The Most Commonly Asked Questions, According To A GP
I’m worried that I’m forgetting things – what can I do?
“Age-related memory decline can result in taking longer to learn new tasks or mild forgetfulness. It’s often considered a normal part of ageing, but serious memory problems can make it difficult to do normal activities like driving and shopping. If you find yourself asking the same questions repeatedly, get lost in familiar places, or become confused about time, places or people, it could be worth speaking to your GP. Moreover, symptoms tend to be more obvious to others than yourself. Despite extensive research, there is no cure for cognitive decline, making prevention even more important. More research is needed on the benefits of brain training, but mental stimulation – such as learning a new language or musical instrument – can improve certain aspects of memory and thinking. Changing your diet can also help – reducing your intake of red meat and eating more oily fish can improve artery health, while supplementing with 400-800iu of vitamin D per day can also help.” – Dr Chiraush Patel, lead doctor at (med)24
Sex has recently become uncomfortable – why is this?
“You’re not alone – around 50% of post-menopausal women experience these symptoms, especially dryness. This is usually down to a lack of oestrogen, which is responsible for maintaining the lining and integrity of the vaginal walls. When there is a lack of oestrogen, it can lead to drying and inflammation, which can lead to painful intercourse and sometimes urinary symptoms. Options for treatment will depend on the severity of your symptoms, but lubricants can provide short term relief and immediately improve symptoms during intercourse. If your symptoms are more constant, then a topical oestrogen treatment could be an option. Low dose use of topical oestrogens is safe, and with a variety of preparations available, it provides a good alternative for women who want to avoid conventional hormone replacement therapy.” – Dr Patel
Why are my migraines getting worse and is there anything I can do?
“Migraines are very common in women and studies suggest they are linked to hormones, explaining why they can get worse during and after the menopause. The majority of migraines are easy to manage, and there are two different types of medications you can take. Acute medication is taken in the moment when you have a migraine, while preventative medication, such as propranolol, is taken daily, and is used by people who have very frequent migraines that are tricky to control. If you are plagued by migraines, you may want to explore getting Botox injections. This is available on the NHS, but a patient needs to have migraines for at least 15 days a month and have tried at least three preventative medications before they can be referred, so it may be something to consider privately.” – Dr Helena Liaka, NHS doctor and aesthetic expert for Vie Aesthetics
How is my bone health?
“After the menopause, the body’s internal production of oestrogen – the main hormone to maintain bone density – diminishes. This will lead to a reduction in bone mass, but the rate of this decline will vary among individuals, which can be accelerated by other risk factors such as smoking and a family history of osteoporosis. A simple and effective way of reducing your risk is by taking a vitamin D supplement as well as doing exercise such as weight training and running. Swimming is less desirable as your bones are not exposed to impact stress which promotes density. If you're particularly concerned about your risk of osteoporosis, speak to your GP, who should be able to calculate your risk and carry out a DEXA scan.” – Dr Patel
Why is it important to keep an eye on your blood pressure?
“High blood pressure is a silent condition that may not cause any symptoms and can go undetected for long periods of time. However, it can lead to problems with the kidneys, heart disease, strokes and aneurysms, so early detection and management can help lower the risk of these conditions. As a general rule, high blood pressure is considered to be 140/90mmHg. Investing in a blood pressure monitor is a good idea – check your blood pressure once or twice a month at the same time of day, or if you feel unwell. If your blood pressure is raised, it’s important to speak to your doctor to start investigating and managing this condition. Medication, however, isn’t the only answer – regular exercise and dietary modification, alongside weight loss, can be just as impactful.” – Dr Patel
Should I be taking statins?
“Once billed as a wonder drug, the public perception of statins has become quite mixed. Statins are very effective for the treatment of high cholesterol as well as having protective effects for the heart. At the same time, patients can be reluctant to start taking statins based on their perceived side effects, such as muscle aches. As a GP, I'll always want to explore the benefits and indications for starting statins but, more importantly, look at other options such as dietary changes, supplements and exercise modifications. These could be considered in preference to statins in certain cases or as an adjunct, making the medication more effective.” – Dr Patel
I’ve started bleeding again – why might this be happening?
“After months or years without bleeding, it can come as quite a shock to see a return of bleeding. There are plenty of reasons why this may be happening, including medications such as steroids, but it is something that shouldn’t be ignored. No matter if it is a single episode, a small amount or if you’re not sure that it was blood, this should be discussed with your GP at the earliest opportunity. It is useful to share with them any recent medication changes, dietary changes or acute life stress. Unless they are very obvious causes, your GP can arrange an ultrasound scan to assess the womb lining or refer you to a gynaecologist.” – Dr Patel
Why am I suddenly getting UTIs – is there anything I can do?
“Urinary tract infections (UTI) are an infection of your bladder, kidneys or the tubes connected to them. They are more common in women than men and become more common as you age. The majority of women who experience UTIs experience frequent infections – if you get one, you will likely experience more. UTIs tend to happen more frequently during the menopause due to structural changes in the vagina and bladder, weakening of the immune system and increased incidence of incontinence. Common symptoms include pain when urinating, needing to urinate more frequently and strong-smelling urine. Triggers include sexual activity, dehydration and drinking alcohol. While there’s no research to prove drinking cranberry juice helps, anecdotally there seems to be some benefit. If you are experiencing recurrent UTIs, you may be referred to a urologist, who will check for structural changes to your genito-urinary system. There’s also the option to go on long-term, preventative antibiotics.” – Dr Liaka
I’m feeling low – could it be depression?
“The main symptoms of depression are low mood and an inability to enjoy the small things in life like you used to – these have to last for two weeks for a diagnosis to be made. Other symptoms can include poor appetite, an inability to fall asleep or waking up during the night, feeling slow or lacking focus, crying more and feeling hopeless. If you have any of these symptoms, you should speak to your GP. It’s also important to understand that mood swings are linked to the menopause, so this could be the reason behind a low mood.” – Dr Liaka
What level of wear and tear in the joints is normal?
“Joint pain is one of the most common issues seen by GPs – a third of all GP appointments are related to pain in the joints and muscles. If you are experiencing abnormally intense pain, or have pain that is limiting your activity, see your GP. You should also speak to your doctor if you have been experiencing pain alongside night sweats, weight loss or a fever. In women over the age of 50, joint pain can be related to osteoarthritis – i.e. wear and tear of the joints. Your GP will also want to rule out rheumatoid arthritis, which can cause painful red and swollen joints, particularly in the hands. If pain is stopping you from your normal activities and has lasted for four to six weeks without improvement, or is associated with swelling and redness, speak to your GP.” – Dr Liaka
(Med)24 is opening mid-April in Paddington, for more information or to enquire about membership visit Med24.Clinic. Also visit Vie-Aesthetics.com.
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