May 2009
"Know Your ABCs"
March 2009
"Carb Control"

June 2008
"Best Brain Boosts After 55"

February 2001
"Baby Steps"

November/December 1999
"Sick of Getting Sick?"

August 1999
"Natural Remedies for Little Aches and Pains"

Spring 1999
"Doctors' Orders"

February 1999
"Head-to-Toe Herbal Health"

October 1998
"Sexual Healing"

July/August 1988
"A Baby Boomer's Guide to Menopause"

general health clips — page 3

go to general health — page 1

February 1999

Head-to-Toe Herbal Health

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Overcome UTIs: If you've heard a that drinking cranberry juice every day can reduce the incidence and duration of urinary tract infections, but you hate the taste, here's great news: Research shows that blueberries contain the same "condensed tannins" that inhibits the adherence of bacteria to the urinary tract lining. Eat a cup of fresh blueberries daily to help prevent infection.
Have happy feet: The antimicrobial, anti-inflammatory and cooling properties of peppermint leaves — a classic herbal remedy for achy, not-so-fragrant feet — fight foot fungus, reduce swelling and soothe hot, irritated skin. To make a footbath, add a handful of dried leaves to a half gallon of boiling water. Let steep for 15 minutes, then soak your feet for 15 to 30 minutes.
Don't be vein: Reduce the pain and swelling caused by poor leg circulation with the extract from horse chestnut seeds, which has a tightening effect on veins, making them less likely to distend. Look for standardized capsules that contain the chemical aescin; 30 to 150 mg is a typical daily dose, but fall the label for exact instructions.
Manage menstrual and menopausal discomfort: Extracts from the black cohosh root have been shown to have estrogen-like effects, making this a promising remedy for cramping, hot flashes, mood swings and more. For the best results, look for a standardized products such as many Remifemin and follow label instructions for exact dosage. Avoid taking it for longer than six months or if you're pregnant.
Tame tummy troubles: Studies show that ginger, an Asian and European folk remedy, can ease motion sickness and heartburn, stimulate healthy digestion and soothe irritated gastric muscles and tissues. Peel and finely mince a piece of ginger root about the size of your thumb. Combine the ginger with 2 tsp. of dark brown sugar and boiling water, cover, and steep for a least five minutes. Pregnant women, anyone taking a blood thinner and people with gallstones should avoid taking ginger.
Be good to your heart: Recent studies suggest that the flowers and leaves of the hawthorn plant strengthen the heart, helping to fight cardiovascular disease, including hypertension and arrhythmia. Take a dropperfull of a hawthorn tincture twice a day, or make at tea from 2 tsp. crushed dried berries and one cup of boiling water.
Get cold comfort: Taken at the first sign of a cold, echinacea will boost your immune system and help your body fight both viral and bacterial infections more quickly. Look for a tincture made from the root of the plant and take one or two droppersfull three times a day. Pregnant women, people with autoimmune disorder illnesses, such as multiple sclerosis or AIDS, and people with ragweed allergies shouldn't take this herb.
Mind your mouth: For painful canker sores or bad breath, try tea tree oil, which has been shown to be an effective antimicrobial. It contains terpenes, substances that kill germs and also produce the oil's characteristic medicinal smell and skin-tingling properties. Dab a tiny bit of pure oil directly onto a canker sore (dilute before applying if you have sensitive guns). To treat halitosis, try a commercial tea tree oil mouth wash, or make your own by diluting several drops of oil in a small glass of water.
Sleep soundly: The essential oil of lavender reduces tension and helps induce sleep. Add several drops to a room diffuser, or apply it to a warm washcloth and drape it over your eyes and noses.
Boost your mood: St. John's Wort is a mild antidepressant and a promising remedy for seasonal affective disorder. Take 3 mg, three times a day, of a standardized formula. Don't combine with prescription antidepressants.
Muscle out migraines: This herb acts as a preventive, not a remedy for a headache that's already developed. But studies show that two to three capsules a day of freeze-dried feverfew leaves over two months can prevent migraines. Avoid it if you're pregnant, taking into a clotting drugs, or if you have ragweed allergies.
Halt hair loss: The essential oils of thyme, rosemary, lavender and cedarwood can reverse alopecia areata (a type of premature hair loss in women). Combine two drops of each oil with 4 tsp. of grapeseed oil and one-half teaspoon jojoba oil; massage a teaspoon of the mixture into your scalp every day.


