Q. I am 54 and have absolutely no signs of menopause coming. Isn't this abnormal? Should I be worried?

A. It is certainly unusual, but not abnormal. Menopause can happen at a variety of ages. There are even cases of premature menopause, where the woman is in her twenties. Of course this is a problem for fertility issues.

If you are having periods on a regular basis (i.e., every 28 days or so) there is nothing to be concerned about.

However, if there is no order to your periods, if, for example they are coming every ten days to two weeks, we must look for another reason. There is even a chance of uterine cancer. As long as your periods are orderly, you should be fine. If not, consult your physician.

Q. My doctor has suggested birth control as a form of hormone replacement, but I hear so many scare stories about birth control AND hormones in general. Help!

A. In the case of estrogen vs. birth control pills, estrogen is actually much safer for peri-menopausal and postmenopausal women. The dosage of hormones in birth control pills is often four or five times greater than what would be prescribed as hormone replacement.

Q. Now that I no longer need my reproductive organs (I am 63) I am considering having elective surgery to eliminate any risk of cancer. Would you support an idea like this?

A. Absolutely not! The risk factors connected to the surgery may very well exceed the risk factor of the cancer.

Just because we are not using certain parts of our body we do not randomly remove them. Just as a doctor will not remove your tonsils or appendix unless there is a problem, your reproductive organs should also be left alone unless there is a reason to remove them.

Surgery of any kind has inherent risks and should not be looked upon lightly or frivolously. In the case you are describing, surgery should not be used strictly for potential prevention.