SERMS help some menopausal symptoms
DEAR DR. DONOHUE: My doctor recently put me on Evista. I had a complete hysterectomy when I was 40 years old. I have taken Fosamax for almost seven years for osteoporosis. My question is: Is Evista safe? The material that comes with it said it can cause strokes, heart attacks and blood clots. I am very uncomfortable taking this medicine. — C.P.
ANSWER: Evista (raloxifene) has been in use for more than 10 years, and many women have greatly benefited from it. It’s a SERM, a selective estrogen receptor modulator. That indicates that, although it is not a hormone, it has some effects that estrogen has. If fits into estrogen receptors on some organs. By fitting into those receptors, like a key in a lock, it opens the door of those organs and has an estrogenlike effect. Evista has an estrogen effect on bones to fight osteoporosis. It doesn’t have an estrogen effect on breasts, so it does not raise the risk of breast cancer.
Evista can up the risk for clot formation, heart attacks and strokes. Women with a history of heart attacks, high blood pressure or previous blood clots shouldn’t take it. The risk of these things happening to other women is quite small.
A woman who is a candidate for severe osteoporosis and for whom drugs like Fosamax have not worked is also a candidate for Evista. If the thought of Evista’s rare but possible complications makes you too uncomfortable, talk to your doctor about alternate treatments.
Even if you choose the Evista route, you have to take the recommended daily doses of vitamin D and calcium.
DEAR DR. DONOHUE: I am a 61-year-old man who was diagnosed with glaucoma four years ago.
I use eyedrops to control it. My drops are timolol and Lumigan. My eye pressure has been good since beginning these drops. I realize that without them, I could go blind.
A family member brought to my attention that these drops have serious side effects. They deplete the body of coenzyme Q10. I understand that this results in weakening of the heart muscle and early death. My eye doctor is one of the top ophthalmologists in our state. When I mentioned this to him, he had no idea what I was talking about. I did some research on the Internet and found a link between glaucoma treatment and Q10 depletions. Should I be on a Q10 supplement? — C.W.
ANSWER: In the manufacturer’s information on these two drugs, no mention is made about the depletion of coenzyme Q10. If they harmed the heart, a warning would be provided.
Your ophthalmologist is a respected eye doctor who has treated thousands of glaucoma patients with the medicines he prescribed for you. He would know of such a complication if one really existed. I trust him far more than I trust your relative or the Internet.
Coenzyme Q10 is found in all body cells and tissues. It assists in the generation of energy for cells and organs. It is abundant in the heart. The evidence that, when taken orally, it enhances heart function isn’t firmly established. It might be of some benefit for congestive heart failure, but you do not have that disorder. I can tell you what I would do: I would forget the relative’s warning.
DEAR DR. DONOHUE: I am writing for my wife, whose symptoms matched those of irritable bowel syndrome, about which you wrote. She consulted an internist, a gynecologist and gastroenterologist. She asked for a CA 125 test, but it was refused. She had stage 3 ovarian cancer, which was treated and now is in remission. — R.V.
ANSWER: Ovarian cancer is deadly because its early symptoms are so nonspecific and so common to other, nonlife-threatening conditions, like irritable bowel syndrome. However, women complaining of bloating, increased abdominal size, pelvic discomfort, abdominal pain, feeling full after a few mouthfuls of food or the need to urinate frequently and urgently should suggest the possibility of ovarian cancer if treatments for the less-serious conditions do not make those symptoms disappear. I am sorry for the delay in your wife’s diagnosis.
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.