September/October 1998

Sexual Healing

Is it your sex drive sluggish? Do you experience more fizzle than fireworks? Energy healers offer a drug-free way to rev things up

At age 32, Patricia was desperate. A recurring ovarian cyst made intercourse almost unbearable, and sex had all but disappeared from her marriage. Depressed and frightened, she consulted a string of specialists, who advised her to have the cyst drained or surgically removed — with the understanding that it would probably return. One doctor even prescribed a hormone therapy that carried with it the risk of infertility. "I was so scared," she says. "I had gone to every source I knew, and I was just exhausted." Along with the cyst, Patricia suffered from what experts call sexual dysfunction, the label put on the inability to function "normally" in bad — basically being able to maintain a healthy sex drive and achieve erections and orgasms.

Before you write sexual dysfunction off as a condition too coldly clinical to apply to anyone you know, take note that in America it may be more the norm than the exception: In one recent study, only 28.6 percent of married women aged 18 to 56 reported that they were always able to achieve orgasm through intercourse. And according to data from the National Institutes of Health, approximately 30 million men in the United States report having at least occasional problems maintaining an erection.

To further confuse the issue, the causes of this condition may have little to do with sex at all. In Patricia's case, the trigger was clear: a physical ailment brought her real, measurable pain during intercourse. For some people, though, dysfunction may stem from a history of rape or abuse. Others may carry psychological baggage from childhood or earlier relationships that eventually lead them into a "dead bed" syndrome of low libido and emotional shutdown. Indeed, according to Erica Goodstone, Ph.D., a certified sex counselor and family therapist in New York City, there is no such thing as a "simple" sexual problem, nor is there a sexual problem that's purely physical or all in your head. "Sex is not separate from the rest of your life. If you're having a sexual problem, that's just the area in which another problem is manifesting itself," she says. The trouble is, sexual problems are so personal that most people would rather just ignore them than actually address them, whether on psychiatrist's couch or in an intimate conversation with a partner or a friend. Fortunately, Patricia felt comfortable enough to discuss her situation with a friend — who recommended she try energy healing.

Healing touch
What is energy healing? For thousands of years, traditional practitioners of Eastern medicine have believed that the body contains an invisible an invisible energy, known throughout the world by several different names, including qi, life force, and prana. In a healthy body, it flows freely. But when the body is afflicted by sickness or stress, energy stagnates, obstructing the flow of blood, lymph, and neurological messages—and creating a host of physical and psychological problems, including sexual dysfunction.
Energy healing is actually a broad term encompassing many forms of therapy that try to unblock these obstructions. Some healers use only their eyes to detect blockages, looking for visible cues like swelling or distended blood vessels, or even observing auras — halos of light that can show areas of stalled energy.

More widespread are therapeutic touch treatments like Reiki and polarity therapy, in which the therapist gently lays his or her hands around the body's of five main energy centers, known as chakras. Each chakra is identified with different physical and emotional functions—from love (located in the heart) to sexuality (located in the pelvis). (For more, see "The Five Primary Chakras," below.)

"The physical part of an energy blockage is really the end of the chain," says Gary Peterson, a polarity therapist in Boulder, Colorado, and executive director of the American Polarity Therapy Association. Peterson, who treats patients with sexual problems, many of whom have suffered abuse, rape, or another trauma, explains: "It's already happened in the mind and it's manifested through the emotions. In the end, the energy just gets trapped in the tissues." That's when it shows up as a physiological problem—be it a headache or a sexual dysfunction.

Some energy healers use a gentle, almost weightless touch, while others will use no touch at all, simply hovering their hands over the patient's body. But the end goal — to release some of this trapped energy — is the same. "The feeling of energy moving through an area it is quite real," says Peterson. "You feel vitality where there was deadness, and that triggers a domino effect throughout the body."

Most energy healers also incorporate talk into their treatments. "With a chronic problem like sexual dysfunction, there is generally a tangle of feelings and beliefs, sometimes bitter experiences and embarrassment," says Bill Weinstein, a certified polarity therapist in New York city. "I listen to a patient for a long time, to gently find my way into their thoughts and feelings. Then, I can take the first step toward unraveling the problem."
For Patricia, the healing process began with a conversation. She consulted Glen Scarpelli, DC, medical director at the Madison Wellness Center in New York City, who uses a form of targeted energy work incorporating subtle manipulation and touch. He queried Patricia about her overall health and specific complaints. The interview and a subsequent visual exam revealed that Patricia had varicose veins and unusually cold feet, both more pronounced on her right side, where the cyst was. When she lay on the examination table, Scarpelli felt a slight enlargement or misalignment of her uterus, which, coupled with the cyst, explains the pain she felt during intercourse.

