DEAR DR. DONOHUE: I read your article about polycystic ovary syndrome – POS. I had it when I was young. That was 40 years ago. My doctor performed surgery. He removed a quarter of each ovary and did not give me any medicines. Within two months I had lost weight and had regular periods. In six months, I become pregnant and had four more children. Is surgery not in style anymore?

I have a daughter who is on the heavy side. I wonder if she could have POS. – S.S.

ANSWER: In 1935, Drs. Stein and Leventhal described a syndrome whose features included a diminution or cessation of menstrual periods, growth of facial and chest hair, obesity and large, cyst-covered ovaries. That syndrome became known as Stein-Leventhal syndrome and is now called polycystic ovary syndrome.

In the early days, there was a lack of knowledge of the complex endocrine abnormalities that lie behind the syndrome. Drs. Stein and Leventhal proposed as treatment the removal of a pie-shaped wedge from one or both ovaries. The operation worked for some women, but the reasons why were obscure, and still are.

Now it is known that POS includes more signs and symptoms than were described by these two pioneers. Infertility is often a consequence. Obesity is not necessary to qualify a woman as having the syndrome, although many patients are overweight. And weight loss for such women often ends many of their POS problems.

The endocrine abnormalities of POS are now known, and with that knowledge, medicines have supplanted surgery as its treatment. Quite recently, many women with POS have been recognized as having insulin insensitivity. The insulin they make doesn’t lower blood sugar as it should, and these women develop type 2 diabetes – a new wrinkle in the POS story.

Of all the women with this syndrome, 5 percent to 10 percent have a close relative with it, so there is a hereditary basis for some patients. Your daughter should mention this to her doctors. Blood tests can help detect it.

DEAR DR. DONOHUE: I have benign prostatic hypertrophy, and it causes me to have a problem urinating. My doctor put me on terazosin. I note that it is an alpha blocker and is used to treat high blood pressure. With all the news concerning the long-term effects of medications, I have become concerned about the long-term use of this medicine. Should I be concerned about taking a blood pressure medicine when I do not have a blood pressure problem? – J.C.

ANSWER: Alpha blockers block alpha nerve signals. Those signals constrict the bands of tiny muscles that surround all arteries. Constriction of the muscles constricts arteries and raises blood pressure. Relaxation of those muscles dilates arteries and lowers blood pressure.

Alpha nerve signals also cause constriction of the muscles that surround the bladder’s outlet and of muscles found in the prostate gland. Relaxation of those muscles permits easier passage of urine in men with enlarged prostate glands – benign prostatic hypertrophy, your condition.

If blood pressure is not elevated, terazosin (Hytrin) doesn’t cause a significant drop in it.

In some men, it causes a temporary drop in pressure when they change positions, such as suddenly rising from a chair or bed. That can make them transiently dizzy. Because that has never happened to you, it’s not likely to now.

Many conditions call for long-term medicine therapy – diabetes, heart failure and blood pressure, to mention only a few. People can take such medicines for life without fearing disastrous side effects. So can you.

DEAR DR. DONOHUE: If I take a drug test after eating poppy seeds, could the test be read as positive for opium? – J.B.

ANSWER: Poppy seeds contain minute concentrations of opiumlike substances – not enough to cause any opium effects but enough to show positive in very sensitive urine tests. For that reason, if a person is to have a urine drug test for illicit drugs, it is best not to eat poppy seeds prior to having the test.

DEAR DR. DONOHUE: How is glaucoma diagnosed and treated? I have many friends who have it, and I wonder if it always leads to blindness. Please explain it for me. – J.P.

ANSWER: The front one-third of the eye is a chamber where fluid is constantly produced and constantly drained. So long as production and drainage are in equilibrium, all is well. When drainage slows or production speeds up – and the problem is usually obstructed drainage – fluid pressure in the eye builds. Increased pressure presses on the optic nerve in the back of the eye. That’s glaucoma. Unless the pressure is relieved, sight can be lost.

More than 4 million North Americans suffer from glaucoma, but only half of them are aware they have it. Early on, symptoms are nonexistent, and unless people have their eye pressure checked, they are unaware that their optic nerves are under attack. With the passage of time, unrelieved pressure on the nerves takes its toll on peripheral vision – vision off to the side. It blurs and is eventually lost. If the process goes unabated, people can no longer judge distances. Then they find it more and more difficult to function in dim light, and finally they lose central vision.

Having eye pressure measured is something everyone over 40 should have done every two years. A machine that blows a puff of air onto the eye records the level of eye pressure painlessly and quickly. In addition to obtaining eye pressure, doctors look into the eye with a lighted, handheld scope that allows them to clearly see the optic nerve. Changes in the nerve are another indication of glaucoma.

Most of the time, eyedrops can bring down the eye’s pressure. If drops can’t budge it, then oral medicines usually can. In the exceptional cases where neither drops nor oral medicines effect a decrease in pressure, a laser can punch a hole in the drainage channel to open it up.

The above description applies to the more common kind of glaucoma, open-angle glaucoma. Narrow-angle (also called angle-closure) glaucoma is a different story. It usually comes on quickly, is quite painful and produces a red eye. Treatment of it is urgent in order to preserve vision.

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. Readers may also order health newsletters from www.rbmamall.com.