Is circumcision necessary?
DEAR DR. DONOHUE: Will you comment on the advantages of circumcision? My two sons, like their father, have not been circumcised because my husband, for reasons I don’t quite understand, is opposed to it. We’re expecting another baby (male) in a few weeks. I think he should be circumcised. My husband doesn’t. What is your thinking? — D.P.
ANSWER: Few topics generate as much heat as circumcision does. In America, beginning around the middle of the 19th century, health officials recommended circumcision on what is now dubious evidence of disease prevention. Excepting religious or cultural preferences, the arguments for circumcision are not overwhelming, save for a few recently proven, compelling circumstances.
Advocates of circumcision site a reduction in male infant urinary-tract infections as one selling point. Circumcision also reduces the risk of penile cancer, a quite-rare cancer. It does make hygiene an easier task. The newest argument in favor of circumcision is the decreased risk of AIDS transmission from women to men. That’s a powerful argument in places where such transmission is prevalent. Circumcised men are also less likely to become infected with the papillomavirus, the cause of genital warts in both sexes and of cervical cancer in women.
Opponents take a stand against the procedure by stating that nature doesn’t devise body parts on a whim. They suggest that removal of the foreskin reduces sensation. And they cite the complications that can arise from the procedure – infection, bleeding and very, very rarely permanent damage.
Official advisory bodies have issued statements that don’t endorse routine circumcision, but those statements were made before the reduction of AIDS transmission was known. They have not yet adopted a new position, but they might.
This is a matter best left to the judgment of parents.
DEAR DR. DONOHUE: I am a 47-year-old man with this question: Is it wise for me to take a daily aspirin? I have gout and have asked two pharmacists about taking aspirin. One said a daily aspirin is fine. The other said it would raise my uric acid level and could cause a gout attack. I take allopurinol for gout. My healthy, 70-year-old father passed away from a stroke. Given these facts, would a daily aspirin be wise? — J.R.
ANSWER: You have two questions. One is the effect of aspirin on gout. At doses of 1 to 2 grams a day, aspirin can raise blood uric acid. You’d have to take three adult (325 mg) aspirin a day to reach those amounts. Aspirin can interfere with one gout medicine, probenecid. You don’t take that drug.
The second question is: Does a 47-year-old man need to take a daily, low-dose (81 mg) aspirin? Your age slightly elevates your risk of a heart attack and stroke. Your dad’s history raises the risk of a stroke. The cons of taking an aspirin are stomach irritation and bleeding. I don’t see any reason why you should not take the low-dose aspirin if it doesn’t upset your stomach. The greatest benefit for you is heart attack prevention. It might reduce your chance of a stroke. In women over 55, taking a daily aspirin can lessen the risk of stroke.
DEAR DR. DONOHUE: What causes anemia? My mother used to weigh 135 pounds. She gradually withdrew from eating and got down to 80 pounds. She would not see a doctor. He death certificate said anemia was the cause of her death. What could the family have done to save her life? — E.B.
ANSWER: Your family could do nothing to have saved your mother’s life if she wouldn’t see a doctor. “Anemia” means “too few red blood cells.” Red blood cells carry oxygen to all parts of the body. Anemia can develop from a lack of iron, a lack of vitamin B-12, from blood loss due to hidden bleeding in the digestive tract, or from a premature destruction of red blood cells by the body itself. Treating an anemia requires finding its cause.
I’m sorry about your mother’s death. The family should feel no guilt about it, however. Sorrow, yes. Guilt, no.
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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