Estrogen story is confusing


Q. I took hormones for four years and then discontinued them for a year. Now I have started again, at the urging of my doctor. While I was not taking hormones, I had hot flashes, night sweats and vaginal dryness.

I stopped taking hormones because the progesterone component made me irritable and depressed. (I was taking Premarin and Provera.) My doctor put me on Estrace and Prometrium this time, but I still feel prickly and sad.

I'm convinced progesterone is the problem, so I wonder if I can take the estrogen alone. I recently read that estrogen has heart benefits.

A. The hormone controversy has heated up again. A study showed that women between 50 and 59 taking estrogen alone were not at increased risk of heart attacks (Archives of Internal Medicine, Feb. 13, 2006). These women had previously undergone hysterectomies, so they did not need progesterone.

Estrogen alone is not safe for a woman who still has her uterus, since it increases the risk of endometrial cancer. Progestins like Provera protect against this kind of cancer. When added to estrogen, however, they may increase the risk of heart attacks and strokes and possibly breast cancer as well. For some women, progesterone lowers libido and leads to depression.

We are sending you our Guide to Estrogen: Benefits, Risks and Interactions. Anyone who would like a copy, please send $2 in check or money order with a long (no. 10), stamped (63 cents), self-addressed envelope to: Graedons' People's Pharmacy, No. W-49, P.O. Box 52027, Durham, NC 27717-2027. It can also be downloaded for $2 from

Q. Is there any adverse interaction between Lipitor and pomegranate juice? I know there is a problem with grapefruit juice and Lipitor and wondered if there could be a similar problem with other tart juices.

I have been reading that pomegranate juice is very beneficial, but I take Lipitor, so I thought I should check it out first.

A. Grapefruit affects drug metabolism and leads to higher levels of many medicines, including Lipitor. As a result, Lipitor may be more likely to cause side effects.

A study in Japan found that pomegranate juice was comparable to grapefruit juice in this activity (Drug Metabolism and Disposition, May 2005). Not all tart juices do this, but you would be wise to skip pomegranate juice. Although it can lower blood pressure and help keep plaque from building up in arteries, it might not be safe with Lipitor.

Q. I have always been very sensitive to cold medicines. Even nighttime cold medicines make me hyper. I can't take any cold medicine after about 5 p.m. if I want to get some sleep at night.

I always take half the recommended dosage (usually that means one pill instead of two), and even then, I experience strong reactions. Why do some people get drowsy when they take these remedies?

A. Cold remedies often contain antihistamines and decongestants. Many people find that drugs like the decongestant pseudoephedrine are very stimulating. Any cold or cough medicine with "D" in the name could pose problems, especially at night.

Antihistamines like diphenhydramine (Benadryl) or chlorpheniramine (Alka-Seltzer Plus Flu tablets) normally make people drowsy. But many children and some adults react differently. Such drugs stimulate them. Taking antihistamines at night could be counterproductive for such individuals.

Q. I want to share a remedy I learned about when traveling in Brazil. Just apply milk of magnesia to your armpits. It is the best underarm deodorant!

A. What an unusual idea. Milk of magnesia contains magnesium hydroxide, which is both an antacid and a laxative. We have never heard of applying it to underarms, though. Perhaps it reduces the acidity of the skin to make odor-forming bacteria less welcome.

Q. I don't like the taste of thyme and ginger in a tea for relieving a cough. But if you add a low-sodium chicken bouillon cube instead of sugar, you have a tasty little broth that calms a cough.

A. Thanks for an interesting modification on an old remedy. Spices like thyme and ginger have a long history against coughs. They do have strong flavors, however, and your solution is one way to make them more palatable.

Dissolve a bouillon cube in a cup of hot water. Add one-half teaspoon of thyme and about a teaspoon of grated fresh ginger root. Steep the mixture for four or five minutes and then pour it through a strainer into a clean mug and sip.

Q. Please pass this on to the woman who cannot stay awake while driving. I have always had the same problem. I do not have a sleep disorder.

Driving and riding in a car are the only situations where I can't stay awake. A friend gave me the solution about nine years ago sunflower seeds! There is something about having to concentrate on cracking them open with your teeth that keeps the brain alert. It's rather messy, but it works for me.

A. We received many messages from readers who were concerned about the woman who could not stay awake while driving. Most feared that she was being poisoned by carbon monoxide and pleaded that she have her car checked.

Other suggestions included keeping a squirt bottle of water in the cup holder for an occasional refreshing spritz. One reader realized that the donut and coffee she had at the beginning of her drive were making her blood sugar drop later. She switched to nuts or cheese sticks as a snack, avoiding cookies, candy, crackers or sugary sodas, and had no further problems with drowsiness while driving.

Q. I'm 47 years old and play basketball. My calves seem to cramp almost every time I play. I stretch them for about 20 minutes beforehand, but it doesn't help.

Would this be due to a lack of calcium or potassium? Please help. I'm sick of hopping around for days after I play.

A. Muscle cramps can be caused by all sorts of things. Lack of minerals like calcium, magnesium and potassium may be responsible. In such cases, replenishing the minerals may prevent the cramps.

A former football player with the Dallas Cowboys and San Francisco 49ers told us that the best home remedy is a jigger of pickle juice. He also found a glass of tonic water with quinine helpful. Other readers tell us that a teaspoonful of yellow mustard also works.

We are sending you our Guide to Leg Pain, with many home remedies and simple suggestions for cramps and restless leg syndrome. Anyone who would like a copy, please send $2 in check or money order with a long (No. 10), stamped (63 cents), self-addressed envelope to: Graedons' People's Pharmacy, No. RLS-5, P.O. Box 52027, Durham, NC 27717-2027. It can also be downloaded for $2 from our Web site:

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