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Common Medical Problems and how to deal with them.

How to cope with some common medical problems. Many common medical problems don't seem serious enough for you to consult a doctor as there are steps you can take to minimise the pain or discomfort. For children's ailments please refer to the Caring for your child page.

If you are in any doubt however phone your local medical helpline or doctor locum service when the doctor's surgery is closed, and if you suspect that you have broken a bone report to your local Accident and Emergency immediately.

The ambulance service may not respond as quickly as you would like if your condition is not life threatening.

Another option is to call a taxi or get a friend to drive you there.

Back Pain

sore backThe lower spine is very mobile, and back pain is normally due to a minor upset of its natural movements. Most people experience back pain at some time (it is one of the main causes of work absence). Most likely affected are those with jobs involving lifting, carrying, or spending long periods sitting or bending awkwardly. Normally, it's not serious and corrects itself in a few days. Some back pain, however, can be related to a specific disorder. If it persists for more than 2-3 days, or associated with weakness in a leg or problems with bladder control, seek medical advice without delay.

Common causes of backache include:
Strain/lifting heavy objects incorrectly.
Digging the garden.
Moving furniture.
Being overweight.
Poorly designed bed.
Poorly designed car seat.
Poorly designed working chair.
Poor posture.

Back Pain may be reduced by resting on a firm mattress or board. Analgesic drugs (aspirin or ibuprofen) and direct heat (a hot water bottle is best) can help to relieve pain. As with all aspects of health care, prevention is always the best method.

Make a note of the following tips and incorporate them in your daily lifecycle:
Take care when stressing your back (e.g. when lifting)
Exercise each week (walking or swimming are best)
Firm bed - if you have a soft bed, place a board under your mattress
When bending down, go down on one knee - don't stretch
When lifting, bend your knees and keep your back straight
When carrying groceries, balance the load evenly with 2 bags
Use chairs which support the small of your back
Do not use soft or bucket-shaped chairs for long periods
Sit correctly - you should be able to rest your feet flat on the floor with your knees at a right-angle.

More information about chronic pain management can be found on the Pain Association Scotland website.

Body Odour

Sweating is a natural way of regulating body temperature in response to hot conditions or strenuous exercise (it's also related to stress or anxiety). Some people naturally sweat more than others. The body continuously secretes moisture through sweat glands (about 3,000,000 of them) all over its surface and normally this evaporates quickly.

Body odour is the smell caused by sweat on skin surface. Sweat itself has no odour, but if it remains on skin for a few hours, bacteria develops and often leads to body odour (however, sweat may smell strongly of garlic, curry or other recently eaten foods).

Do you have body odour?... ask your best friend... (if you don't have a best friend - you DO)

Most body sweat is salt water, which doesn't encourage bacteria to grow and therefore doesn't smell. It comes from the endocrine glands and is initially most profuse from forehead, palms, soles of feet. Feet are the perfect environment for bacteria and fungi to flourish being under warm, airless conditions for many hours.

The other form of body sweat is from apocrine glands, around the armpits, groin and nipples. These don't become active until adolescence and the scent is often associated with sexual attraction. The sweat itself is a sticky, milky fluid which contains fat and proteins. If it's allowed to stay on the skin for long, it may encourage bacteria which leads to the nasty B.O. smell.

Four ways to avoid body odour:
Wash all over once a day, with antibacterial soap
Use a deodorant containing antiperspirant
Wash clothes regularly, particularly those close to skin
Try clothes made from natural fibres (e.g. cotton, wool), they let skin 'breathe' and absorb sweat

Bowel Problems

Most cases of abdominal pain are caused by minor digestive upsets, but if severe and persistent, seek medical advice. In the interim, rest and take fluids only. Diarrhoea is rarely dangerous. Generally a result of viruses and passes within 48hrs. No treatment is required other than rest and drinking plenty of fluids. However, if it persists or re-occurs, seek medical advice.

