Dear Dr. Gott: Can you please give me some information on estradiol and if it can cause breast cancer? None of the articles I have read have information about this subject.

I am 70 years old and have been taking estradiol since having had a complete hysterectomy 25 years ago. A few years ago, I asked my gynaecologist if I should quit or reduce to a half dose, but she advised I would lose my protection against osteoporosis.

I now have a new gynaecologist, who is urging me to taper off and eventually stop the hormone altogether. I don't agree with him. Are there any natural hormones I can take?

Dear reader: Estradiol is an oestrogen-replacement medication. It is used for the treatment of moderate to severe vulvar and vaginal atrophy, symptoms of menopause, to replace oestrogen after removal of the ovaries, treatment of osteoporosis (when non-oestrogen medications are inappropriate) and palliative (comfort) treatment of breast cancer in certain women.

Oestrogen therapy is associated with an increased risk of heart attacks, strokes, blood clots, endometrial (uterine lining) and breast cancers, dementia, gallbladder disease and hypercalcemia (high blood calcium).

Your current physician is correct. At 70, you no longer need oestrogen therapy. You may experience symptoms of menopause once you're off the medication, but tapering off will likely reduce them.

There are several varieties of plant estrogens (Estroven and others) available on the market that might be suitable. They are available without a prescription.

These are very effective for some people, but not for everyone. They provide relief from menopausal symptoms, such as hot flashes, night sweats and more, without the increased risk of cancer and other side effects.

Before starting any new medication, discuss this with your physician. Other options to control menopause symptoms (especially night sweats and hot flashes) include black cohosh (see package instructions), ginger (one 1-inch piece as needed), vitamin E (800 IU daily), acupuncture (two to three times weekly), increased soy intake (50 grams daily) and exercise (20 to 30 minutes, four to five times weekly).

Ginger is also beneficial for the treatment of motion sickness. As for osteoporosis protection, there are several things you can do. First, take calcium (1,200 to 1,500 milligrams) and vitamin D (400 to 800 IU) supplements daily.

Weight-bearing exercises are also helpful. If you develop osteoporosis, there are several prescription medications available, such as Fosamax, Boniva and others.

Follow your doctor's advice. Don't be afraid to ask his opinion about alternative options, such as those I mentioned above.

If you are taking any other prescriptions, be sure that there are no known adverse reactions between the alternative drugs and modern medications.

To give you related information, I am sending you copies of my Health Reports "Menopause" and "Osteoporosis".

Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 (per report) to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).