Closer look at hormone replacement options

Q: I had a full hysterectomy at age 49. My health is excellent otherwise, with no smoking, regular exercise and alcohol in moderation.

My gynecologist put me on Estratest. I felt great on this, but my skin became extremely oily with acne, and my hair also was too oily. I chose to go off the hormones.

Since not being on hormone replacement therapy (HRT), I have terrible mood swings and depression. I have been searching the Web for information about HRT and am really confused.

My gynecologist is very much in favor of hormones, but my friends keep sending me articles about blood clots, breast cancer and other frightening complications. How dangerous is HRT? Are bioidentical hormones better?

A: The male hormone in Estratest (a combination of estrogens and testosterone) was probably responsible for your oily skin and hair.

Doctors continue to debate the pros and cons of HRT. A recent review from the U.S. Preventive Services Task Force concluded that hormones reduce the risk for fractures but increase the chance of gallbladder disease, urinary incontinence and blood clots leading to strokes and heart attacks (Annals of Internal Medicine, July 17, 2012).

We have seen no well-conducted trials demonstrating that bioidentical hormones are safer than conventional therapies.

Q: I heard about eating coconut macaroons to help with irritable bowel syndrome on your radio program. Our dog was having trouble with recurrent bouts of diarrhea, and the vet could not find a reason.

I gave her coconut flakes twice a day, and it worked great. So this remedy also seems to work for dogs with sensitive digestive systems.

A: We have heard from many readers who have found that coconut helps quell diarrhea. We first heard about this remedy from Donald Agar, who used Archway coconut macaroons to treat diarrhea from Crohn's disease. Others have found that plain shredded coconut works just as well.

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Closer look at hormone replacement options