The 5 Primary Chakras



emotional role








solar plexus




sexual function


base of spine


After her very first treatment, Patricia felt a change.

"I could tell that something, a power, and energy, had passed in and out of my body," she recalls. Over the following few months, Patricia went in for treatments three times a week, during which Scarpelli would gently palpate the affected area. He also recommended dietary changes and a few herbal remedies, prescribed to restore her overall energy balance. "During treatments, and I could actually feel my uterus moving," she says. "It was very powerful." And emotional, too. Patricia cried in one session as she began to sense the blockage giving way and the pain subsiding. "I could see the energy flowing between us, and I had a real sense of release," she says.

After the fourth or fifth treatment, Patricia says, the sense of stagnation in her body had all but disappeared. And after six months, the pain was gone entirely, the anxiety and depression had been lifted, and she could enjoy intercourse again. A gynecological exam showed that the cyst had shrunk dramatically, and she and her husband are now expecting their first child. "My husband says I'm back to my old self," says Patricia. "I never thought I had changed, but looking back I realize that I was different. I was tired and bogged down, but after the treatments I felt elated. It was a real transformation."

Four healing therapies
There are several different types of energy healing: Some are formal disciplines, others hybrids of various stripes. Here are four of the most common; many therapists may incorporate elements of several in one treatment.
Polarity therapy: According to polarity therapy, many health issues follow a "step down" process. They begin as a thought in the first chakra (it's the one associated with intelligence) and pass down through the lower chakras. "There are different densities of energy in your body that you could compare to qualities of water," explains Erica Goodstone, Ph.D., who uses polarity therapy in her New York City practice. "Pure energy is flowing, like a stream. If there is a blockage, it gets watery. And if the energy becomes completely stagnant, it will solidify." A mental hang-up about sex, for example, may eventually lead to impotence — starting in the "lighter" chakra, higher in the body, and progressing downward through the "heavier" tissues until it gets stuck. To keep energy flowing, polarity therapists may use gentle massage and stretching exercises and apply pressure to points above and below the blockage. For more information, call the American Polarity Therapy Association at 303-545-2080.
Reiki: In a Reiki treatment, a practitioner channels the universal life force into the client, rather than directing it to any one area, trusting that the energy and the body will cooperate. The therapist gently lays his or her hands on the patient's head, shoulders, and back to conduct the energy into their system. "The important thing in Reiki is that you cannot intend to do anything. You just send a pure energy into the body, and it will go exactly where it needs to," says Patti Templin, a psychotherapist and Reiki practitioner in Telluride, Colorado. Templin uses Reiki to help patients deal with issues linked to abuse, as well as sexual problems associated with tumors and other physical disorders. For more information, call the International Center for Reiki Training at 800-332-8112.
Reflexology: Reflexology addresses the body's energy imbalances by stimulating specific zones in the feet, which are connected to all of the body's organs and glands. There are more than 7000 nerves in each foot, notes Laura Norman, a New York City reflexologist and author of Feet First (Fireside, 1988). Stimulating the feet can have profound effects on the nervous system and may also clear stagnation in the corresponding energy zones. "Sexual dysfunction is often related to stress and tension, and reflexology addresses these things directly," Norman says. Furthermore, reflexology creates an overall feeling of balance in both mind and emotions, which translates into better health — and better sex. For more information, call the International Institute of Reflexology at 813-343-4811.
Healing science: This school of energy medicine was created by Barbara Brennan, author of Hands of Light (Bantam, 1989) and Light Emerging (Bantam, 1993) and director of the Barbara Brennan School of Healing in Great Gorge, New York. An atmospheric physicist for NASA before taking up bioenergetic therapy (a form of body-centered psychotherapy), Brennan chaired the ad hoc panel on energetic therapies for the National Institutes of Health Office of Alternative Medicine. She now trains therapists to work with patients with health problems that may include sexual difficulties. Like polarity therapy, Brennan's method addresses the chakras, reading a patient's aura to target areas of stagnation. Treatments may include a light touch, targeted to specific chakras, plus recommendations for diet and lifestyle changes. For more information, call the Barbara Brennan School of Healing at 516-329-0951. 



