DR. ELLIE CANNON: Does my bleeding disorder mean I can’t take HRT?

I got through menopause without major problems and have never used hormone replacement therapy (HRT). But five years later I now suffer from terrible intimate dryness and have been told that HRT can relieve it. The only thing is I have a blood clotting disorder called Factor V Leiden that came about after I had a mild stroke. Is HRT too risky for me?

Most people have never heard of factor V Leiden blood disease, but it is surprisingly common. It affects chemicals in the blood that help the blood clot – causing it to overdrive – meaning clots are more likely.

Those affected have an increased risk of stroke, mini-stroke and deep vein thrombosis. But many patients will never experience a clot, so they never know they have the disease.

According to the British Menopause Society, HRT in pill form increases the risk of stroke when started in women over 60.

Hematologists who specialize in blood clotting disorders do not recommend HRT for someone who has had a blood clot because the drug may slightly increase the risk of more blood clots.

Dryness in the genital area in older women is usually due to a drop in the female sex hormone estrogen. In these cases, creams, gels and diaphragms containing the hormone can provide relief – and they don’t carry the same risks as tablet HRT.

This is because with this use only a very small amount of estrogen, which affects clotting, is absorbed by the body. You can find this type of treatment as a vaginal tablet, ring, gel or cream.

Everything can be used for a long time.

Any woman considering HRT should have a thorough discussion with her GP about the potential risks and benefits in her individual case.

Alternatively, there are prescription and over-the-counter lubricants and creams that can help relieve vaginal dryness. It’s also worth noting that women over 50 can now get estrogen gels and creams without a prescription.

Over the past few years, I have found that I am unusually hot and sweaty, especially in the face and neck. It sounds trivial, but it has a huge impact on my quality of life. On sunny days, for example, I can no longer play tennis outside because my neck and shoulders are soaked. can you help i am 79

Extreme sweating in the head and neck area is not uncommon. And it can make life very difficult for you.

Doctors call excessive sweating hyperhidrosis, and it can affect the hands, feet, face and obvious parts of the body such as the armpits and groin. When the face and head are affected, it causes fear and embarrassment in particular, as it is impossible to hide.

Sometimes the problem lies in families. It can also be the result of anxiety, menopause, side effects of medication, or even a thyroid disorder.

If the sweat is concentrated in a very specific area, it may be related to nerve damage or serious underlying conditions affecting the nerves, such as: B. a stroke. important to see a doctor for an evaluation.

Doctors can treat hyperhidrosis in several ways. First, a doctor may prescribe a special antiperspirant that contains aluminum chloride.

A GP may decide to refer patients to a specialist who may prescribe other, more intensive treatments such as pills, strong creams and even Botox injections. Patients who have the syringes need regular refills every six to nine months.

Avoiding triggers is also crucial. For more information on common triggers, visit the website of the International Hyperhidrosis Society – sweathelp.org.

My son suffers from earlobe cysts that become inflamed and painful. We asked to have them removed but the GP says it is a cosmetic procedure and not covered by the NHS. Should I dispute it or just go private?

Some people are more likely to have cysts than others, and doctors aren’t sure why.

Cysts are harmless accumulations of fluid that usually look like lumps or hard boils. But when they become infected and filled with pus, they can become painful. Doctors will refer to an infected cyst as an abscess or ulcer.

Cyst removal procedures are funded by the NHS in some areas, but not all.

Patients must meet certain eligibility criteria and it is worth considering the risks of such treatment, such as scarring and infection.

Other options are preferred. For example, you can take antibiotics for any infection. Alternatively, a GP may refer you to a dermatologist who may be able to provide non-surgical treatment. Doctors may even suggest taking a low dose of an antibiotic for a longer period of time.

There are other things that can be done to prevent infection. For example, hair covering the ear can attract bacteria, as can dirty cell phones pressed against the area. While skin is full of healthy bacteria, one type can overgrow and cause infection.

If this is the case, an antiseptic cleanser such as chlorhexidine can disinfect the area.

Women should not panic about talc cancer

Johnson and Johnson has already been successfully sued by a handful of US patients who claim their ovarian cancer was caused by ingesting talc, and now the company is facing similar lawsuits in the UK.

Does talcum powder cause cancer? It emerged last week that Johnson and Johnson, makers of the product, are being sued in the UK over such claims. The company has already been successfully sued by a handful of American patients who claim their ovarian cancer was caused by the use of talc.

I urge women not to panic. First, the reports do not make it clear exactly how talcum powder can get into the ovaries. Researchers have suggested that the damage is related to contamination with asbestos – a naturally occurring mineral that forms in a way similar to talc, and is therefore often found next to it and is a known carcinogen.

However, this is very difficult to prove and Johnson and Johnson strongly deny that their product was contaminated.

When something like talcum powder or deodorant is used so often, it’s almost impossible to tell if infinitesimal effects are due to the product or something else.

And since a number of factors play a role in a person’s cancer risk, from genetics to diet, scientists can’t tell one from the other.

But there is no doubt that more research is needed. Talcum powder has been used by women for centuries and if it is harmful to them, we need to know.

Remove calorie labels from the menu

I’ve never been to restaurants for the new calorie labeling: it’s a gesture policy that hasn’t been proven to help obese people, and it’s harmful to anyone recovering from an eating disorder. So I was pleased to see a report last week questioning its effectiveness. A study from the University of Cambridge suggests that keeping track of how much you need to walk to burn off a meal in this way has absolutely no impact on calorie expenditure. We need to tackle obesity and provide evidence-based prevention and treatment, but this is clearly not the way to go. I just hope the government pays attention.