that many people will need two separate flu shots to be fully protected.
By the way, doctor: Does hormone therapy cause dementia?
The Women's Health Initiative found that hormone therapy wasn't helpful for avoiding dementia there was some suggestion that it might even cause cognitive problems. Am I at risk for dementia by continuing hormone therapy?
By the way, doctor: Do inversion tables work?
What do you think about using inversion tables to relieve back pain?
December, 2009
What to do about postmenopausal fracture risk
The World Health Organization's FRAX is a risk assessment tool that predicts the likelihood of a bone fracture. This information can help identify people who may have osteoporosis and should get a bone mineral density test.
Treating hypothyroidism
Hypothyroidism can manifest in a variety of symptoms including elevated cholesterol, lower heart rate, and changes in weight and appetite. A blood test will determine whether or not a person's thyroid function is normal.
In the journals: Healthy lifestyle, including plenty of physical activity, cuts colon cancer risk
Analysis of data from the Nurses' Health Study found that women who got the most physical activity and practiced other healthy habits were half as likely to develop colon cancer.
In the journals: Optimism may lower your risk of heart disease
Research from the Women's Health Initiative found a strong correlation between a woman's level of optimism or cynicism and risk or heart disease, cancer, or death from any cause.
In the news: Large trial will test vitamin D and omega-3s
A five-year study hopes to determine whether vitamin D and omega-3 fats have an effect on rates of cardiovascular disease, cancer, and other illnesses.
By the way, doctor: Do I need a booster vaccination against whooping cough?
A friend was recently diagnosed with whooping cough. Her doctor told her that everyone, no matter what age, should be vaccinated for the disease every 10 years. Is that true?
By the way, doctor: What causes acid reflux in the throat?
I developed a hoarse voice and annoying phlegm in my throat and was surprised to learn that the cause was acid reflux. I've never had heartburn, so I don't know how this could have happened. Can you explain?
January, 2008
Eight for 2008: Eight things you should know about osteoporosis and fracture risk
All women need to be concerned about osteoporosis, protecting their bones and keeping them strong. Proper nutrition is the key to bone strength: the body needs calcium and vitamin D, and if diet does not provide enough, supplements should be taken.
Comparing surgeries for stress incontinence
Women who suffer from stress incontinence have treatment options incluuding several established surgical procedures. Some women have had success with collagen injections to strengthen the tissue surrounding the urethra.
From the journals: Unhealthy for women not to speak up during marital spats
Researchers found that women who did not express their feelings during marital arguments were at higher risk of dying prematurely.
From the journals: Ovary removal linked to risk for dementia, parkinsonism
Data from studies in Minnesota indicated that women who had one or both ovaries removed for reasons other than cancer were more likely to develop cognitive problems or movement disorders later in life.
By the way, doctor: Does having ridged and split fingernails mean I'm unhealthy?
I'm 63, and I've begun to notice a decline in the quality of my fingernails. They have up-and-down ridges, and at the tips, they're always splitting. I've heard you can tell a lot about a person's health from her nails. What does this say about mine?
February, 2008
The status of statins
Statins have been shown to reduce the risk of cardiac disease in women as well as in men. They may also reduce the risk of breast cancer and slow the progression of cognitive decline, and in general, their benefits seem to outweigh their risks.
The case for exercise in managing chronic lung disease
People who suffer from chronic obstructive pulmonary disease (COPD) may find it difficult to exercise, but a program of pulmonary rehabilitation followed by a regular exercise routine can help rebuild strength and energy.
Burning mouth syndrome
Burning mouth syndrome is a burning or stinging pain in the mouth. While a burning sensation in the mouth can be caused by other conditions and some medications, the primary form of the disorder may be caused by faulty nerve fibers.
From the journals: Nighttime awakenings in menopause may be caused by sleep disorders, not hot flashes
Hot flashes were believed to be responsible for disruptions in sleep in menopausal women, but a study found that half the participants had a primary sleep disorder, such as sleep apnea or periodic limb movements.
By the way, doctor: What can I do about earwax buildup?
My doctor recently noticed lots of wax in my ear, almost blocking the canal. How did this happen? What should I do about it?
By the way, doctor: What is keratosis pilaris?
