The Doc Replies

Our expert answers your medical questions

My wife is becoming terribly forgetful. She is 48. I am worried she is developing dementia but she believes it’s the menopause.

It is possible to have early onset dementia at 48 if this was the only symptom. However, if there are other symptoms it may well be the menopause, particularly if your wife is experiencing flushing, mood swings, aches, difficulty sleeping and a general sense of struggling to cope. These symptoms are usually due to lack of the hormone oestrogen and doctors can prescribe HRT (Hormone Replacement Therapy).

Blood tests are not usually taken for menopause unless periods stop early – before age 45. The average age in Britain for menopause is 51, but anything between 45 and 55 is normal. Women can have symptoms for several years before their periods stop. HRT is generally effective for symptoms but, because of breast cancer risk, should ideally be taken for less than five years. Although menopause can produce a lot of symptoms, it is important to carry out checks to make sure other possible causes are not missed. Your wife should have a chat with her GP, who may well take some blood tests to check for things like thyroid abnormality.

I have piles and they protrude. Can I treat them myself, or do I need to see a doctor?

Piles are swollen veins around the back passage. They are common and usually occur as a result of western diet, constipation and pregnancy. Piles can cause bleeding, which you should report to your doctor, especially if you are older. If they are permanently protruding you may need an operation to remove them, which involves surgery under general anaesthetic. Prevention is possible – with a high-fibre diet of fruit, vegetables, whole grains and pulses.

Can infected teeth bring on a heart attack?

Doctors don’t really know. A lot of studies show people with poor oral health are more likely to have heart attack or stroke, but we don’t know if that’s an association or a cause. To be on the safe side everyone should brush their teeth regularly, go to the dentist, and exercise.