Dysentery (bacterial infection common in hot countries), causes violent blood-stained diarrhoea, with fever and abdominal pain. This is a serious condition which should be treated immediately.

'Irritable bowel' is associated with abnormally strong and irregular muscle contractions in the bowel. Symptoms include recurrent cramping pains in lower abdomen, intermittent diarrhoea and constipation. It usually has no serious underlying disorder. Causes include emotional disorders (stress, anxiety, depression), coffee, raw fruits and vegetables, hormones, drugs and laxative overdose.

A high fibre diet often relieves many symptoms associated with bowel problems. It provides the bulk that helps the large intestine carry away body waste and keeps faeces soft. Eating plenty of fibre may help prevent cancer of the large intestine and other bowel problems. It also aids weight loss by filling the stomach, without extra calories (see 'About Your Diet').

Don't strain when defecating as this puts extra pressure on the anus and can cause haemorrhoids.
Eat plenty of fibre and increase your intake of fluids to avoid constipation.
Using laxatives regularly is harmful and can reduce muscle control of the bowel.


Cancer has affected mankind since prehistoric time and is just as common in animals, birds and fish. It affects many people and is the most common cause of death after heart disease. It's not yet understood what causes cancer, but there are a number of risk factors which increase the chances of developing it.

Without doubt, the sooner cancer is diagnosed and treated, the higher the chance of cure. Some can be completely cured, if diagnosed early enough.

Therefore, it makes sense to adjust your lifestyle to reduce the chance of contracting cancer, and to be aware of simple self-examination techniques to detect it at an early stage.

The lifestyle risks are:
Smoking (a conclusive cause)
Asbestos (a conclusive cause)
Diet (plenty of fibre reduces risk)
Frequent sunbathing
Excessive alcohol consumption
Promiscuous sexual behaviour

There are a number of yet unspecified chemicals in food, water and our environment which are believed to trigger cancer. And it is believed some cancer causing viruses. But, it is known that cancer is hereditary, so check the occurrence of cancer in your family. The risks increase dramatically with age, so make self-examination part of your life. Self-examination is covered thoroughly in its own section. However, the golden rule is be familiar with your own body and examine yourself every month to look for changes. Cancer develops in organs, so check them carefully, look for bumps, swelling, etc. Notice skin changes and keep an eye on any moles and skin blemishes.

These are the major body warning signs:
Coughing up blood
Persistent cough or hoarseness (difficulty swallowing)
Change in shape or size of testes. Checkemlads website
Indigestion or difficulty in swallowing
Passing blood with urine/faeces
Change in bowel or bladder habits
Unexplained loss of weight
Unexplained indigestion
Unexplained persistent abdominal pain
Unexplained persistent tiredness
A sore that does not heal (especially on hands or face, which are more exposed to sun)
Bleeding or discharge from nipples
Unusual bleeding or discharge
Recurrent headaches
Blemish or mole that enlarges, bleeds or itches

As well as self-examination, it makes sense to discuss with your doctor what local screening services are available.

Screening, or testing, for certain types of cancer dramatically aid early detection, often before the person experiences any symptoms. More information about haematuria (blood in urine) can be found on the Patient UK web site >>

Every two years, Bob Steele sends a present to every Scot between the ages of 50 and 74. Inside the small package there’s a letter and a strip of thick card with three door-like flaps on top. Bob explains what to do – and this usually leads to first-time recipients shaking their heads and saying out loud, “you’re serious ?”.

It is the University of Dundee Bowel Screening Program - it is simple quick and non-invasive. I do it and suggest you do too!!


Scales of dead skin from the scalp, most common in young adults. This harmless, but irritating rash often produces unsightly white flakes in hair and on shoulders of clothes. If you have dandruff, shampoo your hair every 1-2 days with an anti-dandruff shampoo. If this fails, seek medical advice.

Excessive Sweating

Annoying, but harmless condition which affects adults. It may occur anywhere on the body but commonly affects armpits, palms and soles of feet. Excessive sweating may last a lifetime, or a few years. The condition is often inherited and aggravated by minor exercise, heat, obesity and emotional state (e.g. stress, anxiety).

