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Question: Please explain vasovagal syncope. My source says it is a "vascular and neurogenic reaction marked by pallor, nausea, sweating, bradycardia and rapid fall in arterial blood pressure that may result in syncope." My sister-in-law was told this is her condition.

- B.J.C.

Answer: Your medical source impresses me. I cannot improve that medical explanation. But just between us, vasovagal syncope is the common faint.

The causes of fainting abound, including emotional stress, fear, fatigue, pain and a too-hot room. Any one or combination of those factors can cause someone to faint.

The syncope is the end result of a chain of fast-moving events that begins with sudden dilation of blood vessels. In this situation, the heart should speed up to correct things. In vasovagal syncope, the opposite occurs, as the vagus nerve mistakenly gets involved.

The vagus nerve, whose job is to slow the heart, starts firing signals. The victim now faces a double whammy: a slowed circulation from dilated vessels and a heart slowdown from the nerve stimulation. Amid all that, the brain becomes blood-starved. The faint ensues.

When the person falls down, the posture change permits restoration of brain circulation. The faint ends. It all occurs in an instant.

A one-time vasovagal attack usually bodes no future ills. Frequent occurrences call for attention.

I wish you had supplied more information about your sister-in-law's situation. Please let me know more.

Question: I am a 70-year-old woman with osteoporosis. My doctor has suggested estrogen. I had a hysterectomy many years ago and would like to know if the estrogen will help at my stage in life. Also, would the estrogen pose a breast cancer danger? I have a history of breast cancer in my family.

- H.V.

Answer: Estrogen slows bone loss for some time after menopause, but more so in the early post-menopausal years.

Experts disagree about just how long a woman should stay on estrogen replacement therapy. Some say for life; others see no point in it after age 70. The middle ground would seem to favor continued use if the osteoporosis is severe. It is a matter of weighing risks against benefits.

I wish I could be precise in the cancer risk matter. For most women, estrogen replacement poses no great risk of breast cancer. However, a woman whose mother, daughter or sister has had breast cancer is considered at greater risk than one with no such family history.

I am asked what I mean by balancing risks and benefits. Here's an example:

If a woman has such severe bone thinning that hip fracture is a real threat, then she might consider estrogen's benefits a worthy option, despite the risks. Remember, too, that whatever risk estrogen may pose is really on the small side.

The osteoporosis booklet, which I am sending on, might interest you. Other readers can order it by writing: Dr. Donohue - No. 23, Box 5539, Riverton, NJ 08077-5539. Enclose $3 and a self-addressed, stamped (52 cents) No. 10 envelope.

For J.A.: You are taking Desyrel for your depression. It's common to stay on such medicine for four months to a year after a major depression to prevent relapse. Some people who have recurring depression take the medicine indefinitely.

You should not stop cold turkey - which might upset your sleep cycles or cause other problems.

Please get your doctor's input.

Question: As a nursing mom, I'm wondering about exercise and milk production. Is it OK for me to exercise? Will it interfere with my lactation?

- Mrs. J.H.

Answer: You can, with your doctor's approval, begin exercise six to eight weeks after delivery. It should not interfere with your milk production. And it should help you tone up any muscles that have fallen into disuse during those months of pregnancy.