Q: I am 69. I had my first hot flashes 20 years ago, and they continue unabated to this day. They wake me up several times at night and come every few hours during the day. What can I do before I ask my doctor for a hormone Rx?
— Sharon, Aurora, Colo.
A: Although hot flashes are as closely linked to menopause as Brad Pitt is to Angelina Jolie, a drop in estrogen isn’t the only thing that can set off inner fireworks. You should talk to your doc, but don’t make hormones topic No. 1.
First, discuss any drugs you are taking. Some medications, such as those used to treat bone-thinning osteoporosis, can turn up your thermostat. Next, ask your doc to run blood tests for two things:
• Thyroid stimulating hormone. Find out if your thyroid gland is overactive (hyperthyroidism), or if Graves’ disease could be heating you up.
• Blood sugar levels. When you’re estrogen-deficient, your body struggles to deliver glucose to the brain, where it’s used to regulate your thermostat.
We’re suggesting tests because menopausal hot flashes don’t usually persist this long. For many women, they stop a year or two after the last period. For others, like you, the heat waves may continue for years, but are generally less extreme.
If your blood tests are normal, talk to your doctor about whether you’re a good candidate for hormone replacement or for other drugs. For example, several antidepressants, including paroxetine (Paxil) and venlafaxine (Effexor), could help you beat the heat.
We reviewed the hormone therapy research for “YOU: Staying Young” and believe a bioidentical estrogen (pharmaceutical grade) and a micronized progestin relieves persistent hot flashes. Taken with two baby aspirin, the combination can prolong quality and length of life when done right.
Q: What is a “venous cluster” in the brain?
— Bernadette, Searcy, Ark.
A: A venous cluster is a fancy way of saying a bunch of veins have gotten tangled up. These snarls are also known as venous angiomas and can appear almost anywhere in your body — the liver, spine, or brain. They’re technically tumors, but usually are benign. There’s also a version that forms a starburst pattern of brain veins called a developmental venous anomaly, or DVA.
DVAs have been associated with more serious brain conditions, and experts suspect they may be a warning or a foundation for trouble.
Meanwhile, we’d recommend some sensible precautions:
• Keep your blood pressure as close to 115/75 as possible.
• Don’t do things that subject you to sudden, intense gravity shifts, like riding on roller coasters.
• Avoid activities that suddenly raise your blood pressure.
• Avoid stimulant drugs like decongestants that can cause a blood pressure spike.
• Don’t take blood thinners or daily aspirin if you don’t need to.
The YOU Docs, Mehmet Oz and Mike Roizen, are authors of “YOU: On a Diet.” Want more? See “The Dr. Oz Show” on TV. To submit questions, go to www.RealAge.com.