DR KAYE: Why am I hit by suits of sneezing throughout intercourse?

I’m 80 and have been taking the erectile dysfunction drug tadalafil for a number of years now.

However, within 30 seconds of sex, I have a sneezing fit. It can often be violent and lasts for a whole minute.

What could be the cause?

Dr Kaye replies: Sneezing during sexual arousal or orgasm is a surprisingly common condition and doctors are still unsure what triggers it.

One intriguing theory is that the inside of the nose contains erectile tissue – the same tissue found in the genital organs in both men and women.

It’s possible that, when blood flows to the genitals in response to arousal, it also travels to the lining of the nostril.

This could block the nose, or irritate the skin, leading to fits of sneezing.

Sneezing could also be a side effect of taking tadalafil.

The erectile dysfunction drug is part of a group of medicines called phosphodiesterase inhibitors, which improve blood flow throughout the body, including the penis.

Interestingly, studies suggest that this effect may mean that phosphodiesterase inhibitors improve heart health as well.

But, as a side effect, it’s possible that this increased flow can lead to higher than normal levels of blood in the small blood vessels inside the nostrils.

This could lead to nasal congestion and, as a result, sneezing.

In fact, nasal congestion is listed as a common or very common side effect meaning that it affects as many as one in ten people.

The same effect is also sometimes seen in patients taking the most famous erectile dysfunction drug, Viagra.

If patients find this symptom concerning, it might be worth discussing it with a doctor, who might suggest a new medicine.

Last week, I woke up and found that I was deaf in my left ear. I also felt woozy and dizzy.

My GP gave me antibiotics for a possible infection.

However, nothing has changed. Is it possible that I have had a stroke?

Dr Kaye replies: Sudden one-sided hearing loss is considered a medical emergency and requires an urgent GP appointment or a visit to A&E.

The cause is often an ear infection. However, it can also be triggered by a blow to the ear or new medicines.

Whatever the trigger, the usual treatment for sudden onset deafness is oral steroid tablets, which reduce inflammation in the body.

Sometimes steriods might be injected into the ear. These medicines work best when given as soon as possible so it’s crucial that anyone who suddenly experiences deafness – in one or both ears – seeks treatment immediately.

Likewise, in some cases, hearing loss can be a sign of a stroke – where a clot blocks blood flow to the brain.

A stroke would normally lead to other symptoms including a loss of balance, blurred vision, drooping on one side of the face, arm or leg weakness, or speech difficulty.

A stroke can have life-threatening consequences so it’s important that you seek medical advice as soon as possible.

A long wait in A&E can be uncomfortable and boring, but the consequences of leaving a serious medical problem untreated are worse.

I’m 87 and suffer from arthritis in my hands.

Six months ago, the surface of my fingernails began flaking.

I’ve tried hand cream and strong nail varnish, which apparently makes them tougher, but to no avail.

Dr Kaye replies: Nail problems can often be an indicator of an underlying health problem.

For example, white spots can be a sign of an iron deficiency, red streaks could be related to a heart valve infection, and ridges due to diabetes.

Nail problems can also be related to a specific type of arthritis – called psoriatic arthritis. This is a type of joint inflammation that also triggers an itchy skin rash. It can also lead to nail changes, including flaking. Peeling nails can also be due to dry hands or excessive hand washing.

It’s worth speaking to a GP about any nail changes, as they may be able to identify any possible causes.

Importantly, they can also ensure that arthritis patients are getting the correct medicines to help manage the associated pain – which may also help combat any nail-flaking.

In the meantime, patients with flaking nails might consider taking steps to protect their nails, such as wearing gloves while doing the washing up and moisturising them.

At last, payouts for mesh pain

There was good news this week that more than 100 women in England who were harmed by vaginal mesh have now received payouts.

The treatment was initially designed to reduce the risk of incontinence and organ prolapse. However, the mesh was later found to harden and cause agonising pain, as well as damaging the bladder and bowels. More than 10,000 women are believed to have been harmed by the product.

And, thankfully, we now have many alternatives to vaginal mesh. The first step is seeing a physiotherapist who can help tighten the muscles in this area, reducing the risk of incontinence or prolapse.

If patients are still at risk, there are safe surgical options. These might involve stitching organs into place or strengthening the tissue lining that holds them inside the body.

If you are concerned about these issues, speak to your GP.

New winter virus jab rolled out too quietly

I WAS relieved when, earlier this year, the NHS announced it would roll out a first-of-its-kind vaccine for a common winter virus.

Every year, respiratory syncytial virus (RSV) hospitalises older adults and young babies with severe infections.

From the beginning of September adults aged between 75 and 79 will be offered the jab at their GP surgery. Pregnant women will also be offered the vaccine 28 weeks into the pregnancy to protect the baby.

However, I am worried that many patients do not realise they are eligible – or are even aware of the RSV vaccine.

I’ve heard from patients who have received an NHS letter or text inviting them to have their RSV jab who say they don’t plan to get it because they are unsure why they need it.

Have you received an invitation for the RSV vaccine? Do you plan to have it? Write in to the email below and tell me.