Ask the Experts: Hormone Therapy Safety; Arthroscopy for Arthritis; Surgery for Sagging Eyelids
Q: I’ve been suffering from menopause symptoms for years now, but have avoided taking hormone therapy because I’ve read that it can be harmful. I’ve recently seen reports that it may be safer in patch form, so I’m wondering if I should start taking it. What are your thoughts?
A: Hormone therapy (HT) has been under a cloud for the last decade due to research linking it to an increased risk of breast cancer, heart disease, stroke, and blood clots, among other side effects. The 2018 study you refer to looked at HT use among about 80,000 women who developed a blood clot and 400,000 women who did not develop a blood clot. The data showed that women who took oral HT were more likely to develop a blood clot, but using HT in transdermal patch or gel form did not increase the risk of blood clots. Previous studies also have suggested a lower risk of blood clots with non-oral forms of HT, likely because they are not metabolized by the liver. Oral HT is—and exposing the liver to estrogen increases clotting factors (proteins that are involved in the clotting process).
If you’ve been experiencing menopause symptoms for years, it’s possible you may now be outside of the safe window for HT use (within 10 years of menopause first starting). If you’re still within that window, I recommend you discuss the options with your doctor. Depending on your age and medical history, the benefits of HT may outweigh the risks.
—Rosanne M. Leipzig, MD, PhD Geriatric Medicine
Q: What is arthroscopy, and could it help relieve my hip arthritis?
A: Arthroscopy is a minimally invasive (“keyhole surgery”) procedure that can help alleviate pain due to certain joint problems. It is performed via a small incision, through which an instrument called an arthroscope is introduced into the problem joint. The arthroscope incorporates a camera that enables your doctor to view the joint, and helps him or her guide surgical instruments that are inserted through another incision.
Arthroscopy can be used to treat conditions that are affecting the cartilage, tendons, and ligaments in a joint. However, some research suggests that people who have hip arthritis may not benefit from the procedure. Even in moderate arthritis, there is some narrowing of the joint space due to cartilage loss—using arthroscopy to pare away the frayed cartilage hastens this cartilage loss.
—Darwin Chen, MD, Orthopedics
Q: I have sagging eyelids that interfere with my peripheral vision, and my eye doctor has suggested I have the problem surgically corrected. Can you tell me more about the procedure?
A: Eyelid surgery—known as blepharoplasty— to tighten the skin above and around the eyes is commonly seen as a cosmetic procedure. However, it also can be an effective solution for people in your situation. The sagging you refer to often occurs with age, as your muscles and the connective tissue in your skin begin to lose their strength and elasticity. The result is “hooded” eyes that can cause the peripheral vision interference you are experiencing.
Upper eyelid blepharoplasty is one of the most commonly performed plastic surgery procedures, and is carried out as an outpatient procedure. Your eyelid area will be numbed, and you’ll be given a sedative to help you relax. Your surgeon will take careful measurements to ensure that sufficient skin remains for you to properly close your eyes, before making an incision along the crease of your eyelid and removing excess skin, muscle, and fat.
You can expect the skin around your eyes to be swollen and bruised for one to two weeks after the surgery, and you also may experience itching, watery eyes, and light sensitivity. Ice packs and/or cool compresses should help ease the discomfort. You also can take acetaminophen (Tylenol®). You’ll be given eyedrops or ointment to help prevent infections. You should avoid strenuous activity and swimming for about a week afterwards, and won’t be able to wear contact lenses. All being well, you should be able to resume normal activities seven to 10 days after the surgery.
—Philip J. Torina, MD, Plastic and Reconstructive Surgery
The post Ask the Experts: Hormone Therapy Safety; Arthroscopy for Arthritis; Surgery for Sagging Eyelids appeared first on University Health News.
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