Women going through the menopause often complain of 'hot-flushes.'

Although there is no medical solution, using a good antiperspirant will control sweating. The most important act, however, is to prevent body odour (see 'Body Odour' above).

When buying clothes, it may be a good idea to choose colours which are less obvious to wetness (e.g. a white shirt camouflages under arm sweat much more effectively than blue). Natural fabrics (e.g. cotton, wool) keep the body cooler by absorbing sweat and letting skin 'breathe'. Therefore, try to avoid wearing synthetic fabrics (e.g. nylon) close to the skin. Ensure your clothes are washed regularly.


Repeated and involuntary spasms of diaphragm, normally after large meals, hot drinks or large quantities of alcohol. Hiccups usually automatically stop within 10-20mins. If they persist more than one day, suggesting underlying abnormalities, seek medical advice.

Hiccups are inhibited by carbon dioxide. Simply holding your breath will allow carbon dioxide to build up in the body. Breathing in and out of a bag is very effective, but do not use a plastic bag as this may obstruct respiration which can be fatal.


A minor discomfort after meals. Symptoms include: Feeling bloated, discomfort in upper abdomen, flatulence, nausea hiccups, heartburn. Sometimes, symptoms are caused by a serious underlying disease (e.g. duodenal ulcer), and so if the discomfort persists or becomes worse, seek medical advice.

 Make a note of which foods cause indigestion (often rich, fatty or highly spiced) and avoid them
Try to eat regularly, 3-4 times a day
Eat slowly
After a large meal, allow 1/2hr for relaxation.

Rest in chair
Take antacids
Drink fluids in small amounts - not alcohol.

If you require antacids regularly please see your doctor to investigate the underlying cause of the problem.

To avoid nervous indigestion, reduce your level of stress (see 'Psychological Health').


Nobody knows why we sleep, but physical and mental damage results from sleep deprivation, and the fact all mammals sleep, indicates it has definite purpose. Most people sleep an average of 7-8hrs/night. It doesn't matter how little, or much, as long as you feel rested and well the next day.

You may think you're an insomniac simply because of a misconception about how much sleep you actually need. Some people require less than 4hrs, others more than 10hrs.

Sleep also tends to become more broken over the age of 55. It's perfectly normal to have an occasional night when it is difficult to fall or stay asleep.

Insomnia is when you regularly have difficulty falling asleep, waking at night or too early in the morning. One third of adults suffer insomnia at sometime in their life.
Insomniacs often sleep much more than they think, but tend to wake regularly. It is the quality, rather than quantity of sleep that is the problem with insomnia.

Here are the common causes:
Worrying - the most common
Erratic hours/lifestyle
Depression (associated with early waking)
Unsuitable environment (e.g. noise, travel)
Upset body clock (e.g. shift-work, jetlag)
      [Treatment consists of finding and removing the problems that prevent sleep.]
Seek medical relief for pain or depression
Try relaxation techniques
Establish regular routines for going to bed and waking up
Avoid napping during the day
Establish regular routine for meals
Don't go to bed within 3hrs of eating a full meal
Reduce fluid intake during evening
Fruit juices and herbal tea are thought to encourage sleep
Exercise in afternoon (e.g. a stroll in fresh air)
Don't take stimulants before bedtime (e.g. coffee, tea, cigarettes)
Get a comfortable bed
Take a hot bath before retiring
If you share a double bed, go to bed at the same time as your partner
Ensure a sleep conducive environment (if necessary, wear ear plugs and eye shade)
Best bedroom temperature for sleep is 16-18C (60-65F)

The body has a regular 24hr clock (the circadian rhythm) which is synchronised to your sleeping hours. You may be out of phase if, for example, the previous night you stayed awake later than usual. This is why routine is so important, your circadian rhythm needs to be synchronised with sleeping hours.