July/August 1998

A Baby Boomer's Guide to Menopause

America's postwar generation enters
"the change."
Here, our latest options

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The generation that once said it didn't trust anyone over 30 is about to enter, or has already crossed into, the menopause zone: that time in every woman's life when menstruation stops and hot flashes begin. Not to mention increased risk for certain cancers, heart disease and osteoporosis. No wonder our mothers and grandmothers never talked about it. Euphemistically dubbed "the change", menopause has traditionally been a subject shrouded in mystery, talked about in hushed tones if talked about at all. But ever the rebels, boomers refuse to take things lying down. Boomers also refuse to focus on the negatives. "We are the generation that won't do what we're told, unless we're sure it's the right thing for us to do," says Kathleen Fry, MD, a physician and homeopath in Scottsdale, Ariz.

Thus, we're seeing an info-driven, enlightened generation—the same one that spawned flower children, shattered gender barriers, and took the word "obey" out of marriage vows—demanding choices when it comes to managing menopause. "These are the women who brought natural childbirth to the front, who brought their significant others into the delivery room, and demanded answers to questions about pregnancy and reproductive health. Now they're reaching menopause, and the subject is no longer taboo," says Wulf Utian, MD, executive director of the North American Menopause Society. There is a side effect to all this candor, though: confusion. What with all of the treatment options being discussed and debated, it's hard to know what's right for you. So to help you prepare and get through this important journey, we set out to find the latest, most practical solutions, which we'll present on the following pages. To simplify things, we've divided the options into three categories: The Minimalist Approach, The Alternative Approach, and The Prescriptive Approach. Read about all three of them here, then talk with your doctor to determine the best strategy for you.

The Minimalist Approach
The Best Candidates: Women who have mild, manageable menopause symptoms, and who are at low risk for menopause-related diseases (see "Is HRT for You?").

The strategy: Using dietary changes, exercise, and other simple habits to offset symptoms and provide added protection against disease. "Many women feel that menopause should be treated as a natural process, " says Bethany Hays, MD, an obstetrician and gynecologist at Women to Women, a holistic women's health center in Yarmouth, Maine. "They say, 'My body is doing what it's supposed to be doing.'"

I talk to my patients about what I consider to be the most important things: what they're eating and whether or not they're exercising. Then we talk about relieving symptoms and address long-term concerns about cardiovascular disease or osteoporosis." Many times, these concerns can be addressed with simple lifestyle changes.

Diet: A high-fiber, low-fat diet has been proven to reduce your risk of many diseases. Most experts point to a diet that's heavy on vegetables and light on meat as a way to avoid fat and cholesterol, and advise women to load up on nutrient-packed plant foods, especially leafy green vegetables. These foods are high in antioxidants, which are known to combat the free radicals that may be part of the puzzle in many diseases. Eating lots of greens and low-fat dairy foods also provides calcium, an antidote against osteoporosis.

Beyond this, many women can identify dietary triggers for their hot flashes, says Sadja Greenwood, MD., author of Menopause Naturally (Volcano Press, 1996). Cutting out the common culprits—caffeine and alcohol—often helps immensely.

Exercise: Regular aerobic exercise reduces your risk of heart disease and obesity; weight-bearing and strength-building exercise also reduce your risk for osteoporosis. Beyond this, researchers are examining a possible link between regular workouts and various forms of cancer, including breast cancer. Exercise is also a mood-lifter and stabilizer—just the thing to smooth out the ups and downs of menopause.

To get optimum bone-building benefits, lift weights at least two or three days a week, suggests Miriam E. Nelson, Ph.D., author of Strong Women Stay Young. Nelson studied a group of moderately active women and found that high-intensity strength training performed two days a week had dramatic effects on bone density, muscle mass, and strength. Augment your strengthening with aerobic workouts (shoot for five a week) to reap cardiovascular and stress
-reduction benefits.

Other remedies. If night sweats are a problem, try sleeping in the nude under several layers of covers instead of wearing a nightgown or pajamas, suggests Adrian Fugh-Berman, MD, chairwoman of the National Women's Health Network in Washington, DC. That way you can quickly regulate your temperature. If you're suffering from insomnia, give yourself an hour or so to wind down before you go to bed, and eat a low-fat snack (it's like a banana or a cup of yogurt) at bedtime. If you're having problems with vaginal dryness, try an over-the-counter lubricant or moisturizer.

The Alternative Approach
The Best Candidates: Women who accept the anecdotal evidence of the effectiveness of herbal medicine; women who are concerned about long-term disease protection, as well as women who have symptoms demanding stronger treatments than those discussed in The Minimalist Approach.

