DEAR DR. DONOHUE: Please give me your advice about mitral valve prolapse. Does it have to be treated with pills for the rest of my life? (I am 60.) Can it be cured without medication? What causes it? – J.Z.

ANSWER: Mitral valve prolapse is the most common heart valve abnormality there is. Most of the time it can be ignored. In a few situations it calls for treatment.

The mitral valve keeps blood flowing from the upper left heart chamber to the lower left heart chamber. It closes when the lower left heart chamber contracts to pump blood out of the heart and into the rest of the body. If the mitral valve doesn’t close, blood flows in a backward direction, and that causes problems.

“Prolapse” means the mitral valve is a floppy valve. With each heartbeat, the valve balloons upward into the upper heart chamber. If there is no blood leak, then the valve problem amounts to no more than a harmless quirk in most instances. It can cause abnormal heartbeats, and they too can be ignored unless they are coming fast and furiously.

I take it that your valve leaks or that your heart has developed peculiar heartbeats. Those would be two reasons to take daily medicine. The medicines do not cure the valve problem, but they control symptoms that result from it. Often such medicine is a lifelong affair.

People with a prolapsing valve that leaks must take antibiotics before any procedure that can release germs into the blood. An example would be a dental procedure where bleeding is expected. Simple drilling of a tooth does not require antibiotics. They are given to prevent heart infections from the bacteria that enter the circulation when a person bleeds.

DEAR DR. DONOHUE: I had a vaginal yeast infection with a discharge that lasted for four months. No matter what I got at the drugstore, it would not go away. It turns out I did not have a yeast infection but an infection with something called trichomonas. I never heard of it. Do your women readers a service by telling them about it. – A.M.

ANSWER: Trichomonas (TRICK-oh-MOAN-us) might not be a household word, but it happens to be one of the most common vaginal infections. On this continent, more than 5 million women come down with the infection yearly.

Trichomonas is most often sexually transmitted. It is an organism that consists of only one cell, similar to the ameba studied in high-school biology. A trichomonas infection produces a yellow, gray or green vaginal discharge with a most unpleasant odor. An infection can cause itching or soreness, pain when passing urine or pain during intercourse.

Treatment for trichomonas is the oral medicine metronidazole. The male partner should be treated along with the infected woman. Men can harbor the organism without experiencing any symptoms. If they stay infected, they can reinfect their partners after their partners’ treatment is completed.

I don’t want to be a nag, but no woman should wait four months before seeking treatment for a persistent vaginal discharge. Yeasts are far from being the only germs that cause such infections.

Readers who would like a current discussion of vaginal infections can order the newly printed pamphlet on that topic. Write to: Dr. Donohue — No. 1203, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order for $4.50 U.S./$6 Can. (no cash) with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I have a puzzle that maybe you can answer. I was told that putting a bar of soap — any brand — under the bottom sheet at your feet would stop leg cramps. It works. I have told several friends about it, and they have gotten rid of their cramps by using the soap trick.

Have you heard of this remedy? How does it work? – C.H.

ANSWER: I have never heard of that cramp treatment, and I haven’t the foggiest idea of why or how it works. Readers are going to let me know if they obtain the same benefit you did. If they don’t, I am forwarding angry letters to you.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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