Sleeping pills cannot deal with the causes of insomnia and do not encourage natural sleep. If they are used regularly, the body develops a resistance and sleep becomes more difficult. It is better to avoid them altogether if possible and address the underlying problem that prevents natural sleep.


  1. Try not to scratch. It only irritates the skin further, leading to more itching and more scratching. Keep your nails short. Try pinching the skin near the itch between your thumb and forefinger through your clothing; this is less damaging than actual scratching.
  2. Take cool or lukewarm (not hot) showers or baths. Don't use irritating, perfumed soaps, shower gel or deodorants. Use moisturising lotions after your bath to keep your skin from drying out. Un-perfumed lotions, or aqueous cream are available cheaply from your chemist.
  3. Add a little baking soda (bicarbonate of soda) to your bath water or soak your scalp or feet in warm water with baking soda if they are itchy.
  4. Soaking in a bath with 2 cups of rolled oats secured in a sock helps to relieve itching.
  5. Use a cold compress or apply soothing calamine lotion.
  6. Avoid wearing any irritating clothes made of wool or some man-made fabrics. Wear cotton if possible. Use cool, light, loose bedclothes.
  7. Keep away from hot, humid environments
  8. Antihistamine tablets can help to control allergic reactions and itching. These can be bought over the counter from your chemist. These may help with sleeping and to break the itch-scratch cycle. They might cause drowsiness, so be careful about when you take them, and follow the directions on the packet.
  9. Over-the-counter hydrocortisone cream can help on localized itchy areas.
  10. Your doctor can also prescribe certain medicines including topical corticosteroids.
  11. If you have itching in less accessible or hairy areas, you can be prescribed liquids or gels designed specifically for these areas rather than using sticky creams.


Excess wind or gas in the digestive system can cause an uncomfortable distended feeling in the abdomen and may produce rumbling noises in the intestines. Passing of wind through mouth or anus to relieve the symptoms, although embarrassing, is rarely a sign of underlying disease.

An 18th century English gentleman was expected to 'fart' after eating; this signalled his enjoyment of the meal!

Generally, it's caused by swallowing air (including smoking), or certain foods not being properly broken down by the digestive juices, leaving residual ferments, which produce gas in the intestines. If you suffer embarrassment with gas, eat food slowly, avoid fizzy drinks and foods which give rise to residual ferments (e.g. beans, onions, cabbage).


A loss of hair, known medically as alopecia. It is hereditary and not caused by wearing hats or too frequent hair washing or brushing. Male baldness progresses with age and cannot be reversed or prevented. Hair thinning may follow 2/3 months after severe illness. Some drugs (especially anti-cancer) and certain diseases, cause temporary loss of hair. Wigs and toupees can be used. Hair transplants are sometimes successful as a permanent method of replacing lost hair. Certain drugs may cause hair regrowth in a few cases.


Any pain, swellings or deformities of the testicles require immediate medical advice. Seek medical advice if the pain is acute or associated with swelling, or if there is swelling without pain.

Testicular cancer is rapidly increasing, but is one of the easiest to treat, if diagnosed early.

It generally occurs after puberty and is most common in young and middle aged men. The risk of testicular cancer is higher in men who have a history of undescended testicles. It most commonly appears in the form of a firm, painless swelling of one testis.

The cure rate is high. Even a mild injury may result in testicular pain, but there is usually no damage, unless by a direct blow.

Self-examination is covered thoroughly on . However, when looking specifically for signs of cancer, the golden rule is be familiar with your own body and examine yourself every month to look for changes.


Pain can be felt at the tip of the penis during urination. This could be a number of disorders which may be associated with other parts of the body.
It is important to avoid sexual intercourse and seek medical advice immediately. Any lump, swelling or open sore on the penis may be a symptom of disease, even if it causes no pain. Seek medical advice.

Male Urination
Common disorders of urination are pain, frequency, lack of control and abnormalities of urine.
With mild pain when urinating, take plenty of fluids, especially cranberry juice, but cut down on the coffee and rest. If severe (burning sensation), or possibility of a STD, seek medical advice without delay.

