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

Woman & Home - - In This Issue… -

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

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