DEAR DR. DONOHUE: My daughter, age 36, has had an IUD for five years. She has not had a menstrual period in that time, and she has hot flashes regularly. She doesn’t feel there is a link between the IUD and her period loss and hot flashes. I feel there is a connection.

Would you advise me on this? I am greatly concerned. – R.F.

ANSWER: I don’t believe there is a link between the intrauterine device (IUD) and her lack of periods and hot flashes.

Intrauterine devices were a popular birth control method for many years. They fell into disfavor because of infections associated with their use. The infection problem has been solved, and they’re making a comeback. ParaGard is a copper IUD that can be left in place for 10 years. It doesn’t stop periods or cause hot flashes. Mirena is an IUD that releases a small amount of levonorgestrel, a progesterone-like hormone that prevents sperm from entering the uterus and shortens the life of sperm. About two out of 10 women stop having periods after one year of Mirena use. Your daughter lost her periods immediately after insertion. Hot flashes are not listed as a side effect of it.

Your daughter must see her doctor. If her symptoms are not due to the IUD – and I don’t think they are – they might indicate that she has premature menopause. If that is the case, her estrogen production is at low ebb. A woman of her age needs estrogen to preserve bone health. Without it, she is bound to develop osteoporosis.

DEAR DR. DONOHUE: I’ve donated blood 44 times. It makes me feel good about myself.

Four weeks ago I gave blood on a Friday. The following Monday, I came down with a cold. Going back over my records, I noticed that, although I don’t get a cold every time I give blood, in recent years they have occurred shortly after blood donation.

Does donating blood temporarily weaken the immune system? Unless I read that my hypothesis is wrong, I am not going to donate blood in the future. – R.K.

ANSWER: You should feel good about yourself. You deserve kudos many times over. Blood is always in short supply and you have been more generous than most.

Blood donation shouldn’t impair the immune system. I would hate for you to give up being a donor, but I don’t want you to come down with another cold. How about an experiment? Try again, at a time when there are no colds in the community. I wonder if being around fellow donors who might be incubating a cold is the reason why you have been getting them.

DEAR DR. DONOHUE: Please answer the question I have written to you many times. Two years ago, I was in a car accident and broke an arm and an ankle. I had a knee laceration with nerve damage, and now have numbness and tingling in my foot. I can’t walk on my foot. Will I get feeling back from the nerve damage that happened in the knee? – Anon.

ANSWER: I don’t have a good answer for you. I’m not sure what’s going on – if it’s the ankle fracture that’s causing your trouble, or the nerve damage. Nerves take a long time to regenerate, but you should be seeing improvement after two years of waiting.

If I were in your shoes, I would get a second opinion from an orthopedic surgeon. I’m sorry, but that’s the best I can do for you.

DEAR DR. DONOHUE: My sister is 23 and is five years younger than I am. She has just been told she has multiple sclerosis. Naturally I am devastated for her by this news, and I am frightened for me. Is it inherited? What are my chances of getting it? What kind of life does my sister face? – S.B.

ANSWER: There is a slight risk of multiple sclerosis affecting a patient’s family members. The chance that a sister of a patient also will come down with the illness is only 3 percent to 5 percent greater than is the chance of an unrelated person coming down with it.

The “sclerosis” of multiple sclerosis refers to scars. “Multiple” indicates that there are many scars located in many places in the brain and spinal cord. The scars come from an immune attack on the myelin, an insulating material around nerves. Without myelin insulation, nerve transmission is short-circuited, and the impaired nerve transmission accounts for the signs and symptoms of the illness: peculiar sensations, numbness, weakness of an arm, hand, leg or foot, stumbling walk, imbalance, muscle spasms. One common initial symptom is optic neuritis – pain in an eye that increases with movement of the eye and impairment of vision in that eye. Vision clears and pain resolves, in most cases, in two to six weeks.

Most multiple sclerosis is the remitting-relapsing variety, meaning symptoms get better but are followed in time by a new set of signs and symptoms. Usually, a stage is reached where the signs and symptoms remain.

What your sister faces is difficult to predict. However, great strides have been made in reducing the incapacity that used to affect most MS patients. Prednisone can blunt new symptoms when they arise. And Betaseron, Avonex, Rebif and Copaxone – medicines most have never heard of – can provide many MS patients with retention of functions that were formerly lost early on in this still very serious disease.

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

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