Question: Should all women use hormones after menopause to prevent osteoporosis?
Women should consider their options at the time of the menopause and discuss them with their doctor. Generally, all women should be on hormone replacement therapy (HRT) after the menopause, not only to prevent osteoporosis, but to also prevent heart disease, strokes, premature ageing of the skin, Alzheimer’s disease and generally protect the body from ageing too quickly.
It always necessary to exclude any contra-indications to HRT, such as liver disease or blood clots.
If a woman is small boned and has a family history of osteoporosis, she has an increased risk of osteoporosis, and HRT is even more important.
The main problem most women complain of with HRT is the continuation of their periods beyond the normal time for their cessation. These periods are usually very light though, and often cease with time. Other side effects are usually related to an incorrect hormone dosage. They include headaches, depression, flushes and pelvic discomfort. As all women are different, finding the correct dosage can sometimes be a matter of trial and error.

Question: I have had breast cancer and a total hysterectomy at a relatively early aqe. I am concerned about premature aqeinq but my doctor says I cannot take hormones. What can I do?
This is an extraordinarily difficult problem to deal with. Most women who have a total hysterectomy take oestrogen to prevent the problems of menopause, but if you have had breast cancer, most doctors believe that you should not use this hormone because it may result in a recurrence of the cancer. More recently, some doctors are using oestrogen in this situation as they argue that oestrogen does not cause breast cancer. I would suggest that you avoid oestrogen unless it is absolutely necessary to use it.
To prevent osteoporosis you should eat plenty of dairy products and take calcium tablets. The premature growth of facial hair can be controlled by a medication called spironolactone. Exercise is important to keep your body toned up as much as possible. A well-fitted bra and possibly plastic surgery may help the sagging breasts and can replace a breast removed for cancer. Skin moisturizers and plastic surgery can be used to control premature skin ageing in all parts of the body.
By being careful with your body and taking the appropriate medical advice there is no reason why anyone should place you in an older age group than you are, and you should live a full and normal life well into your 80s.

Question: I have not had a period for 5 months after stopping the pill. Is this normal?
About 10% of women who use the contraceptive pill have a delay in the return of their periods after stopping it. It is nothing to be overly concerned about, and can occur just as easily after one month on the pill as after ten years on it. Unless you are very eager to fall pregnant, doctors will wait for about six months before prescribing hormone tablets to start your cycle again. The vast majority of women will restart their periods within six months.
Some women have a tendency to miss periods for emotional, hormonal and other reasons. These women are the ones most likely to develop this problem. The pill has no effect on the long-term fertility of a couple, but is often blamed for difficulty in falling pregnancy because 15% of all couples have a delay of over a year in conceiving.

Question: I have just had an appendix operation. The doctor examined my ovaries during the operation, and he says they are very small. Is this serious?
Some people have small noses, others big noses. Some people have small feet, others big feet. Some people have small ovaries, others big ovaries. The actual size of the ovary has no effect upon your fertility or femininity, unless their size is due to fibrosis or disease. If this was the case, the surgeon would probably have commented about it, and referred you to a gynecologist for a further opinion and treatment.
The ovaries are responsible for producing an egg every month that has the potential to be fertilized and implant in the womb in pregnancy. The ovaries also produce hormones that give you your appearance as a woman. The breasts, for example, develop in the first place and continue their firm shape because of the hormones produced in the ovary. If you are concerned, you should contact the surgeon again and ask him if the small size of your ovaries was due to disease.