The strategy: Using natural remedies including herbal preparations, dietary supplements, and mind-body techniques to squelch symptoms and possibly stave off menopause-related diseases.

Herbs: Many herbs have long histories of traditional use but few scientific trials. "There aren't very many studies that have been published on herbal remedies," says Fredi Kronenberg, Ph.D., Director of the Center for Complementary and Alternative Medicine Research in Women's Health at Columbia Presbyterian Medical Center, New York. "It's frustrating," she says, "for both the public and medical community, because there is so much interest in natural remedies. And so little data."

One herb that seems to be on its way to widespread acceptance among the conventional medical community is black cohosh (Cimicifuga racemosa), available as a standardized extract (meaning the manufacturer can attest to its potency) under the trade name Remifemin. Remifemin has proven effective at relieving many menopausal symptoms, including hot flashes, and has the endorsement of Varro Tyler, Ph.D., one of the preeminent herbal experts in United States and a notorious skeptic on many herbal remedies. One caveat: Don't take it for longer than six months, as no long-term safety trials have been done.

A variety of other herbs can also be taken for menopausal symptoms, although they're not as well-tested as black cohosh. Vitex, a.k.a. chasteberry, is sometimes used to reduce hot flashes and dizziness, and dong quai is a Chinese herb that appears to regulate estrogen levels in the body.

Over-the-counter herbal progesterone creams are wildly popular, but according to most experts, they're of debatable worth. "You'd have to rub the cream all over your body several times a day to get a dose of progesterone that would produce any effects, " says Utian.

Because herbal remedies do not undergo the scrutiny that pharmaceuticals face from the Food and Drug Administration, most practitioners advise a cautious approach when using them. The same goes for supplements, which aren't regulated in the same way that drugs are. But there are few options that look promising:

Diet: Eating a diet that's largely plant-based provides plenty of disease-fighting benefits. You can take it one step further and supplement your diet with a few natural foods and oils that contain disease- and symptom-preventing components.

Soybeans are one of the group of plants that contain chemical compounds called isoflavones, which have been shown to offset heart disease and certain cancers. A recent analysis of several studies found that replacing meat protein with soy had significant impact on cholesterol levels, lowering both triglycerides and LDL (or "bad") cholesterol levels and raising HDL ("good ") cholesterol. Soy isoflavones have other benefits as well: Eating soy can reduce hot flashes, according to a recent Italian study in which menopausal women were given 60 grams a day of isolated soy protein. Another isoflavone source is a new product called Promensil, a supplement that comes from red clover. However, most natural health care practitioners recommend getting your isoflavones from real food—by replacing dairy with soy milk and meat with tofu and tempeh (a fermented soy product) as often as you can.

Flax seeds are another good (and natural) source of isoflavones. Grind them in a coffee or spice mill and sprinkle over foods. Try to get a teaspoon a day. Evening primrose oil, which contains essential fatty acids, is also used as a remedy for hot flashes, although evidence of its efficacy is purely anecdotal, says Fugh-Berman. Try taking two 500-milligram capsules twice a day.

Mind-body techniques: Researchers have shown that conscious abdominal breathing exercises, similar to those performed by yoga practitioners, can help alleviate hot flashes. Acupuncture also has been studied as a treatment for hot flashes, and in one study produced a 50 -percent drop in the number of hot flashes experienced by a group of 21 Swedish women. Acupuncture is typically administered by Chinese medicine practitioners, who may incorporate herbal remedies into their treatments (see below). Homeopathy, which uses minute doses of certain organic compounds, is also used to treat menopausal symptoms, although it has yet to be studied clinically for that use. It appears to be very safe (see "Where to find out more" for tips on finding a practitioner).

The Prescriptive Approach
The Best Candidates: Women with one or more predisposing factors for cardiovascular disease or osteoporosis (see below), and women who are experiencing unrelenting menopausal symptoms.

The strategy: Using hormone replacement therapy (HRT) and/or other medications to treat menopausal symptoms and prevent disease.

"I am strongly supportive of HRT, and I see a lot of women who aren't taking it because they're not fully informed about their health risks and benefits of taking hormones," says Michele Curtis, MD, assistant professor of obstetrics and gynecology at the University of Texas. "I exercise and eat well, yet I just had a bone density test that showed low bone mass. I'm 35 now, and there's no question in my mind: In 15 years, you'd better believe I'll be taking HRT." Here's what's available in prescriptive treatments:

Hormones: Hormone replacement therapy is widely accepted as the most effective remedy for menopausal symptoms, and many doctors prescribe it as a preventive measure as well. Evidence shows HRT can reduce your risk of osteoporosis and cardiovascular disease. However, it can also cause side effects, and may even increase your risk of developing breast cancer (see "Is HRT for you?," below). The FDA began approving various estrogen products in 1938, its first year of existence (progestins entered the FDA's arsenal of following year), which puts them among the best-researched drugs around. But they're not for everyone.

