Ask the doctor: readers’ health questions answered

Professor Kerryn Phelps answers your questions on polycystic ovaries, breast cancer testing and dandruff, and highlights the national child immunisation policy.

QI am 56 and healthy. I have great hair, but recently I have developed quite severe dandruff. What are the causes and do you have any advice on how to stop it? F.G., NSW. Have you changed shampoos? You may be sensitive to it. Skin conditions such as eczema, seborrhoeic dermatitis, psoriasis or fungal infections can all cause dandruff. Try using a shampoo for sensitive scalps. If it persists, ask your doctor to check for a skin problem and prescribe a treatment.

QMy 29-year-old daughter has recently been told she has polycystic ovaries, but not PCOS. How common are polycystic ovaries and will it affect her chances of conceiving a child? M.M., Qld. It is common to have polycystic ovaries without having PCOS (polycystic ovary syndrome), which can involve insulin resistance and weight gain, irregular periods, acne, excess hair, depression and anxiety. Unlike PCOS, polycystic ovaries without the associated syndrome have no impact on fertility.

QI have lost five kilograms recently, but really struggle with sugar cravings at night before bed. I am trying to lose more weight, but my 9pm snacks are letting me down. Do you have any advice? K.H., Vic. Evening sugar cravings are usually due to being either still hungry or just a bad old habit. If you’re genuinely hungry, it may mean your kilojoule and carbohydrates are too light through the day, which is common with dieting. Have a proper breakfast with quality carbohydrates and protein, a balanced lunch and a substantial afternoon tea. If you think it’s just an old habit, then try having a cup of tea, have a bath, or read a book to distract yourself. It will get easier!

QI am four months pregnant and have been reading a lot about the risk of whooping cough, particularly with babies. When should I get my booster and should everyone who comes near my baby once it’s born have the vaccine, too? L.O., SA. We recommend vaccination in the third trimester of pregnancy, as antibodies travel from the mother to the foetus and protect the baby in the first weeks of life. Anyone who will be spending time with your baby should have pertussis (whooping cough) vaccine.

QMy five-year-old son doesn’t like dairy. I am worried about his lack of calcium and that it will affect his bones and growth. Should I opt for a supplement? T.S., NSW. You will need to provide alternative sources of calcium and protein. Soybeans, tofu, tempeh, sesame products, canned salmon with bones, green vegetables are some options. I suggest you see a dietitian who has experience with children.

QMy mother was diagnosed with breast cancer last year, at the age of 59. My grandmother also had it. How do I go about genetic testing to ensure I don’t have the gene? I would prefer to get preventative surgery if I carry it. P.E., WA. You are wise to check your risk. You and your mother can be referred for genetic counselling at a family cancer clinic. If she carries the BRCA1 or BRCA2 gene mutation, then you would be tested. Your risk would then be assessed and you will be given options for prevention.

QI’m 45 and was diagnosed with sciatica last year. What types of treatments are available? G.G, Qld. Because your pain has persisted, your GP is likely to arrange an MRI scan to find out the cause. Treatment options include physical therapies and cortisone injections to reduce swelling. Sciatica caused by a prolapsed disc may need surgery to remove the disc fragment causing pressure on the nerve.