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I have had itchy genitals for years. I take prescription medications that have itching as a side effect, but I can’t figure it out. why would he be confined alone down there. My GP says there is no rash. What can I do?
Dr. Ellie answers: Itching is a side effect of many common medications, including antibiotics, statins, and antidepressants.
Anyone taking prescription medications and experiencing new symptoms should consider stopping treatment briefly to see if the problem goes away. This should be done under the supervision of a doctor.
However, it is unusual for a symptom such as itching to be limited to one location.
Another cause could be a skin problem known as dermatitis, but this is usually accompanied by a visible rash. Other less common causes include lichen sclerosus or lichen simplex, both chronic, itchy skin conditions caused by tissue changes. They are harder to detect but can be treated with prescription creams.
Nerve problems are known to cause itching, and this can occur in the genitals.
Infections can also cause itching, especially thrush. However, again, this would usually cause a rash or discharge.
There is a chance that menopause is to blame. During menopause, the body produces less estrogen, which can leave the vulva dry and itchy. A simple emollient can help, not only to hydrate the area, but also as a substitute for soap, since regular soap can irritate sensitive skin.
A topical estrogen cream can help relieve these symptoms and can be used for a trial period to see if there is any improvement.
Nerve problems are known to cause itching, and this can occur in the genitals. Our nerves control all sensations, including touch, and any damage to them can lead to chronic itching. It is not uncommon for a nerve problem resulting from back problems or a herniated disc to cause itching elsewhere.
Some hospitals have a vulva specialist in their gynecology or dermatology departments who can perform an examination to see if a GP has missed an underlying cause of the itching. Even if the cause is not found, anti-itch treatments, such as hydroxyzine, can help. GPs may also prescribe the antidepressant amitriptyline if itching affects sleep and quality of life.
After buying a smart watch I noticed my heart rate jumping from 160 to 65. Sometimes in the morning my head spins and I get out of breath walking up stairs. Should I be worried?
Dr. Ellie answers: It is normal for the speed at which your heart pumps to change throughout the day.
When you are exercising it will increase and during sleep it will decrease. The normal range while not exercising is between 60 and 100 beats per minute (BPM). For some, this may decrease even more during sleep.
However, anyone who regularly has a heart rate above 165 BPM while not exercising should see a doctor. This could be a sign of a number of serious heart conditions, including atrial fibrillation, which causes irregular heartbeats.
A GP can perform a heart test called an electrocardiogram (ECG) which can detect problems. Patients may also need to wear a monitor for 48 hours that watches how the heart works over a long period of time.
It’s also important to remember that while smartwatches can be useful, they are not medical devices and may be inaccurate.
Anyone concerned about their heart health should speak to a GP, who can offer a range of tests, including those for cholesterol and blood pressure, which are more important indicators of disease than heart rate.
My mother has pink-rimmed eyes. He was prescribed an ointment called chloramphenicol, but it does not completely solve the problem. Is there any treatment that would be better for her?
Dr. Ellie answers: Chloramphenicol is an antibiotic used to treat bacterial eye infection, also known as conjunctivitis. It comes in the form of eye drops that can be purchased without a prescription or in the form of a stronger ointment, which must be prescribed.
Eyes with pink edges on both sides are not a typical symptom of infection. Instead, it is more likely to be an eyelid disease called blepharitis, where the tissue around the eyelashes becomes inflamed. It is generally caused by a buildup of oil produced by the eyelashes.
People who suffer from blepharitis often experience pink, watery eyes, which can cause pain, itching, and crusting, especially in the mornings.
Chloramphenicol can help relieve symptoms, but it cannot cure them. A better option is regular, thorough cleaning of the eyelids, known as eyelid hygiene. It involves massaging your eyelids with baby shampoo diluted in warm water to remove scabs and allow the oils to drain properly. It may be easier to use blepharitis-specific cleansing wipes that you can buy at the pharmacy.
Anyone who has been prescribed chloramphenicol should ask their GP exactly why they are taking it. If it is not due to an infection, it should eventually be discontinued, as it should not be taken long term.
Rising rickets is a national scandal
You may have read about the rise of “Victorian” diseases such as scurvy and rickets among UK children – a national shame.
These are caused by poor nutrition. Scurvy is triggered by a lack of vitamin C, which is found in many fruits and vegetables. It can cause swollen and bleeding gums, fatigue, muscle aches, and skin that bruises easily.
Rickets is due to a lack of vitamin D, obtained through sunlight, oily fish and foods fortified with this vitamin, such as breakfast cereals and milk. It can soften children’s bones and cause disabilities.
We have almost eradicated these diseases, but they are on the rise again, the Royal College of General Practitioners has found.
This is because parents do not know what a healthy diet is. It’s tragic because there is so much information available.
The Government must do more to educate new parents about child nutrition.
Has the risk of stroke caused you to stop taking HRT?
I was interested to read the new NHS guidelines on hormone replacement therapy (HRT) for menopause.
GPs have been asked to tell patients about the dangers, which include a slight increase in the risk of cancer, dementia and stroke. The longer hormone replacement therapy is continued, the greater the risk of a life-threatening stroke, in which a clot blocks the blood supply to the brain. The chances are even greater in patients with underlying cardiovascular problems, such as high blood pressure and unusual heart rhythms.
In the UK there is no upper limit on how long women can take HRT and many experts believe doctors should be stricter when telling patients to stop HRT.
I’d like to know what you think. Have you been taking HRT for over a decade? Have you been informed of the risks but have decided to continue? Write to me and let me know.