HRT may have links to heart disease

Dear Dr. Gott: What is the current dogma about hormone replacement therapy in early menopause?

Dear Reader: The current position is not favorable for women who choose HRT.

This issue was addressed in the March 8, 2004, issue of the journal Archives of Internal Medicine. Cardiovascular disease has become the leading cause of death in both women and men; it carries three times the risk of breast cancer, which women fear more. However, women tend to develop CVD at older ages than men. The cause of this phenomenon is not known, although it is probably related to the post-menopausal loss of estrogen and its protective effects; increase in cholesterol levels; smoking; and other factors that are, as yet, undefined.

In the study I mentioned, researchers found that HRT did not protect women from heart disease; in fact, there was a “50 percent excess in CVD morbidity and a twofold increased risk for stroke.” This trend translated into increased rates of heart attack (especially in women who smoke).

The researchers concluded that “the potential drawbacks of post-menopausal (hormone) therapy should be considered carefully before recommending its widespread use.”

Although I am not a gynecologist, it would be irresponsible for me to ignore these findings. Therefore, I recommend that average, healthy, menopausal women avoid hormone replacement therapy unless, under the guidance of their physicians, they should take it because of special circumstances.

To give you related information, I am sending you a copy of my Health Report “Menopause.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title.

Dear Dr. Gott: My wife quit smoking for six months. During that interval, she developed painful blisters in her mouth and they became infected.

She subsequently quit again, and the blisters returned. She is very uncomfortable with this situation, and two mouth specialists are confused.

Dear Reader: So am I.

I suppose that an ingredient in the tobacco smoke could, in some fashion, deactivate the viruses that commonly cause mouth ulcers, but this would be highly unusual, in my experience. Nonetheless, your wife’s pattern is intriguing.

I suggest that she have a herpes virus culture taken when the mouth lesions are in their most active stage. If the test confirms the presence of viruses (which I suspect it will), your wife’s physician may consider prescribing an antiviral drug, such as acyclovir, to kill the herpes and relieve her symptoms.

In the meantime, she should refrain from smoking because of the recognized hazards of cigarettes, including circulatory problems and cancers of the lungs and mouth.