My GP tells me I need to stop taking HRT because I’m too old. Is this true? DR ELLIE has the answer

I’m 86 and have been taking HRT since my early 40s, when I had a hysterectomy. I believe it has kept me healthy and active.

I’ve never broken a single bone – even though osteoporosis runs in families – and that must have been the HRT. Now my GP wants me to stop using the patches because he says I’m too old to take HRT. What should I do?

Dr. Ellie Cannon responds: Doctors are always cautious about older patients taking prescription medications because they are more likely to suffer side effects, some of which can be dangerous.

In the case of hormone replacement therapy (HRT), it may increase the risk of a potentially fatal stroke or blood clot.

NHS guidelines also state that patients should take HRT for as short a period as possible and recommend that women stop it every few years to find out if it makes a significant difference to their symptoms.

Doctors are always cautious about older patients taking hormone replacement therapy (HRT) because it can increase the risk of a stroke or life-threatening blood clot.

However, this does not mean that an 80-year-old woman categorically cannot handle it.

Firstly, there is no upper age limit for taking HRT. Second, menopause treatment is supposed to be personalized for each patient.

Indeed, the symptoms affect women in different ways. Some women will need higher – or lower – doses of HRT than others. And some benefit from taking these replacement hormones for decades, while others will only need them for a year or two.

It is also important to consider the different types of HRT available.

Patches are considered to have a lower risk of stroke than tablets, and there are also low-strength patches containing less estrogen, which may reduce this risk even further.

Additionally, HRT gel is even safer than patches because it can be used in very small doses. These are all options worth discussing with a GP.

However, for anyone concerned about the risk of developing osteoporosis, it is essential to understand that HRT – although it has been shown to protect against this bone-thinning disease – is not the only way to prevent it. Walking can keep it at bay, along with a diet containing adequate amounts of calcium and vitamin D. Adults need 1,000 mg of calcium per day to reduce the risk of bone fractures.

In June I developed a rash on my feet, legs and butt. My GP diagnosed me with scabies and it seems the treatment is working. However, apparently it is spread through close sexual contact – often sexual – and I haven’t had an intimate relationship with anyone in over a year. Could it really be scabies?

Dr. Ellie responds: Scabies is a skin infestation caused by a parasite called a mite. Itching is caused by the body’s reaction to mites and their eggs on the skin.

Parasites often congregate in the fingers, stomach, genitals, arms and buttocks.

In recent years, I have noticed an increase in the number of scabies patients in my medical practice, suggesting that this disease is more common than it once was.

These mites are also slowly becoming resistant to current treatments. It’s true that it usually takes close physical contact to spread scabies, which is why it’s often spread during sex. Brief physical contact – such as a handshake – is unlikely to lead to scabies.

However, mites can also survive for several days in humid environments. Contaminated linens and clothing should always be washed at warm temperatures to kill mites and eggs.

The most common treatment is an antiparasitic liquid called Derbac M – also known as malathion. For most patients, it is quick and effective.

I’ve had balance issues since I had a pacemaker put in in 2019. I feel like I’m drunk at all times. I was seen by a neurologist who told me I didn’t have brain problems such as like Parkinson’s disease. Could my pacemaker be to blame?

Dr. Ellie responds: It is important to always consult a GP if you have balance problems.

Not only is this a very distressing symptom, but it can also lead to falls and injuries that can change your life. But discovering the cause can be complicated, because there are several possible triggers.

For example, if dizziness occurs when you suddenly stand up or sit down, it may be due to uncontrolled blood pressure.

However, pacemakers rarely have side effects.

The devices are equipped to monitor the heartbeat. For most who benefit from them, they significantly improve the quality of life and even save lives. However, a small percentage of patients may suffer from pacemaker syndrome.

This is when the electrical activity of the heart is not regulated properly, meaning the organ does not beat as it should. As a result, people may experience dizziness, fatigue, and lightheadedness. Some even faint.

Anyone who experiences balance problems after having a pacemaker installed should see a cardiologist to explore the possibility of this syndrome.

There are tests that specialists can perform at the hospital to determine if the device is the cause. If this is the case, another type of pacemaker may be used instead. A general practitioner can refer you to a cardiologist.

My fears if we removed GPs from breast checks

I was concerned to learn that a government program would allow women to undergo breast cancer screening themselves without first consulting a GP.

In Somerset, they will be able to call the non-emergency line 111 – or use the NHS app – to report a breast lump, then be referred to a specialist clinic for a cancer check. If successful, the project will be extended throughout the country.

Currently, any woman registered with a GP will be invited for an NHS breast cancer screening every 3 years between the ages of 50 and 71.

I don’t support that. Delays in cancer diagnoses cost lives, and we need to speed up this process, but the vast majority of new masses are not cancerous. Testing every mass could lead to unnecessary invasive investigations and would certainly overwhelm NHS resources.

Do you agree? Do you think your breast cancer could have been diagnosed earlier if you had been able to seek medical attention yourself? Please let me know using the email address below.

Will deathbed singing bring peace?

My Way by Frank Sinatra has been chosen as one of the best songs to listen to in your final moments, according to the charity Marie Curie.

I was surprised last week when the charity Marie Curie published a list of the most popular songs people want to listen to in their final moments.

Frank Sinatra’s My Way, The Beatles’ Hey Jude and Judy Garland’s Over The Rainbow were among the top responses. I’m sure they’re all great songs, but the idea of ​​playing music at the end of life seems strange to me.

Unfortunately, over the past year, I have experienced the death of four members of my family. None of them asked for music to be played at the end. However, that doesn’t mean it doesn’t bring peace and happiness to others.

Do you have a song you would like to play on your deathbed? Did a family member ask for one? Please write to me and let me know.

Do you have a question for Dr. Ellie Cannon? Email [email protected]

Dr. Cannon cannot engage in personal correspondence and his responses should be considered in a general context.