Ever since my teens, I've had a rash that looks like goose bumps on my arms and legs. My doctor says it's keratosis pilaris. What do you know about this condition?
March, 2008
The ups and downs of folic acid fortification
Folic acid is essential to the production of new cells, and helps protect against certain kinds of birth defects, but studies have suggested that an excess of folic acid may contribute to the growth of cancer cells.
In Brief: "No-bones" calculator can help predict hip fracture risk
Bone density is used as a key indicator of a woman's risk of hip fracture, but an online assessment that uses other factors to determine risk may be useful to women who have a normal bone density reading.
Combating MRSA: The drug-resistant "superbug"
Though the drug-resistant bacterial infection known as MRSA typically occurs in hospital settings, new cases have developed as patients are discharged and bring the infection with them into their communities.
Floaters, flashes, and retinal tears
Floaters and flashes in the eyes are fairly common among older people, but sometimes they can indicate a retinal tear, which, if not treated promptly, can lead to retinal detachment.
From the journals: Four small lifestyle changes can mean an extra 14 years
A study found that people who followed four easily accomplished healthy behavior habits lived an average of 14 years longer than those who did not practice any of them.
By the way, doctor: Should I get the HPV vaccine if I'm already infected?
I'm 26 and positive for HPV. Is there any point in my getting the new HPV vaccine?
By the way, doctor: What are the side effects of lithium?
What can you tell me about the side effects of lithium? I've heard it causes thyroid and memory problems.
April, 2008
Negotiating the "bio-identicals" controversy
The FDA has taken issue with certain pharmacies that produce custom-compounded hormone therapy products, because some of them claim, without proof, that their products are safer or more effective than traditionally-produced hormones.
In the journals: Strength training relieves chronic neck pain
In a study, women who followed a program of exercises designed to strengthen neck and shoulder muscles experienced a significant decrease in neck pain.
Dermal fillers: Caulking the lines of time
Dermal fillers, which are substances injected into the skin, are increasing in popularity as an alternative to face lifts for women who wish to look younger. They are less expensive than cosmetic surgery, and the procedures are also simpler and faster.
In Brief: Research backs cranberries for preventing urinary tract infections in women
An analysis of studies found that regular consumption of cranberry juice (or other cranberry products) helped reduce the likelihood of urinary tract infections in women who had a history of recurrent UTIs.
By the way, doctor: Should I be tested at Life Line Screening?
Do you recommend preventive screening for vascular disease through companies such as Life Line Screening? I just got a notice for one that also includes osteoporosis testing.
May, 2008
The dubious practice of detox
Various types of body detoxification processes, such as fast diets and intestinal cleansing, have become popular. Generally there is no medical evidence to support their claims of effectiveness, and there are risks to some of the procedures.
Treating lumbar spinal stenosis
Spinal stenosis is a narrowing of the spinal canal that puts pressure on the spinal cord or its nerves. Typically doctors recommend conservative treatment, mainly physical therapy and pain medication. Surgery may be needed if a patient does not improve.
In Brief: Aromatherapy's benefits limited to mood improvement
A study of aromatherapy found that while lemon oil did enhance mood, neither it nor lavender oil had any discernible effect on the body in terms of immune function or wound healing.
In Brief: Blood test for ovarian cancer shows promise in early study
Researchers have developed a test for ovarian cancer that works by testing for the presence of a group of proteins believed to be affected by tumor development in the body.
In Brief: Many drugs prevent fractures, but none is best, study finds
A review of dozens of studies of the various types of medications prescribed to help prevent fractures concluded that there is not enough evidence to declare that one medication is better than others.
By the way, doctor: What can I do about a high coronary calcium score?
What can you tell me about coronary calcium scores and overall heart health? I have a high calcium score but normal cholesterol. I don't smoke or have diabetes. My cardiologist thinks I should take a statin, but my internist disagrees. What should I do?
June, 2008
Depression at perimenopause: More than just hormones
Research affirms a previously established connection between perimenopause and depression. However, an expected link between depression and hormone levels was not found.
Up with HDL, the "good" cholesterol
While attention to cholesterol has largely focused on lowering LDL through the use of statins, raising HDL is equally important, if not more so. Niacin boosts HDL, but its side effects can be tricky, so some people try exercise and dietary changes.
