Q. The continuing bad news about hormone replacement therapy has me upset. Can you clear up another question for me? The news has focused on the dangers of estrogen plus progestin for older women.
What about the danger to younger women taking the same hormones as birth control pills? Are our daughters at risk from using birth control pills that contain estrogen and progestin?
A. Most birth control pills are combinations of estrogen and progestin, not that different from postmenopausal hormone replacement therapy (HRT). Doses differ, but some similar concerns about side effects have been raised.
Postmenopausal HRT raises the risk of breast cancer. But the effect of oral contraceptives on this disease remains controversial. A pooled analysis showed that birth control pills increased the risk of breast cancer by 24 percent. A more recent study did not demonstrate this degree of risk, but it was less rigorous than the Women’s Health Initiative.
Birth control pills increase the risk of blood clots, which could lodge in the lungs, heart or brain. This is especially dangerous for women who smoke or have high blood pressure, but nonsmoking healthy women are at very low risk.
Q. Is it true that you should not drink cranberry juice if you are on Coumadin to thin the blood?
A. British regulatory authorities issued a warning to patients taking warfarin (Coumadin) not to drink cranberry juice. This combination has been associated with excessive bleeding and one man died. Until this interaction has been more thoroughly studied, it would be wise for those on Coumadin to avoid cranberry juice.
Q. I have been on Zoloft for close to two years. During that time I have gained weight, lost all interest in sex and had trouble sleeping. I tried to stop taking Zoloft and experienced sensations like electric shocks going through my body.
My doctors treated me as if I were crazy. Neurological tests (MRIs and CT scans) were normal. When I went back on Zoloft the dizziness and shocks disappeared. Will I have to take this drug forever?
A. Insomnia, sexual difficulties and weight gain are not uncommon with some antidepressants. Dizziness, electric shock-like sensations and nausea have been reported when people stop such drugs suddenly.
We are sending you our Guide to Antidepressants Pros and Cons for more information about complications, interactions and withdrawal. Anyone who would like copies, please send $2 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. MX-23, P. O. Box 52027, Durham, NC 27717-2027.
Q. My nine-year-old daughter has head lice for the second time this school year. Over-the-counter lice medicine is ineffective and I need a way to get rid of these annoying critters.
A. Lice are developing resistance to some of the louse-killing compounds that are most widely used. You may want to try an herbal preparation containing essential oils such as anise and ylang-ylang as well as coconut oil. It is called HairClean 1-2-3. Clinical tests have shown this product works against lice that have developed resistance to standard lice shampoos.
Getting rid of nits (lice eggs) is also necessary. Try coating the hair with mineral oil and using a special nit comb to remove them more easily.
The People's Perspective on Medicine