If your ears are ringing, perhaps you just have taken a painkiller

Q. I have taken Advil for years for inflammation or pain. I have stopped because I began to have ringing in the ears, ear pain, dizziness and loss of hearing. This all disappeared when I stopped the Advil.

I just assume that I can’t take NSAIDs anymore. What do you recommend I take for problems with heel spurs, disk problems and torn cartilage in the knee? I am a registered nurse and do a lot of walking and lifting at work.

A. Nonsteroidal anti- inflammatory drugs (NSAIDs) include pain relievers such as aspirin, ibuprofen (Advil, Motrin IB, etc.) and naproxen (Aleve) or prescription drugs such as Celebrex, diclofenac and meloxicam. Such medications can cause ringing in the ears (tinnitus) and even hearing loss (Drug Safety, March 1996).

Dealing with arthritis, bone spurs and back and knee inflammation can be challenging if you can’t take regular pain relievers. You may find topical NSAIDs safer, along with herbal approaches such as turmeric, boswellia, stinging nettle and ginger. We discuss these and other home remedies in our Guide to Alternatives for Arthritis. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (61 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. AA-2, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our Web site: www.peoplespharmacy.com.

Q. I’m 50 years old with type 1 diabetes, and I have erectile dysfunction. I’m exercising regularly 20 minutes daily. Do those pills you see on TV with the guy smiling all the time really work?

A. Diabetes is linked to sexual difficulties, particularly erectile dysfunction. There is ample evidence that drugs such as Viagra, Cialis and Levitra do work for many men. An analysis of several studies reports that Viagra results in successful intercourse roughly 50 percent to 80 percent of the time. That compares with 14 percent to 35 percent success for placebo treatment (Clinical Interventions in Aging, December 2006).

Please discuss this problem with your physician. Even if the ED drugs you see advertised are not effective for you, there are a number of other treatment options.

Q. I took cod-liver oil in the late 1930s and early 1940s when I was a kid. In the 1940s, a new form of cod-liver oil was introduced that my father called the sunshine pill. I guess that even then there must have been an understanding of the need for sunshine.

A. Many people your age have memories of being dosed with cod-liver oil for their health when they were children. Most make a face at the recollection!

Cod-liver oil in those days was rich in vitamin D, vitamin A and omega-3 fatty acids. Nowadays, cod-liver oil is much easier to take, but the vitamin D and some of the vitamin A may be removed during the purification process.

Brief sun exposure is an excellent way to maintain good blood levels of vitamin D. In the winter, however, sun exposure is neither practical nor effective, so vitamin D supplements are advisable. An intake between 1,000 and 2,000 IU daily usually provides most people with enough of this crucial nutrient.

Q. I took bio-identical hormone replacement therapy (BHRT) to handle my horrible hot flashes. After taking it for three months, I started having pains in my breasts. A mammogram did not show any problems, but the recommendation was made that I stop taking the compounded HRT. The pain went away when I did so.

I did feel better while on BHRT. My doctor told me, though, that even compounded bio-identical HRT still counts as hormone treatment. Any thoughts?

A. For more than 50 years, physicians prescribed traditional hormone replacement therapy (HRT) for menopausal symptoms with the expectation that it would protect the cardiovascular system and the bones as well. The Women’s Health Initiative in 2002 revealed that HRT could increase the risk for heart attacks, strokes and breast cancer. Bio-identical hormone therapy has not been subjected to the same careful scrutiny as the WHI, so its long-term safety is still a question. We believe that, in your case, stopping the BHRT was smart.

Q. I am not enjoying sex with my partner, as he is not a good lover. Please suggest some odorless, colorless medicine I could put in his food to reduce his libido.

A. Despite folklore that saltpeter (potassium nitrate) will dampen desire, there is no OTC drug to reduce libido. Please seek counseling with your partner to improve his skills and the relationship.

XIn their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of The Vindicator or e-mail them via their Web site: www.PeoplesPharmacy.com. 2009 King Features Syndicate Inc.