Passing urine that is red or pink indicates bleeding in urinary system.

Seek medical advice if the red cannot be attributed to something that you have eaten (some food dyes affect urine), or if the colour or smell of your urine changes.

Dark urine is a symptom of jaundice, blue or green urine is usually caused by medicines. Offensive or fishy smelling urine is often a sign of infection. Ideally, your urine should be the colour of light straw.

If a child or older person suddenly becomes disorientated there is a strong possibility of Urinary Tract Infection - get medical attention as soon as possible.


Disorders of the Prostate

Prostatitis may account for up to 25 percent of all consultations by young and middle-aged men for complaints involving the genital and urinary systems. The term prostatitis actually encompasses four disorders:

Acute bacterial prostatitis is the least common of the four types but also the easiest to diagnose and treat effectively. Men with this disease often have chills, fever, pain in the lower back and genital area, urinary frequency and urgency often at night, burning or painful urination, body aches, and a demonstrable infection of the urinary tract as evidenced by white blood cells and bacteria in the urine. The treatment is an appropriate antibiotic.

Chronic bacterial prostatitis, also relatively uncommon, is acute prostatitis associated with an underlying defect in the prostate, which becomes a focal point for bacterial persistence in the urinary tract. Effective treatment usually requires identifying and removing the defect and then treating the infection with antibiotics. However, antibiotics often do not cure this condition.

Chronic prostatitis/chronic pelvic pain syndrome is the most common but least understood form of prostatitis. It is found in men of any age, its symptoms go away and then return without warning, and it may be inflammatory or noninflammatory. In the inflammatory form, urine, semen, and other fluids from the prostate show no evidence of a known infecting organism but do contain the kinds of cells the body usually produces to fight infection. In the noninflammatory form, no evidence of inflammation, including infection-fighting cells, is present.

Antibiotics will not help nonbacterial prostatitis. You may have to work with your doctor to find a treatment that's good for you. Changing your diet or taking warm baths may help. Your doctor may give you a medicine called an alpha blocker to relax the muscle tissue in the prostate. No single solution works for everyone with this condition. If you have been prescribed drugs please read the notes carefully to learn of the side effects. Proscar (Finasteride) is known to be dangerous for women of child-bearing age and is clearly marked for "Use by Men Only".

Asymptomatic inflammatory prostatitis is the diagnosis when the patient does not complain of pain or discomfort but has infection-fighting cells in his semen. Doctors usually find this form of prostatitis when looking for causes of infertility or testing for prostate cancer.

For More Information see the Wikipedia article on Benign_Prostatic_Hyperplasia and the


A man's breast is an immature version of the female. A woman's breast contains fatty tissues which hold milk-producing glands.
The size and shape is determined by the amount of fatty tissue and conditions of muscles and ligaments supporting it. It's not uncommon for one breast to be slightly larger than the other.

Most breast problems are minor and easy to treat.

However, if you notice any of these changes, seek medical advice:
Painless lump in breast or armpit (possible cancer)
Change in outline of skin or breast
Discharge from nipple, or retraction or inverted nipple
Pain with breast feeding (including cracked nipples).

Breast cancer is the most common form of cancer in women, 1:20 are affected and in the U.K. it causes 10,000 deaths/year. Most occur because the disease has spread beyond the breast at time of detection.

Therefore early detection is vital and regular self-examination essential (see 'Self Examination').

The golden rule is be familiar with your own body and examine yourself every month to look for changes.

Increased risks include:
Not having children (or having them late in life), being overweight, family history of breast cancer.
If you are 40+ and at increased risk, as well as regular self-examination, find out from your doctor about local screening services.

Female Genitals
Itching in the vagina or painful sex may be symptoms of infection (vaginal itching is common after menopause and results from low oestrogen levels). However, some result from reactions to chemicals in deodorants, creams and spermicides. Soft swellings often follow overstretching during childbirth, but other swellings or sores may indicate serious underlying problem. Seek medical advice.