What to do about hemorrhoids
Many people experience the discomfort of hemorrhoids. Often they can be treated effectively with topical products and by eating more fiber. If they persist, surgical options are available.
Artificial joints for the hand and wrist
Arthritis sufferers may find some relief by having wrist joint replacement surgery. In some cases the wrist joints are fused, but this affects dexterity. Certain finger joints can also be replaced, though the success rate for these surgeries is lower.
By the way, doctor: How long can I keep getting cortisone shots in my knee?
I've been getting cortisone injections in my knee for osteoarthritis every four months. What are the possible side effects, and how long can I continue this? I'm a strong 81-year-old.
By the way, doctor: Which is better, flaxseed or fish oil?
For the healthy omega-3 fats we hear so much about, which is better - ground flaxseed or fish oil capsules?
July, 2008
Age no bar to routine mammography
Traditionally, mammography has not been recommended for women over 70, but as this age group grows in size, evidence is starting to support the position that breast cancer screening makes sense for older women.
Travel tips: Ways to minimize jet lag
Tips for minimizing jet lag when traveling include shifting to your destination time zone before leaving, staying hydrated, but avoiding caffeine and alcohol, and getting into the rhythm of the local time as quickly as possible after arriving.
What to do about fibroids
Uterine fibroids frequently do not cause any symptoms and are generally not dangerous, but they can cause discomfort and heavy menstrual bleeding. If medications are not effective, there are surgical options, some of which are minimally invasive.
Anxiety and physical illness
Persistent anxiety can contribute to respiratory disorders, gastrointestinal problems, and heart disease. Treating anxiety with psychotherapy, medications, or a combination can reduce or relieve physiological distress.
By the way, doctor: What are drusen, and why do I have them?
My ophthalmologist says I have drusen scattered over the macula in both eyes and wants to check them every nine months. Could you say something about what drusen are and what they mean?
August, 2008
Staying independent in our later years
Aging does not automatically mean relinquishing independence. Independent living can be sustained through attention to health issues like diet, exercise, control of blood pressure, vision, and maintaining a safe home environment to prevent falls.
In the journals: Head maneuvers work best for common vertigo
A study found that a series of head movements known as the Epley maneuver was an effective and safe treatment for those suffering from vertigo.
In the journals: Experts call for home blood pressure monitoring
Three organizations of cardiovascular experts recommend daily at-home blood pressure monitoring for those patients who have hypertension or are on the borderline of having it.
In the news: FDA approves one drug for irritable bowel syndrome but suspends another
The FDA has approved a new medication for constipation-predominant irritable bowel syndrome, soon after suspending another drug and restricting it to use only in emergency situations.
By the way, doctor: Can Hoodia help you lose weight?
I've seen a lot of Internet ads for Hoodia, a natural supplement that suppresses your appetite. What do you know about it? Does it work, and is it safe?
By the way, doctor: What's in sunscreen that protects against UVA rays?
What UVA-blocking ingredients should I look for in a sunscreen? And does a higher SPF rating mean greater UVA protection?
September, 2008
Time for more vitamin D
Vitamin D has been linked to a growing list of health benefits beyond bone strengthening, but many people, particularly seniors, have vitamin D deficiency. Because few foods are rich in the vitamin, taking a supplement is recommended.
Heart failure in women
Many factors can cause or contribute to heart failure in women, including coronary artery disease, hypertension, and diabetes. Treatment generally involves medications such as ACE inhibitors, beta blockers, and diuretics.
In the journals: Nerve block quells hot flashes in women with breast cancer
A procedure called stellate ganglion blockade, in which an anaesthetic is injected into a nerve cluster in the neck, helped relieve hot flashes and sleep disturbances in test subjects who were taking breast cancer medications.
In the journals: Coffee drinking lowers mortality risk in women
Researchers found an association between increased coffee consumption and a lower death rate, primarily due to fewer deaths from cardiovascular disease.
In the journals: No cardiovascular help from B vitamins in high-risk women
A study found that women at high risk for cardiovascular disease did not benefit from taking B vitamins, even though they lowered levels of homocysteine, which at high levels has been linked to cardiovascular trouble.
By the way, doctor: What can I do about Meibomian cysts?
