i am 78 and was taking low-dose HRT until I was 70, when it was stopped. I have osteoporosis and since I stopped taking it, I have had bone fractures and a heart attack, and my skin is dry and thin.
My doctor now refuses to prescribe it because of my age, despite I pleading with him.
Why can’t I take it?
A reader, 78, has asked Dr. Ellie why her GP won’t put her back on HRT, which she claims makes her feel better
Hormone replacement therapy, or HRT, can be life-changing for menopausal and post-menopausal women. And there is no official cut-off point for when a woman should stop taking it, as long as the benefits outweigh the risks.
But it is a difficult line to walk, and it involves a careful analysis of the advantages and potential pitfalls for individual women carried out by the GP.
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Older women have a slightly higher risk of stroke and breast cancer if they take HRT in tablet form.
As for the benefits, in addition to alleviating dreadful menopausal symptoms, the treatment protects against bone fractures.
If a patient has a history of heart disease, this process of gaining weight is more complicated because HRT can increase the risk of blood clots as you age.
We therefore reduce the potential risks of HRT by using lower doses and other forms of treatment, such as patches and creams, which have less risk than pills.
HRT may be prescribed to treat osteoporosis, but there are other options that protect bones that may be more appropriate.
Likewise, there are several widely available treatments that prevent heart attacks, which are known to be incredibly effective.
It is not uncommon for doctors and patients to disagree about treatment – and patients should always be given a chance to air their views.
If you are not listened to, you can always get a second opinion from another GP, or request a referral to a hormone specialist.
I have suffered from painful mouth ulcers for years, but successfully treated them with hydrocortisone tablets.
But I recently heard that there is a link between ulcers and cancer, and I am now concerned.
can you help?
Most of us get mouth ulcers occasionally and in most of the cases, they are not serious. They usually present as painful ruptures in the fleshy lining of the mouth and can appear on the inside of the lips, cheeks, gums, and tongue.
They can be incredibly painful but respond well to painkillers and usually go away within two or three weeks. If a mouth ulcer lasts for more than three weeks, get it checked out by a GP or dentist immediately, as oral cancer can be mistaken for an ulcer.
Besides pain relievers like ibuprofen or paracetamol, the best thing you can do for mouth ulcers is to gargle with saline or antibacterial mouthwash, which you can get from a pharmacist.
Repeated mouth ulcers over many years have nothing to do with cancer. Some people just get them more often than others.
This can happen with stress, dental hygiene and even some toothpastes – which contain a foaming agent called SLS, can exacerbate the problem.
There are other conditions that are associated with mouth ulcers – Crohn’s or celiac disease and other problems affecting the immune system, such as HIV or lupus. And in some cases, persistent ulcers can be a sign of iron or vitamin B12 deficiency, so it may be a good idea to ask the GP for a blood test so he or she can get tested.
Four months ago I saw my GP about warts on my back and face that had become scaly and itchy. On some occasions they bled.
The GP referred me to a dermatologist but months later, I am still waiting for my appointment. I called the hospital and they said they have a huge backlog.
Is it okay to wait, or should I go private?
There is no doubt that the delay caused by COVID has proved to be dangerous for thousands of people across the country and sadly, missed cases of serious diseases like cancer are inevitable.
Patients concerned about skin lesions, who are on long waiting lists, should return to see their GP. Many surgeries have specialist camera equipment that can spot something frightening.
Do you have any questions for Dr. Ellie?
Email [email protected] or write to Health, Mail on Sundays, 2 Derry Street, London, W8 5TT.
Dr. Ellie can only answer in a general context and cannot answer individual cases, or give individual answers. If you have any health concerns, always consult your own GP.
If a GP is concerned about a skin cancer such as melanoma, they will issue an immediate cancer referral, meaning patients must be seen within two weeks.
If there is a long waiting list, it may be because a GP is not concerned about the lesion and has not classified the referral as urgent – but it is worth checking.
A type of skin cancer called basal cell carcinoma or BCC is the most common type in the UK – and is not usually…