Cleaning the genital area should be part of daily washing. The skin is delicate and needs to be treated gently to prevent inflammation or irritation. Use only plain water (bath salt, soap, may cause irritation).

It should only be necessary to wash the external skin of the vulva; the internal lining is kept clean and moist by natural secretions (thin white discharge), which also protects against infection.

Vaginal douches and deodorants may cause irritation as they upset the chemical balance inside the vagina.

Here are a few tips to prevent infection:
Keep genital area clean
Empty bladder completely when urinating, wipe away any residue
Always wipe anus towards back (keeps germs from bladder opening)
Reduce urine acidity (dilute fruit juice with water)
Drink plenty of fluids, avoid very sweet drinks
Always empty bladder after sexual intercourse
If using a diaphragm, get your doctor to check it fits correctly
Avoid wearing nylon tights or pants; cotton is best, since it absorbs sweat and allows air to circulate


Many women suffer pain or discomfort during menstruation, often a dragging or cramping sensation in the lower abdomen. Other common problems include irregularity, emotional upset, puffiness, migraine, pain, heavy discharge and bleeding after menopause.

Painful periods are more a fact of life than a sign of ill health. If, however, you feel pain, seek medical advice.

Periods normally start between the ages of 11-14 (but CAN vary between 9-17) and finish permanently during middle age (menopause).

If they haven't started by 14, consult your doctor for reassurance. An absent period may indicate pregnancy, but can also be attributed to illness, stress or strenuous activity. It rarely implies an underlying disorder.


Pre-menstrual Syndrome (PMS or PMT), covers a wide range of physical and emotional symptoms during the week before a menstrual period. 90% of women at some time suffer PMS, which although troublesome, is harmless. It's caused by natural changes in the balance of hormones, which leads to a build-up of salt and fluids in the body.

Symptoms may include:
Bloated, puffy feeling
Slight weight gain
Tenderness of breasts
Abdominal pain

The best solution is to explain your condition to close family and friends and adjust your routine to avoid extra stress. Sometimes, taking exercise, eating a balanced diet and reducing salt intake can help. PMS usually disappears after a few years or after pregnancy. If it becomes intolerable to you and your friends, seek medical advice.

Hormone treatment and psychological counselling may be recommended for women with serious PMS.

Irregular periods and blood loss between normal periods may include occasional light spotting or heavier bleeding between periods, especially if accompanied by pain, or if it occurs in older women, may be a sign of serious underlying problem. Seek medical advice.

Female Urination
Common disorders of urination are pain, frequency, lack of control and, change in colour or smell of urine. With mild pain when urinating, take plenty of fluids and rest. If you feel a  severe burning sensation, or there is any possibility of a sexually transmitted disease, get immediate medical advice.

Poor bladder control is generally caused by weak muscle control or infection in the urinary system.

Frequent urination is often related to normal menstruation or excessive fluid intake. Seek medical advice if the urination is painful, contains blood or if there's possibility of sexually transmitted disease.

Stress incontinence (slight urination during coughing or laughing) is quite common, particularly after childbirth. If it curtails social activity, surgical treatment may be required.

Sudden loss of bladder control may indicate injury of spinal or nervous system. If you've recently suffered a back injury (or fail to urinate longer than 15-20hrs), seek medical advice.

Passing red/pink urine indicates bleeding in urinary system. Seek medical advice if it can't be attributed to something you've eaten (food dyes affect urine), or if the colour/smell of urine changes.

Dark urine is a symptom of jaundice. Blue or green urine is usually caused by medicines.

Offensive or fishy smelling urine is often a sign of infection.


A woman's last menstrual phase (more commonly associated with the few years around the last period), occurs between the ages of 40-55. It is caused when the ovaries lose the ability to produce oestrogen. 70% of women experience no symptoms, apart from the end of their periods.

