Q: I am 41 years old. I have irregular periods, for which I consulted a gynaecologist who suggested to go for FSH, LH and TSH. The reports are FSH - 63.90; LH - 27.88; and TSH - 1.6 mU/mL. The doctor said that it is due to early menopause. Is taking Soya Isoflavone tablet like Estovon advisable? How far it is beneficial? Do I need to take calcium since doctors say that it may be beneficial? My mammogram is suggestive of a cyst of 12x5 mms size in superior and lateral breast quadrant which is benign. Doctor says that tablet Evion-400 should be taken daily, which can dissolve the cyst. What is the real fact? I weigh 58 kg and my height is 151 cms. I have mitral valve prolapse (MVP) and high blood pressure. I am on medicines Betaloc 50 twice and Losar-H half daily. Kindly advise.

A:There is no harm in taking Soya isoflavon though I doubt it has any useful purpose in your case. Calcium is only required if there is proven deficiency. The daily requirement of Vitamin E is less than 12 mg. More than this amount is available in the normal diet. Cases of real vitamin E deficiency are rare. Overdosage can lead to unpleasant side effects. There is no scientific evidence that it can dissolve cysts. In any case, cysts in breasts should be taken seriously and treated appropriately, particularly in patients after middle age. In the treatment of hypertension, we generally prefer atenolol (such as Aten 50mg) over propranolol. Both belong to the same family of betablockers but atenolol is more selective and hence has lesser side effects. General statement on selection of brands: There are scores, sometimes hundreds, of brands of the same medicine. Against about 300 pharmaceutical manufacturers in western countries like Britain, there are over 20,000 producers in India that market more than 40,000 brands. Most manufacturers do not have quality testing laboratories. Hence selection of brands is important. Many companies give incentives to prescribers to patronise their products. Patients should check the reputation of manufacturers before consuming medicines. Fixed-Dose Combinations (FDCs): Medicines are discovered individually and are supposed to be taken separately. A huge number of irrational, illegal combinations of drugs are being sold in India; quite a few without mandatory approval of the Drugs Controller General, India (DCGI). Except in a few cases (such as TB medicines), it is always better to take medicines separately so that dosage can be adjusted and side effects monitored.