Dear Dr. Gott: I am a 43-year-old female with irregular periods. When I finally went to my doctor, he told me that I have perimenopause. Can you tell me what this is?

Reply: Simply put, perimenopause is an introduction to menopause. It commonly occurs when a female is in her 40s, but can happen to some women in their mid-30s. It generally lasts between two to eight years and is a natural part of the aging process. Oestrogen levels rise and fall in an erratic pattern, and women may experience problems sleeping, hot flashes, vaginal dryness, mood changes and more. Repeated menstrual irregularity, however, is one of the most widely recognised initial phases of the condition. As long as the irregularity isn't accompanied by extremely heavy bleeding, breakthrough bleeding between cycles, bleeding that lasts longer than eight days and cycles that occur fewer than 21 days apart, you can usually consider things as progressing normally. However, complications outside these guidelines should be brought to your primary-care physician's or gynaecologist's attention.

There are several circumstances that have a bearing on when perimenopause or menopause might begin. Smoking, for example, is known to trigger menopause up to two years earlier than in those without a history. Other signs of an earlier-than-normal occurrence are chemotherapy for childhood cancer, never having delivered a baby, hysterectomy and pelvic radiation therapy.

Therapy might include the use of oral contraceptives for the purpose of regulating cycles, and reducing vaginal dryness and hot flashes. A progestin-containing IUD (intrauterine device) might control heavy bleeding, while progestin therapy might regulate cycles.

If you are satisfied with the information you already received, I recommend you continue as you are, eat well, exercise, avoid alcohol and caffeine, which can trigger hot flashes, and enjoy each day to the fullest. If you are dissatisfied, either jot down a list of questions and return to your physician for an explanation, or request a second opinion.

In the interim, I am sending you a copy of my Health Report 'Menopause'. Other readers who would like a copy should send a self-addressed stamped number ten envelope and a $2 cheque or money order to Newsletter, PO Box 167, Wickliffe, Ohio 44092-0167. Be sure to mention the title or print an order form at www.AskDrGottMD.com.

Dear Dr. Gott: I am considering taking colloidal silver and want your opinion. Is it safe, or is it toxic?

Reply: Colloidal silver is touted as a cure-all that boosts the immune system and treats a plethora of issues from viruses, cancer, HIV/AIDS, shingles and even prostatitis. There is no scientific evidence to substantiate such claims. It is not an essential mineral. Colloidal silver is made up of tiny silver particles suspended in a liquid. It is available in oral, spray and topical forms. It is known to build up in the tissues of the body over time and most commonly results in a blue-gray discoloration of the skin, nails, gums, eyes and internal organs. While this isn't a serious health problem, it is a serious cosmetic problem because the discolouration doesn't go away even if the supplement is discontinued.

My opinion is probably not one you want to hear, but I can't recommend this product. If you eat a nutritious diet, exercise and get adequate sleep, forgo something so questionable until firm scientific studies prove it is beneficial.

Dr. Peter H. Gott is a retired physician and the author of several books, including 'Live Longer, Live Better', 'Dr. Gott's No Flour, No Sugar Diet' and 'Dr. Gott's No Flour, No Sugar Cookbook', which are available at most bookstores or online. His website is www.AskDrGottMD.com. Contact him c/o United Media, 200 Madison Avenue, fourth floor, New York, New York 10016.