I have small white bumps on my eyelids, which are driving me crazy. They don't hurt, but they look awful. I've been told they're Meibomian cysts and that the only solution is surgery. What is your take on this?
October, 2008
Understanding ductal carcinoma in situ
Ductal carcinoma in situ is a very early and highly curable form of breast cancer in which abnormal cells are still in the process of evolving into cancer cells. Increased use of mammography means that the disease is being diagnosed and treated earlier.
Core conditioning: It's not just about abs
Core conditioning refers to exercises that strengthen the muscles in the lower back, stomach, and pelvic area. Strengthening the core promotes good posture and overall fitness.
In the journals: Sleep duration affects stroke risk in postmenopausal women
Researchers found that women who slept a lot (nine or more hours a night) or a little (six or less hours per night) were at higher risk of stroke, heart disease, high blood pressure, low HDL cholesterol, metabolic syndrome, and premature death.
In the journals: Hormone therapy: Gallbladder risk is lower with a patch than a pill
Women who take hormone therapy have a higher risk of gallbladder disease, but a study found that women who received hormones through a skin patch or gel had a lower risk than those who took hormones orally.
In the journals: Viagra improves sexual function in women taking antidepressants
The erectile dysfunction drug sildenafil may improve sexual function in women who take antidepressants, but it does not boost sexual desire.
By the way, doctor: Should I be worried about a kidney cyst?
Recently, I had a pelvic ultrasound to evaluate uterine fibroids. During the procedure, the radiologist found a cyst in one of my kidneys. Should I be concerned about kidney cancer?
By the way, doctor: Does red yeast rice reduce cholesterol?
I've heard that red yeast rice can help lower cholesterol. What can you tell me about its effectiveness and safety?
November, 2008
What's the story with Fosamax?
Research suggests that the osteoporosis medication Fosamax, if taken for a long period of time, could cause a change in bones that makes them more susceptible to fracture. But the studies in question are inconclusive, so more research is necessary.
Managing common vulvar skin conditions
There are a number of skin conditions that can affect the vulva. Sometimes the products a woman uses every day can irritate the skin or provoke an allergic reaction.
Preparing for a colonoscopy
Preparation for a colonoscopy involves taking a substance the day before the procedure that induces bowel-clearing diarrhea. It's unpleasant and takes several hours, but adequate preparation can make the process somewhat easier to endure.
By the way, doctor: Should I get an implant to treat an overactive bladder?
I'm 80 and suffer from an overactive bladder that hasn't responded to the usual treatments. My urologist is recommending an Interstim neuromodulator. What are the pros and cons of this therapy?
December, 2008
What to do about social anxiety disorder
For those with social anxiety disorder, social situations are highly distressing. The condition may stem from self-image and fear of being judged by others. Treatment typically involves cognitive behavioral therapy and an anti-anxiety medication.
Treating osteoporotic fractures of the spine
About half of all osteoporosis-related fractures occur in the vertebrae. The initial treatment is usually a back brace and pain medication. If a patient is still in pain after several weeks, there are procedures to stabilize a damaged vertebra.
In the journals: Studies find a link between hot flashes and cardiovascular risk
Three large studies showed an association between hot flashes and increased risk of heart disease or stroke.
In the journals: Alexander technique helps relieve chronic back pain
A British study found that people with chronic back pain who had regular sessions of a rehabilitative movement discipline known as the Alexander technique felt better and had fewer days with pain.
By the way, doctor: How long should I keep getting Pap tests?
Is there an age when a woman no longer needs a Pap smear?
February, 2007
New view of heart disease in women
A landmark study found that women are susceptible to a different type of heart disease called microvascular dysfunction. It affects both larger and smaller blood vessels, but is not detected by the standard cardiac tests.
Recovering from an ankle sprain
Ankle sprains are common, but they require proper treatment to heal correctly. You should rest for one or two days and use ice to reduce swelling, then begin exercising to regain strength and range of motion.
In Brief: Experts say benefits of eating fish outweigh possible risks
Two reports conclude that the health benefits of eating seafood outweigh any risks. However, some people should avoid certain kinds of fish, and it's wise to stay informed regarding toxins in seafood.
Update: New research sheds light on "chemobrain"
Two studies show that chemotherapy and cancer drugs may have lingering effects on the brain after treatment concludes. Memory and attention are affected, but not permanently.
