Your health medical queries answered

got a medical problem or need health advice? Ask Gp Dr Rosemary Leonard This Month... How to predict the menopause • Removing varicose veins • Finger swellings

QI have varicose veins on my legs, both big lumpy ones and smaller thread veins. I became really conscious of them last summer and I’d like to have them removed, but I’ve heard they aren’t treated any more on the nHs. Is this correct? I can’t afford to get them dealt with privately.

AVaricose veins that are just a cosmetic problem and no matter how ugly they may be, can’t be treated now on the nHs (and most private medical insurance companies don’t cover this type of treatment either). But varicose veins that are causing medical problems can usually be treated on the nHs. This includes problems such as increased pigmentation or eczema around your ankles or, worse still, ulcers, which are all signs of a long-standing problem with the flow of blood in the veins. Repeated bouts of veins becoming hard and painful, which indicates that small clots may have developed inside them, is also usually considered a valid medical reason for treatment. swelling of the ankles, aching and itching skin may also be taken into consideration. If you think you may be eligible for nHs treatment, arrange an appointment to see your gP as soon as possible – winter is a particularly good time to have treatment, as it often involves wearing a thick support stocking for a few weeks afterwards.

QIs there any way of predicting the menopause? A friend suggested AMH levels might be useful?

AAnti-Müllerian hormone (AMH) is produced by developing follicles in the ovaries, and levels peak around puberty, and then fall until the menopause. It’s sometimes used as a measure of “fertility reserve” and can predict how well a woman will respond to drugs used to stimulate the ovaries in IVF. However, although studies have suggested that low levels may predict a premature menopause (under 45), it’s of limited use in predicting the age of the menopause in most women, as levels are usually low from the early forties onwards. A family history of early menopause can mean that it is more likely to happen to you, and smoking can shorten the lifespan of your ovaries.

QI’m 52, and I’ve had a swelling at the base of my index finger nail for the past six months. My mother has arthritis in her fingers, and I thought that was the cause, but now I’ve a dent in the nail as well, which my mother has never had. so is this arthritis, or something else?

AI suspect that what you have is a myxoid cyst. They are small pouches of jelly-like fluid that connect to a joint, usually an end finger joint, though they can occur on toes as well. They are more common in women in their fifties and sixties, and tend to occur in joints that have early “wear and tear” (or osteoarthritis). Pressure on the nail bed can affect nail growth, causing a dent in the nail. They are not dangerous and can be left. However, if a cyst starts leaking fluid onto the edge of the nail, there’s a risk of it becoming infected, which can spread to the joint, causing septic arthritis. In this case, the cyst is best removed surgically, under a local anaesthetic. w&h