Column: Are you nervous about natural oils?

Q: I was alarmed to hear that using lavender oil or tea tree oil caused breast development in young boys. Should these products be avoided?

A: The story here is that three young boys in Colorado - ages 4, 7 and 10 - were diagnosed with enlarged breast tissue, a rare condition called prepubertal gynecomastia. Their physician, a pediatric endocrinologist at the University of Colorado, looked for common environmental exposures and discovered that all three had used either lavender-scented soap and skin lotions or shampoos or styling products that contained tea tree oil or lavender oil.

To investigate whether the oils were responsible, researchers at the National Institute of Environmental Health Sciences conducted laboratory tests to see if lavender and tea tree oils mimicked the effects of estrogen or blocked the effects of androgen, the male hormone that inhibits breast tissue growth. They also tested the ability of the oils to influence gene expression.

Tests showed that pure lavender and tea tree oils had dual effects: They acted like estrogen and also blocked androgen effects. Their combined impact makes them "somewhat unique as endocrine disruptors," the researchers said. Fortunately, the oils didn't upset the boys' natural circulating estrogens and androgens, and a few months after the three stopped using the soaps, lotions and shampoos, their breasts returned to normal. The study was reported in the Feb. 1, 2007, issue of the New England Journal of Medicine.

What does this mean? Maybe nothing. Case reports of just three individuals are suggestive, at best, and the test tube results may have no clinical significance. We do not know what caused the abnormal breast development in these boys. Interestingly, one of the three boys had a fraternal twin who had used the same products as his brother but did not develop enlarged breasts.

Lavender has been used for centuries in topical products without being associated with any toxicity, and tea tree oil also has a long history of safe use. I would not expose young children to high doses of any essential oils, but for now, I see no reason to avoid moderate use of soaps or shampoos containing them.

Q: I just heard that the American Cancer Society and other organizations have announced that there are early symptoms of ovarian cancer - bloating and other stomach issues. I've read this before. What's new?

A: You're correct. The symptoms that cancer experts have listed as possible signs of ovarian cancer have been known for some time. I discussed them on my Web site in 2005. What's new is that there is finally agreement that if women were more aware of the possible significance of these symptoms, some cases of ovarian cancer could be caught and treated sooner, lives would be saved and survival prolonged.

More than 22,000 women are diagnosed with this disease in the United States every year. For the record, here are the symptoms: bloating; pelvic or abdominal pain; trouble eating or feeling full quickly; a frequent, urgent need to urinate.

Of course, these symptoms are very common, so bear in mind that they need attention only when they're new and unusual, occur almost daily, and persist for more than two or three weeks. If so, women should see their gynecologists for pelvic and rectal examinations (the best way to physically check the size of ovaries), along with an ultrasound examination if needed. A blood test for the CA-125 antigen may also be useful.

We don't yet know what this new, more aggressive approach will yield. Testing can create anxiety and expense and, in most cases, will not turn up cancer. It may even lead to unnecessary surgery. Nevertheless, I believe that publicizing the possible early symptoms of ovarian cancer will make doctors take them more seriously.

The fact is that women complaining of these symptoms have often gotten the medical brush-off, only to discover weeks or months later that they had ovarian cancer.

In a survey of more than 1,700 women published in the June 9, 2004, issue of the Journal of the American Medical Association, 36 percent of patients diagnosed with ovarian cancer initially were misdiagnosed with disorders such as irritable bowel syndrome or depression, and 12 percent were told it was all in their heads.

We have to do much better than that.