By the way, doctor: Are NSAIDs available in a patch?
I understand that NSAID patches are used in Europe to treat some kinds of arthritis. Are they available in the United States?
By the way, doctor: How does radiation cause thyroid cancer?
What kind of radiation causes thyroid cancer? What about microwave ovens and dental x-rays?
March, 2007
Lung cancer screening in women
Women are at greater risk of developing lung cancer than men, even if they have never smoked. Screening via a spiral CT scan can detect tumors while they are still treatable.
What to do about cataract
For people with cataracts, surgery is common and safe, and is typically covered by insurance. Depending on need and other eye issues, various types of lenses are available.
In Brief: Hot flash herb no better than placebo in large trial
A study by the National Institutes of Health found that black cohosh, an herb marketed to treat hot flashes, performed no better than a placebo.
The benefits of balance training
Balance training helps the body recover after an injury by relearning proprioception, its sense of itself in space. It can also help older people maintain mobility and prevent falls.
By the way, doctor: Does lysine prevent cold sores?
For years, I was plagued by cold sores and took antiviral drugs to treat the outbreaks. But at a friend's suggestion, I started taking lysine every day, and it seems to prevent them altogether. What do you know about this supplement?
By the way, doctor: Does taking Prilosec cause hip fractures?
I heard that taking a proton-pump inhibitor could cause hip fractures. I've been taking 20 mg of Prilosec every day for a year. Should I be concerned?
April, 2007
A better way to predict cardiovascular risk
The Framingham risk-assessment tool is used to evaluate a person's risk of heart attack, but it does not consider the influence of inflammation. Researchers have developed a new tool that uses three additional factors to evaluate your heart attack risk.
In Brief: Cognitive behavioral therapy helps ease tinnitus discomforts
A review of research suggests that cognitive behavioral therapy may provide some relief for those who suffer from tinnitus.
In Brief: Even mildly impaired kidney function can affect bone health
Even slightly decreased kidney function can cause a much higher risk of a hip fracture, because the kidneys produce vitamin D, and disrupting their function affects the body's regulation of calcium.
What to do about tennis elbow
Tennis elbow can persist for months, and is often prolonged by returning too soon to the activities that caused it. Various treatments can offer temporary relief, but the best course of action is to limit activity and take a pain reliever.
Sunscreens: New wave in sun protection: Blocking ultraviolet A
Experts now believe that ultraviolet A rays are as damaging to the skin as UVB rays. There is no standard for measuring effectiveness of UVA protection in sunscreens, but there are products on the market that protect well against both UVA and UVB.
C. difficile-associated disease on the rise
C. difficile, a bacterium that can infect the digestive tract, was formerly a problem primarily for the elderly and hospitalized. But the number of cases of C. difficile-related illness is growing, and they are more severe and harder to treat.
By the way, doctor: How often do I need a bone density test?
I'm a healthy 65-year-old woman and just had my first bone density test. How often do I need to have it repeated?
May, 2007
Why regular check-ups are still a good idea
Although guidelines recommend an as-needed, prevention-based approach to check-ups, both doctors and patients prefer an annual physical exam because it fosters and strengthens their relationship, leading to better overall care.
In Brief: Pelvic organ prolapse can run in the family
Studies of pelvic organ prolapse suggest that there may be a genetic tendency for the condition to run in families, making it more likely to be inherited and more likely to develop in some pairs of female siblings.
Exercise after age 70
Fitness is important at every age. For seniors, regular exercise can improve or perhaps prolong life. An exercise program for someone over 70 should focus on cardiovascular conditioning, strength training, improving flexibility, and improving balance.
Joint problems: Caution in treating temporomandibular disorders
Temporomandibular (jaw) disorders are typically very painful. Some people undergo treatments and even surgeries that do not offer any proven benefits. Conservative treatment is the safest approach.
By the way, doctor: What can I do about vitiligo?
I have white skin patches on both hands. My doctor says it's vitiligo. What causes this, and how can I treat it?
June, 2007
Exploring the depression-bone connection
Studies of a link between depression and osteoporosis suggest the bone deterioration could be a result of the depression, or may be caused by taking antidepressant medications for a long period of time.