However, for some women, physical symptoms may include:
Night sweats
Sleeping difficulties
Hot flushes
Dry vagina
Soreness during sexual intercourse
Vaginal infections
Loss of confidence
Poor memory
Difficulty making decisions
Loss of sex drive
If the symptoms are minor, try to be positive.

Here are a few tips which should make the process easier:

Hot Flushes
Wear layers of clothing (so you can take them off and put them on easily). Wear cotton night-clothes and use cotton sheets (they absorb sweat more easily and allow the skin to breathe, which will keep you cooler).

Keep a deodorant in your handbag or near the bedside. Check in a mirror when you suspect you're having a hot flush, it might not be as noticeable as you think!!

Dry Vagina
Vagina walls naturally become thinner. If intercourse is painful seek medical advice. Avoid tight clothes, stress and extremes of temperature, which can make vaginal infections more likely.

If the symptoms significantly affect your lifestyle, medical treatment is available. This is done by artificially supplementing your levels of oestrogen, administered by tablet, skin patches or implant.

This is known as HRT or Hormonal Replacement Treatment.

However, the major use of HRT is to reduce the risk of osteoporosis (see 'HRT' and 'Osteoporosis').

Osteoporosis (The Silent Killer)

Osteoporosis is where the body's bones become porous, fragile and more prone to fracture.

Although osteoporosis is a natural process, affecting both men and women in later life, statistics show that women after menopause are much more vulnerable (1:4 women initially and 1:2 by 75yrs).

Medical evidence indicates that osteoporosis is caused by the body losing its ability to absorb calcium from food. This may be due to some interaction with a lack of oestrogen when a women experiences menopause.

There is a greater risk if you've been on a long course of cortisone, have a diabetic disorder, or smoke or drink heavily. It used to be thought that total hysterectomy would have no consequences but this has been disproved.

In the view of many doctors, HRT can be used to prevent osteoporosis (see 'HRT' section). Medical opinion is, however, divided because of possible long-term side effects. In the USA, where the Federal Drug Administration has approved oestrogen to prevent osteoporosis, the number of recorded fractures has been reduced by 50%.
Natural ways to prevent osteoporosis are based on increasing the amount of calcium in diet, preferably before menopause.

Calcium is contained in cheese, milk (skimmed milk contains as much calcium as whole milk), oily fish, broccoli, spinach, green beans, wholemeal bread.

Other preventive measures include not smoking and regular exercise.


Hormonal Replacement Treatment (HRT), the artificial supplement of oestrogen, administered by tablet, skin patches or implant. The major advantage to menopausal women is that it reduces risk of osteoporosis (see 'Osteoporosis above').

Other advantages may include:
Control of 'hot flushes'
Improved skin complexion
Improved hair
Improved physical well-being
Improved sex-drive
Relief from depression

Disadvantages may include:
Return of periods
Occasional breast tenderness
Possible link with breast cancer

Medical evidence suggests the advantages of HRT for menopausal women outweigh the disadvantages.

For other women, HRT offers some protection against cancer of womb and cervix. However, there is thought to be a higher incidence of breast cancer. Therefore, all women using HRT should have their breasts examined every year.


Piles are swollen blood vessels in or around the rectum. It is one of the prices of evolution, standing up on 2 legs, rather than on all 4's. Piles occur when blood vessels in the rectum become swollen with blood.

They are most common in middle-aged men and women, and the elderly, or with the extra pressure of a baby during pregnancy and childbirth.

Causes include mainly persistent constipation, combined with straining when defecating. Occasionally, more severe conditions (e.g. liver complaint), affect the blood circulation in the area of the rectum.

Tales about contracting piles from sitting on cold or damp surfaces, hot radiators, etc. are unfounded, although they can irritate the condition.

Generally, internal or external piles are only occasionally painful, when they become inflamed, itchy and give off a slight blood stained discharge.

