Q: I am 50 years old and my hysterectomy was done 11 years back. Since then I am taking Oestrogen 0.625, regular for 2 years in the beginning and then seasonally like only in summers and not in winters. I left it completely 4 years back till date. The problem is that I get severe hot flashes in summers and my migraine has also increased a lot after hysterectomy. These days I am facing very intense skin irritation too and it happened once also before last year but after taking allopathic medicine it gets cured. I am taking calcium regularly since 5-6 years. Bone density and mammography tests have also been conducted and the reports were normal. I also go for daily morning walk and do exercise also. My weight also keeps on increasing and decreasing. Some doctors recommend oestrogen and some don't. What do you suggest?

A:There is a great deal of controversy in the medical literature about oestrogens. On one hand oestrogens are the most effective medicine against hot flashes, and in some hormone related migraines. On the other hand recent studies have implicated them in breast cancer, blood clots, strokes etc. Knowing the risk and benefits of oestrogens, you can make an informed decision for yourself as to whether the benefits in your quality of life are worth the small risk of oestrogens. There are some other medicines for hot flashes that you may try. Most of them are herbal products. Clonidine is an allopathic medicine that has been reportedly effective for hot flashes and for migraine prevention (very small doses). Discuss the various options with your physician, and make a decision that best suits you. Best of luck!