By Peggy O'Farrell
The Cincinnati Enquirer

Check your inbox on any given day, and you'll find them: Dozens of ads promising to make your waistline smaller and other parts of your body bigger.

There's nothing like e-mail that promises to enhance body parts you might not even have to brighten up your day, says Jeanne Uhl.

CUTTING SPAM

Tired of spam? It's a big club. Here are some ideas for reducing (note we didn't say eliminating) some of the junk that finds its way to your inbox: Set up two e-mail accounts, and use one when signing up for mailing lists, etc., and one for personal or business mail. Most of the spam will go to the mailing lists account. Try SpamCop.net, McAfee SpamKiller or other similar programs. When you sign up for newslists, updates, etc., doublecheck those info boxes: Some should be left blank if you don't want information, and others need to checked.

"Even though my name is Jeanne, I get an awful lot of messages about penis size," jokes Uhl, the education program supervisor for TriHealth's Integrative Health and Medicine Center in Blue Ash. "There's a lot of crazy stuff out there."

Are all these online come-ons good for anything besides cluttering your inbox?

Keep your credit card in your wallet and hit the "delete" key, experts advise. Any effects the miracle pills, devices and potions have will likely be expensive, temporary and - in some cases - dangerous.

Losing more than weight

Dozens of weight-loss products promise to help consumers drop pounds without diet or exercise, thanks to "all-natural" ingredients.

Some contain ingredients that act as diuretics, leading to temporary loss of water weight.

Others contain ephedra, or ma huang, the controversial herb linked to the February death of baseball pitcher Steve Bechler.

The herb acts in the same way adrenaline does, speeding the metabolism and suppressing the appetite.

Ephedra has its pros and cons, experts say. It will spur weight loss - and, in some cases, heart attack, stroke and seizures.

"Certain people need to be advised about that," says Dr. Gregory Koo, a family practitioner and director of weight-loss programs at St. Elizabeth Medical Center's Holistic Health Center. "It can also wreak havoc on your nerves, and most of us are nervous enough, and the last thing we need is to be all hyped up."

Some fiber-based compounds, which help us lose weight by blocking absorption of carbohydrates and fats, work to a slight degree. For the most part, they're safe, Koo says. Supplements such as chromium speed metabolism slightly.

But the herbal weight loss products that produce the quickest results contain ephedra, he says, "and they're just not safe."

"If people are serious about losing weight, they should consult their physician, get a good overall assessment and go from there," Uhl says.

Exercising and controlling food portion sizes are key strategies for taking off weight, and will produce long-term results, she says.

It's just temporary

Dr. Jennifer Butterfield, an assistant professor of surgery at the University of Cincinnati, knows that thousands of people get e-mails promising bigger breasts.

"I never open those spam ads," she says.

Some of the spam is hawking special bras or silicone pads that make the bust look bigger. Some are selling suction-cup devices that are placed over the breast to "pump up" the tissue.

"Those can cause pretty bad bruising," Butterfield says. And the effects are temporary.

Many of the e-mails - and television commercials - promise all-natural breast enlargement, thanks to a blend of herb and plant extracts.

"There's never been any documentation that these things work," Butterfield says.

So how do the creams and potions work?

"They don't," she says - at least not permanently.

Many of the creams and lotions contain herbs and plant extracts that are weakly estrogenic, and that causes breast tissue to become slightly enlarged - just like the hormone estrogen does in the body.

Years ago, women took birth control pills containing high doses of estrogen to increase their breast size, says Dr. Michael Thomas of Greater Cincinnati OB/Gyn Inc. The pill now contains much lower doses of estrogen.

Wild yam, black cohosh and dong quai are popular ingredients that have estrogenic properties, says Dr. Cathy Rosenbaum, pharmacy clinical effectiveness and safety office for TriHealth.

"They can cause temporary enlargement of the breasts," Rosenbaum says. "The down side is that some are also diuretics and laxatives ...."

Another problem is that estrogen and other hormones affect cell growth and other body processes in ways that can be dangerous. Women with a history of, or higher risk for, estrogen-receptor positive breast cancer should avoid medications that contain the hormone. And estrogen without progesterone increases the risk for endometrial cancer, Thomas says.

Another point: Supplements aren't subject to federal regulation, so quality control and dosage can be a concern, experts say.

With phytoestrogens such as wild yam, Thomas says, "you don't know what you're getting from dose to dose."

Saw palmetto, another popular ingredient, "is antiestrogenic, so I don't see how that works," Rosenbaum says.

Other ingredients, such as watercress and dandelion, cause fluid retention, which can make breasts look bigger. But dandelion also causes the body to retain potassium, a problem for people with congestive heart failure or other ailments, and pregnant women shouldn't take watercress, which can lower blood pressure and increase the risk of bleeding.

Dong quai increases sensitivity to the sun and can interfere with blood thinners and some anti-inflammatory medications, such as ibuprofen, Rosenbaum says.

The only permanent way to enlarge breasts is with surgery, says Dr. Daniel Kuy of the Mangat-Kuy Plastic Surgery Center.

"What most women tell me is that as soon as they stop using the stuff, the effects will shrink rapidly and dramatically," Kuy says.

Many of the pills and creams show no effect for at least a month, and some take three to six months.

"The enhancement amount would be about half a cup size," Kuy says. "Most women want to gain one to two cup sizes."

Matters of size

Breasts aren't the only part of the anatomy people think they need to enlarge.

Dr. Safwat Zaki, a urologist with UC Physicians at University Pointe, says products purported to enlarge the penis don't work.

Some surgical options are available: Pumps can be implanted into the penis, and fat can be injected to increase its girth. But the injections don't last, and the implants carry the risk of infection and scarring.

"When there is a pathological indication, a congenital defect or something, there are plastic surgeries that can be done. But the American Urologic Association does not recommend (surgery) for vanity reasons," Zaki says.

Pumps are available that can be placed over the organ. Some men use small weights in an attempt to stretch the organ.

"We really don't recommend these things because they carry potential hazards," Zaki says, including bruising, blistering and damage to the skin; infections; scarring and permanent curvature of the penis.

Much of the Net spam geared toward men is for herbal products containing yohimbe, saw palmetto, ginseng and other herbs.

"There is nothing documented whatsoever to indicate these work," Zaki says.

Some of the ingredients, such as ginseng, are reported to increase blood flow to the penis.

Other ingredients function as steroid precursors to testosterone, increasing the sex drive. Others, such as yohimbe, are central nervous stimulants and increase sensation in the penis. Yohimbe, or yohimbine, was sometimes prescribed to treat erectile dysfunction before Viagra was discovered.

Men with high blood pressure or heart disease shouldn't take yohimbe, Rosenbaum says. Pumpkin seed, a popular ingredient, is a diuretic. Cuscuta, reportedly an aphrodisiac, also acts as a laxative.

"As with all of these, sometimes quality is an issue. You don't know what you're getting, and you don't have dosage information, so we're conjecturing a lot on dosage and quality," Rosenbaum says.