Improve your diet and increase intake of fibre and fluids (see 'About Your Diet'); this helps keep faeces soft, preventing constipation
Try not to strain when defecating (lean forward from the hips to reduce straining)
Certain drugs can cause constipation (e.g. pain-killers), and so increase the fibre in your diet even further.
Laxatives should only be used for short periods and as a last resort.
     To prevent skin infection improve personal hygiene (keep anal area clean and dry) and wear cotton underwear, it absorbs moisture and lets skin breathe.


Arthritis is the inflammation of a joint. There are a number of causes, from viruses to simple 'wear and tear'. However, there is no evidence to suggest that food, cold, damp, or creaking/clicking joints are to blame.

Although there is no specific cure for arthritis, there are a number of treatments which help to control the pain and stiffness.

Osteoarthritis is the most common form, it affects about 9% of people in the U.K. It's due to natural wear and tear of weight bearing joints (hips, knees, ankles), particularly in the elderly.

You are more likely to suffer osteoarthritis of the weight-bearing joints if you are overweight. It is restricted to bone ends and doesn't spread.

Rheumatoid arthritis is a long term disease of the immune system, in which joints become inflamed. It affects about 2% of people in the U.K., mostly women in their 30s and 40's. It attacks joints and tendons, especially in smaller joints.

Still's disease (juvenile rheumatoid arthritis) affects children under 4. It may disappear after a few years, but can stunt growth and cause permanent deformities.

Ankylosing spondylitis causes bony bridges to form between vertebrae in spine. Initial symptoms include stiffness of the back and neck.

20% of people with the skin condition psoriasis, develop stiff and painful joints (particularly finger), this is called Psoriatic Arthritis. The symptoms are similar to rheumatoid arthritis.

Gout is a painful condition caused by too much uric acid in the bloodstream. This causes crystals to form in the joints. It is generally hereditary, in men aged 30-50.
Gout can appear suddenly and often in the big toe. Reducing alcohol intake may help prevent attacks.

In addition to those mentioned previously, there are many other forms of arthritis. If medication is ineffective, some forms can be treated by surgery (e.g. hip replacement).

For those suffering arthritis, here are a few self-help guidelines:
Maintain an active and busy lifestyle
Always do the exercises recommended by your doctor
Use heat treatment before exercising (e.g. hot bath)
Intersperse work periods with rest every hour
Rest before you feel tired
Don't sit in any one position too long
Avoid lifting heavy objects
Use your strongest joint where possible (e.g. shut drawers with your hands, not fingers)
Use 2 hands to hold a cup
Use as many labour-saving devices as possible
Avoid being overweight.

Varicose Veins

Varicose veins are swollen and enlarged veins, usually blue or dark purple in colour. They may also be lumpy, bulging or twisted in appearance. They mostly occur in the legs.

Other symptoms include:
- aching, heavy and uncomfortable legs
- swollen feet and ankles
- muscle cramp in your legs

Varicose veins develop when the small return valves inside the veins stop working properly. In a healthy vein, blood flows smoothly to the heart. The blood is prevented from flowing backwards by a series of tiny valves that open and close to let blood through. If the valves weaken or are damaged, the blood can flow backwards and can collect in the vein, eventually causing it to be swollen and enlarged (varicose).

Your chances of getting varicose veins increase with:
- pregnancy
- being overweight
- advancing age

Varicose veins are a common condition, affecting around one in three people. Women tend to be more affected than men. They may have an unpleasant appearance, but should not affect circulation or cause long-term health problems.

Most varicose veins do not require any treatment.

If your varicose veins are causing you pain or discomfort or they cause complications, they can be treated in several ways, the most common being:
- heat sealing
- special injection to close the veins
- surgery to remove the affected veins
- compression stockings - usually the first option and effective in many cases.

Laser treatment for cosmetic reasons is an expensive option which may  not be available with your health provider.

To ease the symptoms of existing varicose veins try:
- avoiding standing or sitting still for longer than 30 minutes
- take breaks and rest your legs upon pillows
- regular gentle walks to improve circulation and help maintain a healthy weight

Airplane / DVT / flight socks which are readily available may be all you need for occasional use if you have problem shins or calves.


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