Managing irritable bowel syndrome without special drugs
The FDA removed the drug Zelnorm, used to treat IBS, from the market due to concerns about increased risk of heart disease. Other mediciations and some over-the-counter products may help relieve discomfort from IBS, depending on the symptoms.
Driving safely as we get older
If you have concerns about your ability to continue driving safely as you age, periodically evaluate your health and any issues that may affect your driving skills, and consider taking a driver retraining course.
Changing the rules on CPR for cardiac arrest
Victims of cardiac arrest who received only chest compressions, without interruption for breaths, had a much lower risk of suffering neurological damage as a result of the attack.
By the way, doctor: Should I switch from tamoxifen to an aromatase inhibitor?
Two years ago, I had a lumpectomy and radiation for invasive early-stage breast cancer. My oncologist prescribed five years of tamoxifen. But I keep hearing about new drugs that might be better. Should I switch to one of these newer drugs?
July, 2007
Repaying your sleep debt
Besides the effets of fatigue and irritability, a sustained sleep defecit can lead to a greater risk of other health problems such as obesity, heart disease, diabetes, and stroke.
What to do about rotator cuff tendinitis
Rotator cuff tendinits is the most common shoulder injury. The best course of treatment is to rest, apply ice, take ibuprofen, and do stretching and strengthening exercises.
In Brief: Study reveals the biology of patient-psychotherapist empathy
A study found that when patients and therapists have a strong, positive emotional connection, their bodies' physiological reactions were also closely matched.
In Brief: Overweight linked to lower death risk in older women
Researchers found that a body mass index in the overweight range was not necessarily an accurate predictor of death rate in older women, but additional weight still increases the risk of many other health problems.
In Brief: Drop in breast cancer may reflect decline in hormone use
The recent decrease in new breast cancer cases in women over 50 appears to be linked to the decline in the use of hormone therapy for symptoms of menopause.
By the way, doctor: Should I supplement my diet with Ambrotose?
What do you know about the health supplement Ambrotose? I looked it up on the Internet, where it's described as an "advanced glyconutrient."
By the way, doctor: Should I take an intravenous drug for osteoporosis?
I've been taking a Fosamax pill once a week for two years for osteoporosis. I heard that there is an intravenous drug for osteoporosis that's taken just once a year. Should I consider switching to it?
August, 2007
New cervical cancer vaccine highly promising, but questions remain
Studies of the cervical cancer vaccine found that it was most effective when given before the start of sexual activity, but the benefits and risks of the vaccine over time are still not fully known.
In Brief: Hysterectomy doesn't harm - and may help - sexual function
Researchers found that women who had a hysterectomy did not suffer a decline in sexual satisfaction after the surgery, but rather an improvement.
Easing the pain of plantar fasciitis
The pain of plantar fascitis can often be relieved with rest, ice, and a nonsteroidal anti-inflammatory drug such as ibuprofen. Stretching will help restore flexibility so pain does not return upon resuming your activities.
In the News: Heart failure risk prompts warning labels on diabetes drugs
The FDA has ordered a warning label be put on the diabetes drugs Avandia and Actos due to evidence from studies that the medications may increase the risk of heart attack or death from cardiovascular disease.
By the way, doctor: Can strontium help treat osteoporosis?
What can you tell me about the mineral strontium, which is advertised for treating osteoporosis?
By the way, doctor: How much should I limit my salt intake?
If I want to lower my blood pressure, how much salt can I afford to take in?
September, 2007
Wake-up call on stroke in women
More women than men are victims of stroke, and the consequences for survivors are more serious in women. Medication to dissolve blood clots is available, but must be administered within the first three hours after a stroke to be most effective.
Exercise: Rx for overcoming osteoarthritis
Exercise does not increase the risk for osteoarthritis, and in fact is beneficial for those who have it, because it helps to strengthen muscles, improve balance and flexibility, ease stiffness, and promote overall health and well-being.
In Brief: Certain symptoms may be early signs of ovarian cancer
Researchers have identified four symptoms that are more likely to occur in women who develop ovarian cancer. Women who experience one or more of these symptoms for more than a few weeks should get a pelvic exam.