HRT typically includes estrogen and progestin. Estrogen alleviates menopausal symptoms and provides protection against heart disease and osteoporosis. Progestin is typically taken along with the estrogen, to offset the estrogen's effect on endometrial lining. Most women experience a few unpleasant side effects from supplemental estrogen, such as breast tenderness, headaches, mood swings, and bloating. Other potential problems include an increased risk for gallstones and blood clots. And progestins can cause headaches, weight gain, and depression.

In addition to estrogen and progestins, supplemental testosterone is sometimes given to menopausal women complaining of hot flashes and diminished libido.

Beyond the standard hormone drugs, some doctors prescribe natural hormones (micronized progesterone and some individual estrogens), which are made by special "compounding" pharmacies. However, the use of these compounds is a subject of some debate among practitioners.

The new estrogens: A new class of drugs are the SERMs, or selective estrogen receptor modulators. The most famous SERM is tamoxifen, which recently made headlines as a breast cancer preventive. Another, raloxifene, recently gained FDA approval as a menopause drug. SERMs act in a decidedly schizophrenic way in the body: estrogen-like in terms of bone-building and "bad" cholesterol-reducing, anti-estrogenic in the tissues of the breast and uterus, where receptors that receive too much estrogen can trigger the development of cancer.

While that means SERMs won't resolve hot flashes or other menopausal symptoms, Stephen R. Goldstein, MD., of the New York University School of Medicine, contends that these still are drugs of great promise. "Raloxifene and other SERMs may be answer for women who'd previously be given estrogen for its bone-protecting benefits but are worried about breast cancer risk." Another bonus is that users do not have to take progestin with Raloxifene because of its anti-estrogenic effects in the uterus.

Nonhormonal drugs: Nonhormone medications prescribed to menopausal women include clonidine, which is sometimes given for hot flashes, and alendronate, an anti-osteoporosis drug. Both seem to be effective, although each has contraindications and cautions, which you should discuss with your doctor.

In fact, no matter which approach you choose, an open dialogue with your doctor is the key. Many medicines can work miracles—but only you know if they're working on you.

Where to find out more
The American Association of Naturopathic Physicians offers referrals to physicians (not necessarily MDs) who include nutritional counseling and other natural techniques in their practices: www.natoropathic.org or (206) 298-0125.
The American Holistic Medical Association provides referrals to MDs who incorporate various natural and alternative methods in their practices: www.holisticmedicine.org or (216) 292-6644.
And for general information, you can contact the following organizations:
The North America Menopause Society provides educational materials and referrals: www.menopause.org or (800) 774-5342.
The Society for the Advancement of Women's Health Care Research: www.women's-health.org.
The American College of Obstetricians and Gynecologists: www.acog.com.
The National Institutes of Health: www.nih.gov.

Is HRT for you?
Hormone replacement therapy (HRT) is powerful medicine. Here are a few things to consider:
Menopausal symptoms. If you're having hot flashes, night sweats, or other menopause-related symptoms that are significantly interfering with your life, HRT may be an effective short-term option.
Cardiovascular disease risk. Risk factors for heart disease and other cardiovascular problems include family history, being overweight and/or inactive, having high blood pressure or diabetes, and smoking. If you've got them, your doctor may recommend HRT as a long-term, preventive measure.
Osteoporosis risk. Predisposing risk factors for osteoporosis include family history, a thin or small frame, insufficient dietary calcium and other nutrients, use of certain medications, smoking, physical inactivity, and excessive use of alcohol. If you fit this profile, you might be advised to take HRT.
Cancer risk. If you have an active breast or uterine cancer, you aren't a candidate for HRT. In addition, if you are at risk for developing breast cancer—you have a mother or sister with the disease or you have had biopsies that showed certain types of benign breast disease—your doctor may advise against HRT.
Other factors. Women with the following health concerns would probably be advised not to take HRT: active gall bladder disease, active liver disease, certain blood-clotting disorders, and certain kinds of stroke. Conditions that make HRT risky include hypertension, epilepsy, and migraine headaches.


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