DEAR DR. DONOHUE: Will you please tell me if there is something I can take to get rid of hot flashes? I am 74 and have them all the time. I sweat terribly. I have tried Estrace (female hormone), Estroblend (a dietary supplement) and black cohosh (an herbal remedy). — M.B.
ANSWER: It’s said that 8 percent of women still have hot flashes into their 70s. Most women get over them in six months to five years after menopause. The drop in estrogen production that occurs with menopause affects a part of the brain that regulates body temperature. The brain’s thermostat is thrown out of whack, and the result is spells of sudden, uncomfortable warming with sweating.
Let me give you the usual recommendations made for control of hot flashes. I’m pretty sure you must have tried them after more than 20 years of putting up with flashes. Dress in layers so that outer garments can be shed at the first inkling of a hot flash. That can keep it from becoming a full-blown one. Keep ice water on hand and drink it at the start of a flash. Cut back on caffeine. Slow, deep breathing at the onset of a flash is said to minimize it.
Estrogen, which you have tried, is the most effective treatment for flashes. It should be taken in as low a dose as possible for the shortest time possible. Maybe a different estrogen preparation would work for you.
Effexor and Lexapro, two antidepressants, have met with success in suppressing hot flashes for some women. Here they are not used for their antidepressant action. It’s an example of medicines that have more than one function. Neurontin (gabapentin) is a seizure-control medicine that is also used for control of hot flashes.
Hot flashes that have lasted as long as yours call for a consideration of conditions other than estrogen deprivation. An overactive thyroid gland, a hidden infection and two unusual tumors — carcinoid and pheochromocytoma — are examples of illnesses that produce symptoms similar to a hot flash.
DEAR DR. DONOHUE: I am 84 years old. Recently I had a CT scan of my abdomen. It revealed multiple diverticula in the sigmoid colon. Will you please explain diverticulitis to me, and what I can expect from it? — H.T.
ANSWER: You don’t have diverticulitis. You have diverticulosis — small, pea-size protrusions of the colon lining on the outer surface of the colon. Between 50 percent and 80 percent of people your age have the same condition. Diverticulosis almost never causes pain. It hasn’t caused any trouble in your past. It’s most unlikely to cause you any trouble in the future.
Fiber stops diverticula from forming. Make sure you’re getting 25-30 grams of it every day.
Diverticulitis is inflammation of diverticula. It happens to only a few people with diverticulosis. Fiber also will prevent inflammation from developing.
The booklet on diverticulosis explains this common malady in detail. To order a copy, write: Dr. Donohue — No. 502W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.