DEAR DR. DONOHUE: I am 37, have two children and also have fibroids. My periods are quite heavy. My doctor says that removal of the uterus is the best way to end my problem. My husband and I would like to have more children. What other options do I have? — P.S.

ANSWER: The uterus is a large, hollow muscle with an internal layer that grows every month in preparation for the reception of a fertilized egg. Fibroids are noncancerous growths of the uterine muscle. They’re common, and for most women they cause few, if any, symptoms. Large fibroids can compress the bladder and provoke frequent urination. Or they can press on the colon and bring on constipation. They sometimes reduce the chances of pregnancy. They can be responsible for heavy menstrual bleeding.

Their cause hasn’t been discovered, but female hormones must be involved in their appearance, because they tend to regress with menopause.

If they’re not producing symptoms, they can be ignored. If they are kicking up a fuss, hysterectomy – removal of the uterus – is one solution, but not the only one. Options depend on what the woman wants.

For a woman approaching menopause, the medicine Lupron is a good choice. It suppresses estrogen production, which shrinks fibroids. Since this has a time limit on use, women who will soon be menopausal are the ones who can take advantage of it.

Danazol (a synthetic male hormone), birth-control pills and Depo-Provera control excessive menstrual bleeding due to fibroids.

Sometimes doctors can remove a fibroid with a scope that enters the uterus through the vagina without any external cutting.

Uterine artery embolization is a procedure where the doctor threads a soft tube (a catheter) to the artery feeding the fibroid. When the right position is reached, the doctor releases particles that obstruct the artery and cut off blood supply to the fibroid. It falls off.

MRgFUS, magnetic resonance-guided focused ultrasound, is a new technique employing sound waves to heat the fibroid and shrink it. It can interfere with subsequent pregnancies, however.

The booklet on fibroids explains these growths in detail. To order a copy, write: Dr. Donohue – No. 1106, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: My husband tells me I have bad breath. I have seen my dentist and done all the things I was told to do, but there hasn’t been any improvement. I have tried many mouthwashes, without success. What more can I do? – W.B.

ANSWER: You were right in starting out with your dentist. When no oral conditions are found that produce bad breath, then the most likely cause is mouth bacteria that produce odoriferous, sulfur compounds. Let me repeat the things your dentists told you for the sake of others. Brush after every meal and brush your tongue as far back as you can. You might want to get a tongue scraper for the backmost part of the tongue. That’s where the sulfur-producing bacteria live. Keep your mouth moist by drinking water or chewing sugar-free gum.

Products containing zinc have been on the market since the 1970s and have gotten mixed reviews for their effect on halitosis. Listerine with zinc is one product. Another is SmartMouth. The manufacturer of SmartMouth used to offer a money-back guarantee. I don’t know if it still does. But that says something for the manufacturer’s belief in its product.

DEAR DR. DONOHUE: Enclosed is an ad for vitamin B-4. Is it as good as the ad says? – L.F.

ANSWER: Sometime in the past, scientists thought there was a vitamin B-4 whose lack was responsible for slow growth in animals. It was called adenine. Adenine is real, but it’s not a vitamin. It’s the building material for DNA and RNA. It’s found in many foods. You don’t need a supplement of it.

DEAR DR. DONOHUE: At 24, I have a moustache. It’s not attractive on a woman. I’ve been pulling the hair out by the roots, and that is not exactly fun. I was told that this causes the hair to grow back thicker. Please let me know if this is the case. If it is, I’ll stop. However, I haven’t noticed any new hair in the places I have pulled it out. – N.N.

ANSWER: Shaving or pulling out hair doesn’t stimulate hair growth or make hair thicker. Usually, it’s a disproportionate production of male hormone that causes male pattern hair growth in women. You don’t have to run to the doctor tomorrow, but you should speak to a doctor about this. If you are making too much male hormone, the specific cause has to be found so that the normal balance between female and male hormone can be established.

If you want to learn of other ways of getting rid of the hair, drop me another note. Better ways than hair-pulling exist.

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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