Q. People worry about the problems of hormone replacement therapy (HRT). I know one case doesn’t prove anything, but I took Premarin for 26 years with no negative effects.

The doctor prescribed Premarin after a hysterectomy, not to deal with hot flashes or night sweats, since I had none. Instead, it was meant to avoid osteoporosis. My doctors say that it worked. Some have said that with the fears about giving hormones these days, there has been an increase in osteoporosis.

I have seen no negative effects whatsoever from being on Premarin all that time. I have not developed breast cancer, even though having a sister with breast cancer put me at higher-than-average risk. I feel I was fortunate to have had my surgery and to have been on Premarin before they decided long-term HRT was too risky.

A. We appreciate you sharing your story. A recent study supports your experience. The investigators reviewed records from more than 450,000 women under 55 years of age. Those receiving estrogen alone after a hysterectomy were less likely to develop breast cancer (Lancet Oncology, July 2025). On the other hand, women who took both estrogen and progestin had a higher risk of young-onset breast cancer.

Another study (JAMA Network Open, July 1, 2025) also found that estrogen plus progestin was associated with an increase in breast cancer.

Q. My father has severe COPD. The doctors at the Department of Veterans Affairs hospital prescribed Wixela, in addition to several other inhalers. Soon, he began to notice swelling in his feet. The edema then moved to his legs and onto his neck and face. Over three months, he gained more than 20 pounds from extra fluid buildup.

After numerous ER visits, his COPD doctor took him off Wixela and within 24 hours, the edema started disappearing!

A. When chronic obstructive pulmonary disease is not well-controlled, patients may experience fluid buildup, as your father did. A recent study from the Veterans Health Administration analyzed a switch from a metered-dose inhaler budesonide-formoterol (Symbicort) to a dry-powder inhaler fluticasone-salmeterol (Wixela Inhub). The investigators reported that patients needed more rescue medication and had more hospitalizations after the switch (JAMA Internal Medicine, July 7, 2025).

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 300 W. 57th Street, 41st Floor, New York, NY 10019, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”

Q. When I was in my 30s, I was told that I had high cholesterol and should take a statin. A physician friend discouraged me from that, so I didn’t take it.

I avoided red meat and eggs and limited processed foods in an attempt to lower it as much as I could without taking medication. About 25 years later, my doctor referred me to a cardiologist because of high cholesterol.

The cardiologist said I needed an angiogram. He was sure that because of my high cholesterol, I must have blockage in my arteries, and he was determined to find it. While I was still groggy from the anesthesia, he said, “There is no blockage, but if you don’t take a statin, you will die.” I have not taken any statins, feel great and am still alive many years later.

A. There is no question that statins lower cholesterol levels. People at high risk of heart disease appear less likely to suffer a fatal heart attack if they take a statin. But healthy people at low risk of heart disease may not experience the same benefit.

You can learn more about the pros and cons of statins in our “eGuide to Cholesterol Control & Heart Health.” This online resource may be found under the Health eGuides tab at www.PeoplesPharmacy.com.

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In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 300 W. 57th Street, 41st Floor, New York, NY 10019, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”

(c) 2025 King Features Syndicate, Inc.