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Ask the doctors

Q. I've been experiencing some menopause symptoms, such as hot flashes. Can acupuncture help?

A. There is some evidence that acupuncture may be able to provide short-term relief from some menopausal symptoms, including hot flashes. Acupuncture is a long-used type of Chinese medicine in which a trained practitioner inserts thin needles into specific locations on your body.

Research we're watching

Need another reason to quit smoking? A study published in the September 2020 issue of the Journal of Neurology, Neurosurgery and Psychiatry found that women ages 30 to 60 who smoked had four times the risk of having a brain aneurysm (a weakened artery in the brain that bulges and could burst) compared with nonsmokers.

Researchers looked at nearly 550 women who had a brain scan performed, most often because of persistent headaches. The scans showed that 113 of them had one or more brain aneurysms. These individuals were then matched with 113 people who did not have brain aneurysms. In comparing the two groups, the researchers found not only that smoking drove up the risk of finding a brain aneurysm, but also that women who both smoked and had high blood pressure had seven times the risk compared to nonsmokers with normal blood pressure. If future research shows that smokers also have a significantly higher risk of brain aneurysm rupture, women smokers ages 30 to 60 might be candidates for aneurysm screening.

The benefits of multivitamins are looking doubtful. Can we do without them?

The answer is a qualified yes � we can do without them, as long as you eat a well-balanced diet rich in fruits and vegetables.

In the past, doctors often suggested a standard multivitamin with minerals each day. They don't cost much, and earlier studies had shown some benefits. For example, it appeared that folic acid and other B vitamins might lower the risk of heart disease, stroke and possibly cancer. But more recent studies have shown no added benefit of multivitamins for healthy people that eat a balanced diet.

Q.I am 53. I've had fibroids for some time but have experienced heavy menstrual bleeding lately. A recent ultrasound showed fibroids and polyps. What are my options?

A. As you know, you're almost certainly in perimenopause, the four to eight years leading up to menopause and the complete cessation of menstruation. Every woman's script for the transition to menopause is a little bit different, but it's very common for the menstrual cycle to be irregular and the amount of blood flow to vary. Erratic ovulation � the release of eggs from the ovaries � may result in hormonal changes that cause the lining of the uterus (the endometrium) to become thicker than usual, so when it sloughs off, the menstrual bleeding is heavier and more prolonged than women are used to.

With summer's approach come plans for travel, including flying long distances. But the prospect of a long flight often raises health concerns. Especially in passengers who are older or have certain conditions, air travel and the related stress can have an impact on health. Here are a few trouble areas and some precautions you can take.

Deep-vein thrombosis (DVT). Not all experts agree on an association between DVT (blood clots in the legs) and air travel. Symptoms may not occur for several days, so it's difficult to establish a cause-and-effect relationship. If there is one, it's likely due to prolonged inactivity. Limited airline space can discourage moving about. Dry cabin air may also increase the risk of DVT.

Overall risk is very small, and older women who used hormonal contraceptives many years ago aren't likely to have a higher risk.

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Hormonal birth control � whether it comes as pills, injections, a ring, an intrauterine device (IUD), or an implant � may raise your risk of breast cancer, according to a study published Dec. 7, 2017, in The New England Journal of Medicine.

If you're like many women who currently use one of these contraceptive methods, or if you used one for years in the past, should you be worried?

Increasingly, doctors are turning to prevention for this hard-to treat cancer.

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Ovarian cancer is a challenging foe. It's often found at an advanced stage when it's difficult to treat.

In recent years, researchers have learned that many cases of ovarian cancer don't even start in the ovaries. "It turns out that ovarian cancer is a bit of a misnomer. We think a portion of ovarian cancers actually arise from cells in the fallopian tubes," says Shelley Tworoger, adjunct associate professor of epidemiology at Harvard Medical School and associate center director of population science at the Moffitt Cancer Center.

A new study suggests that hormone therapy might help with perimenopausal depression. But is it safe for you?

Hormone therapy has long been a controversial topic, and a new study about the role of hormones in depression is adding some fodder to the debate. A study published in the January 10 issue of JAMA Psychiatry determined that hormone therapy may help ward off symptoms of depression in women. Researchers found that perimenopausal and early postmenopausal women who were treated with hormones were less likely to experience symptoms of depression than women in the study who were given a placebo.

But while the findings of the study are important � particularly considering that a woman's risk of depression doubles or even quadruples during the menopausal transition � that doesn't mean hormone therapy should be widely used for preventing depression in women at this stage of life, says Dr. Hadine Joffe, the Paula A. Johnson Associate Professor of Psychiatry in Women's Health at Harvard Medical School, who wrote an editorial accompanying the study. "It's not a 'never,' but it shouldn't be a standard approach; in general, all of medicine has moved away from using hormones for prevention," she says.