In Brief: Retinol helps reverse normal skin aging
In addition to treating damage to the skin caused by sun exposure, topical retinol has also been found to be effective in treating the normal signs of aging on the skin, but the treatments must be continued in order to remain effective.
In Brief: Dietary calcium may be better for bones than calcium pills
A study found that women who consumed a greater percentage of their daily calcium intake from dietary sources had a higher bone mineral density than women who got more of their calcium from a supplement.
By the way, doctor: Is it safe to take a pill that eliminates periods?
Some of my friends are excited about the new oral contraceptive that eliminates periods. But it worries me. Does anyone know what happens when you stop menstruating for a long time? It just seems unnatural.
October, 2007
MRI's emerging role in breast cancer screening
Studies have found that MRI tests used in addition to mammography detected more cancers in women at high risk for breast cancer. Women at average risk would not necessarily benefit from the additional testing.
Recovering from a stroke
After a stroke, the body can often recover some functions on its own if medical care is received promptly, but many people also need some form of rehabilatation program or physical, speech, or occupational therapy.
In Brief: New way to test triglycerides helps reveal women's heart risk
Two studies found that women with high nonfasting triglyceride levels (measured after a meal) had a much higher risk of cardiovascular problems.
By the way, doctor: Is palm oil good for you?
I was surprised to see an ad in one of my cooking magazines promoting palm oil as a healthy fat. I thought it was supposed to be really bad for you. What's the story?
By the way, doctor: Is it okay to take antibiotics indefinitely to prevent urinary tract infections?
This year I've had four urinary tract infections. Each cleared up with antibiotic treatment. Now, my doctor is prescribing a prophylactic antibiotic, Bactrim 400/80, that I'm supposed to take every day. Are there long-term risks in this?
By the way, doctor: Should I get the shingles vaccine?
I'm 67 and had shingles four years ago. Am I immune to it now? If not, should I get the new shingles vaccine?
November, 2007
Keeping portions in proportion
Increasing portion sizes mean we consume more calories, which has contributed to the increase in obesity among Americans. Discipline and changes in habits can help us reduce how much we eat, while still maintaining a good nutritional balance.
Preventing stroke
The habits and behaviors of a healthy lifestyle can also reduce the risk of stroke: don't smoke, exercise, keep cholesterol and blood presure as low as possible, and eat a healthy diet.
In Brief: Hypnosis before breast cancer surgery eases pain, cuts costs
A study found that women who underwent hypnosis before a breast cancer biopsy or surgical procedure were more relaxed, felt less anxiety and pain, and required less anaesthesia.
By the way, doctor: Is vaginal estrogen safe?
My doctor prescribed a low-dose vaginal estrogen cream, applied twice a week, for atrophic vaginitis. I've heard this dose is so low that it carries no health risk. Do you agree?
By the way, doctor: Am I taking too much vitamin D?
I take Fosamax with vitamin D and a multivitamin that contains vitamin D. Now I see my calcium tablets also have vitamin D in them. Am I in danger of getting too much of this vitamin?
December, 2007
Revisiting hormone therapy's risks and benefits
Though long-term hormone therapy has been shown to increase the risk of cardiovascular problems, short-term use may still be beneficial for certain symptoms, and without the risk of heart disease if started early in menopause.
Topical drug treatments for age spots
Physical removal of age spots can be costly and painful. Topical treatments take time to work, but are generally safe, cost less than removal procedures, and are easier on the skin.
From the Journals: Herbs and supplements for anxiety: Kava, inositol may help
There is evidence that certain herbs and supplements may be effective in treating certain types of anxiety disorders.
In Brief: Dietary lutein and zeaxanthin may slow macular degeneration
Diets rich in lutein and zeaxanthin, typically found in fruits and vegetables, can reduce the risk of age-related macular degeneration. Researchers will attempt to determine if taking the substances in a supplement can produce similar benefits.
By the way, doctor: Do I need to take a cholesterol-lowering drug?
I'm 53 and on the fence about taking a medication for cholesterol. My father had three bypass surgeries during his lifetime. My cholesterol is high (256), but my good cholesterol is also high (62). My LDL cholesterol is 161. Should I take a medication?
By the way, doctor: Why do I yawn when I exercise?
I'm 40, and for the past few years I've been starting to yawn whenever I get an intense aerobic workout. Is this something I should worry about?