DEAR DR. DONOHUE: Before I leave this world, I would like you to explain in simple language something that began for me 75 years ago. I started menstruating at age 13. I dreaded it when that time of the month rolled around. I would get deathly sick. In those days, people didn’t go to doctors for such things. My mother said, “That’s just the way it is.” Why did my friends get by with little or no pain? When I got married and after I gave birth, I no longer had painful periods. Why? What caused the agonizing pain? – I.L.
ANSWER: Your mother wasn’t far off. Many, if not most, adolescent girls have painful menstrual periods — perhaps not to the degree that you had, but the majority suffer some discomfort.
The pain comes from overproduction of hormonelike substances called prostaglandins. They cause the uterine muscles to contract, and the contractions can be quite painful. Along with pain, many also become sick to their stomach and might have vomiting spells.
The difference between your adolescence and the adolescence of today’s young women is that now there are medicines that can relieve the pain of menses for most girls. Anti-inflammatory drugs like Advil, Motrin and Aleve can quiet the painful contractions of uterine muscles. If they cannot, birth control pills can. If neither works, then the doctor has to think of pain-causing conditions like endometriosis.
The birth of your child stopped your overproduction of prostaglandins or desensitized your uterus to their action. In time, even without childbirth, painful periods usually disappear.
DEAR DR. DONOHUE: I have suffered from ulcerative colitis for most of my adult life. I am 80. Last month, I had my yearly colonoscopy. The doctor said I have a large polyp that has to be removed surgically because it is so big. I dread going under the knife. Please advise me if this is necessary. My sister is a colon-cancer patient. I am very frightened. – J.L.
ANSWER: No one relishes the thought of having to go under the knife. However, I believe the indications for removal of the polyp in your circumstances are quite persuasive.
Polyps are the usual precursors of colon cancer. The larger the polyp, the greater the chance that it harbors cancer. Prompt removal of early cancer all but assures a cure.
Furthermore, your long history of ulcerative colitis puts you at high risk of developing cancer.
And finally, your sister’s colon cancer is another risk for your developing it.
You have three cogent reasons for having the polyp removed. The operation is not extensive, and you should recover quickly.
DEAR DR. DONOHUE: What can you tell me about proctitis? I had uterine cancer, and my operation was followed by 12 weeks of radiation. Now I am dealing with proctitis, which has caused rectal bleeding. I am anemic as a result. I use Proctofoam-HC enemas. Is there a permanent cure for this condition? – L.D.
ANSWER: You have radiation-induced proctitis, an inflammation of the rectal lining. Radiation treatments can be lifesaving, but they can, at times, cause unavoidable problems. Radiation proctitis is one of those problems.
Cortisone enemas, like your Proctofoam-HC, often quiet the inflammation and stop the bleeding. If they don’t, a heated probe or a laser can seal the bleeding vessels. In some instances, if the bleeding persists and is brisk, surgical removal of the involved segment is considered.
The anemia can be treated with iron or, if necessary, with blood transfusions.
DEAR DR. DONOHUE: I am 92. The large muscles behind the shins in both my legs hurt if I walk or stand very long. Is there any rubbing stuff that would help? – A.S.
ANSWER: What you describe strongly suggests peripheral artery disease. One or more arteries in your legs might be clogged with cholesterol, fat and platelets. There are medicines for this condition, as well as invasive procedures with a balloon-tipped catheter. Surgical replacement of the blocked arteries with grafts is also possible. Speak to your doctor about this. No rubbing stuff works for clogged arteries.
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.
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