DEAR DR. ROACH: I would appreciate your insights concerning the health risks of tattoos (body art). I have heard that tattoo ink can get into the bloodstream, and over time can damage the liver and kidneys. The tattoo craze seems to have spread everywhere recently, and I wonder if people know all the health risks. — P.B.

ANSWER: Tattoos do have health risks, but they can largely be managed. The biggest risk is of infection. Amateur tattoos are very risky. Reputable tattoo parlors use good technique: sterile water to clean the area, alcohol to disinfect, gloves for the tattoo artist. Tattoo needles should be sterilized, individually wrapped and opened in front of the person getting the tattoo. If you are going to get one, get a tattoo from a well-established parlor.

The second medical risk is an allergic reaction to the dye. Serious reactions are rare. I have not read of liver or kidney problems from professional tattoo pigments.

The major problem I see is regret for having gotten one. My advice is to wait a good while before deciding on a tattoo — never do so spontaneously or under the influence of alcohol or drugs. Talk to people who have had a tattoo. Visit several studios and watch the process. Consider placing the first tattoo on an area you can cover with clothing.

DEAR DR. ROACH: I had a hysterectomy and removal of my ovaries. Is there a correlation between hysterectomy and mental illness/depression? What happened to the moisture of my body, and what happened to the orgasms? — C.H.

ANSWER: I think the major issue is the removal of the ovaries (oophorectomy), not the hysterectomy, which is removal of the uterus.

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Estrogen, made in your ovaries, has complicated effects on depression, with different effects on different women. Sudden loss, as from surgical removal of the ovaries, may exacerbate the tendency for depression. The drop in estrogen after childbirth occurs at the same time as the high risk for postpartum depression, but it’s not proven that the two are related.

On the other hand, it’s clear that estrogen also is necessary for the lining of the vagina, and its loss causes tissues to dry and thin. Many women notice dryness in other places as well. Orgasms also can be affected by hormone loss. Replacement of estrogen helps many women, but other women get more relief with combinations of estrogen, progesterone and testosterone.

A discussion with your doctor about hormone replacement is a good idea. However, estrogen by itself usually doesn’t make depression better.

DEAR DR. ROACH: What causes constant dizziness? Could it be low blood pressure? Are there medical reasons for this condition? — D.P.

ANSWER: Dizziness means different things to different people. In the medical world, we distinguish between two major types: vertigo and lightheadedness.

Vertigo is the sense that the world is moving (usually spinning), but sometimes it’s the person who feels like he or she is moving. Vertigo usually is caused by problems in the organ of balance in the inner ear, or by the nerve that connects it to the brain.

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Lightheadedness does not have a sense of motion, but induces a sensation of being about to faint. This can come from low blood pressure, especially if it occurs upon standing, but a whole host of problems can cause it, including blood sugar problems, hormonal changes, medications and just getting older.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

(c) 2013 North America Syndicate Inc.

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