Is it safe for GP to stop me taking the Pill after 36 years?

I AM 52 and have been taking the combined contraceptive Pill since I was 16, initially to deal with heavy periods, but then for contraception. In February I ordered my repeat prescription as usual. A new GP at the practice, whom I hadn’t met, called to say that as I was over 50 I could no longer have it. I’m worried if I stop, my body will go into shock. What do you think?

WHAT GPs can and can’t treat with each drug is set by national prescribing guidelines.

These are based on evidence provided by clinical trials and other kinds of scientific research. So we know, as best we can, what works for a particular type of patient with a particular illness or condition, and what doesn’t.

We can prescribe the combined contraceptive Pill, which contains synthetic versions of the hormones oestrogen and progesterone, for birth control and also for heavy periods or skin problems. The national guidelines allow it to be offered to women up to the age of 50.

After that age, risks from potential side effects such as blood clots and breast cancer increase. If a woman still needs contraception we can offer the mini-Pill, which contains progesterone but no oestrogen – it’s the oestrogen that’s linked to the increased risks. A coil might be another option.

It is safe to stop taking the Pill – you don’t need to taper off.

The average age when the menopause begins varies, but it usually happens between 47 and 52. It’s unlikely that a woman stopping the Pill at 52 would have heavy uncontrolled periods, and if, when stopping at this age, menopausal symptoms emerge, then hormone replacement therapy (HRT) should be considered.

While HRT usually contains oestrogen, the dosage is completely different to the Pill and the safety of HRT during the menopause is proven.

I SUFFER terrible irritable bowel syndrome, and have always been told no one knows what causes it. But recently I’ve read it might be due to something called SIBO, which can be diagnosed using a breath test. Can I get this on the NHS?

IRRITABLE bowel syndrome or IBS is a very common condition characterised by regular tummy pain, bloating and diarrhoea or constipation. It should only be diagnosed once other conditions have been ruled out, such as Crohn’s disease or colitis. Diseases like endometriosis, a pain condition lined to hormones, and even ovarian cancer can also cause similar symptoms.

SIBO stands for small intestine bacterial overgrowth and happens when the upper part of the gut gets overtaken with bacteria usually found only in the lower part of the bowels. The symptoms are very similar to

IBS including diarrhoea, gas and pains. There are tests available, including the breath test, which can be done on the NHS at the request of a gastroenterologist.

If a GP feels this condition is a possibility, it may be worth giving the treatment for SIBO without even doing the tests: this involves a course of specific antibiotics and improvements can start within a week.

In anybody diagnosed with irritable bowel syndrome, but particularly somebody older, it is vitally important to rule out bowel cancer. Even if bowels have been abnormal for years, cancer can be masked by the symptoms. This can be tested for with stool tests at the GP, with a FIT test, as well as through general blood tests.

I HAVE been suffering from itching in my pubic area. At first everything looked normal, and I assumed it was a bit of dermatitis, but last week I discovered some dark, pimplelike bumps around my vulva. I am not embarrassed to see my GP but I’d rather not. Should I be worried? I’m 66 years old.

NEW symptoms in the pubic area or vulva in a woman over the age of 60 should always be investigated. Vulval cancer is rare, with just over 1,300 cases diagnosed in the UK each year. But it’s seen mostly in women

over 60. Symptoms include an ongoing vulval itch, thickened raised or darker patches on the vulva and moles that change shape or colour.

An examination with a gynaecologist or GP is crucial if these symptoms occur.

However, many non-cancerous conditions can cause itching and changes in the skin.

Dermatitis or eczema can occur in this area and require the same treatment as they do elsewhere, with moisturising creams and possibly steroids.

Thrush is common on the genital area and causes itching as well as skin changes from scratching: this can be treated easily with cream from the pharmacist. Also, the menopause is associated with irritation of the vulva. Falling oestrogen levels lead to thinner, drier skin that’s prone to itching. An oestrogen cream can be used to improve

things. Lichen sclerosus is a skin condition that causes itchy patches on the genitals, particularly in women over the age of 50. The patches are often paler rather than dark and typically occur on the vulva.

It is an important condition to treat to prevent longer term damage from scarring to the genitals and it also carries an increased risk of cancer.

Any women suffering with genital itching should remember to avoid soap, bubble baths and highly scented laundry products, including fabric conditioner and biological washing powder.