I’m 52 and have been taking the combined birth control pill since I was 16, first to cope with heavy periods and then for contraception.
In February, I ordered my new prescription as usual.
A new GP at the practice, whom I had not met, called me to say I was over 50, I couldn’t have him anymore.
I’m afraid that if I stop, my body will go into shock.
What do you think?
Today’s reader asked if it was okay for his GP to stop his pill prescription after 36 years
What GPs can and cannot treat with each drug is defined by national prescribing guidelines.
These are based on evidence provided by clinical trials and other types of scientific research. So we know, as best we can, what works for a particular type of patient with a particular disease or condition, and what doesn’t.
More Dr Ellie Cannon for The Mail on Sunday…
We can prescribe the combined birth control pill, which contains synthetic versions of the hormones estrogen and progesterone, for birth control and also for heavy periods or skin problems. National guidelines allow it to be offered to women up to the age of 50.
After this age, the risk of potential side effects such as blood clots and breast cancer increases.
If a woman still needs contraception, we can offer the mini-pill, which contains progesterone but no estrogen – it is estrogen that is linked to increased risk.
A coil could be another option.
It is safe to stop taking the pill – you do not need to stop gradually.
The average age of onset of menopause varies, but is usually between 47 and 52 years old.
A woman stopping the pill at age 52 is unlikely to have uncontrolled heavy periods, and if when stopping at this age menopausal symptoms appear, then hormone replacement therapy (HRT) should be considered .
While HRT usually contains estrogen, the dosage is completely different from the pill and the safety of HRT during menopause is proven.
I suffer from terrible irritable bowel syndrome and I was always told that no one knew what caused it. But recently I read that it could be due to something called SIBO, which can be diagnosed using a breath test. Can I get it on the NHS?
Irritable bowel syndrome or IBS is a very common condition characterized by regular abdominal pain, bloating, and diarrhea or constipation. It should only be diagnosed once other conditions have been ruled out, such as Crohn’s disease or colitis. Diseases like endometriosis, hormone-related pain, and even ovarian cancer can also cause similar symptoms.
SIBO stands for small intestinal bacterial overgrowth and occurs when the upper part of the intestine is overrun with bacteria that are usually found only in the lower part of the intestines. Symptoms are very similar to those of IBS, including diarrhea, gas, and pain. There are tests available, including the breath test, which can be carried out on the NHS if requested by a gastroenterologist.
If a GP feels this condition is a possibility, it may be worth giving the treatment for SIBO without even doing the tests: this involves specific antibiotic treatment and improvements can start within a week.
In anyone diagnosed with irritable bowel syndrome, but especially in an older person, it is extremely important to rule out bowel cancer. Even if the bowels have been abnormal for years, the cancer can be masked by the symptoms. This can be tested with stool tests at the GP, with a FIT test, as well as with general blood tests.
I suffered from itching in my pubic area. At first everything looked normal, and I assumed it was a bit of dermatitis, but last week I discovered dark pimple-like bumps around my vulva.
I don’t mind seeing my GP, but I prefer not to.
Should I be worried?
I am 66 years old.
New symptoms in the pubic area or vulva in a woman over 60 should always be looked for.
Vulvar cancer is rare, with just over 1,300 cases diagnosed in the UK each year. But it is seen especially in women over 60.
Do you have a question for Dr. Ellie?
Email [email protected] or write to Health, The Mail on Sunday, 2 Derry Street, London, W8 5TT.
Dr. Ellie can only answer in a general context and cannot answer individual cases, nor give personal answers. If you have a medical condition, always consult your own GP.
Symptoms include continuous vulvar itching, raised or darkened thickened patches on the vulva, and moles that change shape or color.
An examination by a gynecologist or a general practitioner is crucial if these symptoms occur.
However, many non-cancerous conditions can cause itching and skin changes.
Dermatitis or eczema may occur in this area and require the same treatment as elsewhere, with moisturizers and possibly steroids.
Thrush is common in the genital area and causes itching as well as skin changes due to scratching: this can be easily treated with a cream from the pharmacist.
In addition, menopause is associated with irritation of the vulva.
Falling estrogen levels lead to thinner, drier, itchy skin.
An estrogen cream can be used to make things better.
Lichen sclerosus is a skin condition that causes itching on the genitals, especially in women over 50. The patches are often lighter than dark and usually occur on the vulva.
This is an important condition to treat to prevent long-term damage caused by scars on the genitals and it also carries an increased risk of cancer.
Any woman with genital itching should remember to avoid soap, bubble baths, and heavily scented laundry products, including fabric softener and organic laundry detergent.
Beware of sharks who offer you money for your care
Beware of companies that offer to apply for continuing care assistance for a high upfront fee
I have heard disturbing reports of companies charging thousands of elderly and vulnerable people to ‘help’ them arrange NHS-funded home care.
It concerns what is called NHS Continuing Healthcare – money that is earmarked for certain patients with extremely complex needs to pay for nursing care at home.
Accessing this can be a tricky process, and there are companies online that claim to be able to do the paperwork, but at huge upfront costs.
I’m told these companies target people who are clearly not eligible for continuing care and then, when they don’t guarantee care, don’t reimburse.
I want to put an end to it. If anyone has been contacted by a company like this, write to me and let me know. And for real advice on ongoing NHS healthcare, contact your GP.
Don’t ignore a lung analysis letter
If you receive a letter or text message inviting you to a lung checkup, please go for it!
The NHS recently launched the first screening program for lung cancer.
Over the next few weeks, large trucks equipped with mobile lung scanners will be based in supermarket car parks across the country, making it easy for smokers and ex-smokers to get a quick and potentially life-saving MoT of their chest.
There are now very effective treatments for lung cancer, but most of them are only available to patients if their disease is detected early. A pilot of the program was launched last summer, which saw 600 people diagnosed earlier.
Some 23 trucks are currently making the rounds, and another 20 are ready for action. If you are eligible, you will receive an invitation. It could save your life.