From the surgery
Woman’s GP Dr Philippa Kaye answers your burning questions in her surgery this week
I have terrible PMS
Q Every month just before my period, I’m miserable, anxious and moody. I can’t go on the contraceptive pill because I get migraines. Is there anything else that could help my PMS?
A The symptoms of pre-menstrual syndrome include breast tenderness, feeling bloated, headaches, skin changes and mood changes. PMS is common, but about 5-10% of women have symptoms so severe it affects their ability to function. A healthy diet, exercise and reducing stress can help, but do see your GP. Alternative options to the oral contraceptive pill include trying an antidepressant just for two weeks in the second half of your cycle, and in very severe cases medication can be used to induce a temporary menopause. There’s some evidence that supplements of calcium, vitamin D, magnesium and agnus castus (from pharmacies) can also help.
How do I get rid of my spots?
Q I’m 28 and I still have acne. no over-the-counter creams work and it’s spreading to my chest and really getting me down.
A Acne can persist way beyond adolescence or even start in adulthood, so you’re not alone! Your menstrual cycle and pregnancy can cause acne, as can stress and smoking. The spots tend to occur on the face, chest and upper back and can be whiteheads, blackheads, painful red lumps and cysts. See your GP as there are lots of medications that can help. They may recommend a topical antibiotic in the form of a gel or lotion to apply to skin daily. Other options include a low-dose daily antibiotic, the contraceptive pill or roaccutane, for which you would be referred to a dermatologist.
Do I need to get vaccinated?
Q I’m going on an elephant safari in Sri Lanka with my husband and our two children aged 11 and 14. Do we need any special vaccines?
A It is likely that you will need to have some vaccines. For Sri Lanka it is recommended that you have vaccinations against hepatitis A and typhoid (which can be combined) and that you are up to date with your jabs against diphtheria, polio and tetanus. You are also likely to need tablets against malaria (though this also depends on exactly where you are travelling to). Your notes at your GP surgery will detail which immunisations you have already had and the nurse can advise you on which jabs and anti-malarials are appropriate. If this is not available at your GP, you will need to find a local travel clinic. Travel immunisations and anti-malarials are not an NHS service, so expect a fee.
scared I’m going bald
Q Three years ago I went through the menopause and although the flushes and sweats have now gone, my hair has become really thin and dry. I’m worried I might end up bald!
A Hair loss can often occur during and after the menopause. Unlike men, who do develop bald patches, in women there tends to be a more generalised thinning of the hair. The hair loss around the menopause is related to the changing hormones. It is worth seeing your GP to rule out iron deficiency or hypothyroidism. You may find that taking supplements of B vitamins and minerals may help, as may increasing the essential fatty acids in your diet (found in salmon and nuts). Rogaine – a shampoo containing the medication minoxidil – can also help and is available over the counter.