I’m a 68-year-old man and I’m suffering with hot flushes. Sometimes I get as many as 15 a day, often during the night. What can I do?
Anyone suffering with regular hot flushes should see their GP as soon as possible.
While they are a common menopause symptom in women, in men it can sometimes be a sign of blood cancer.
Often it is accompanied with fatigue or a lack of appetite.
Hot flushes can also be a sign of tuberculosis (TB) – a contagious infection that affects the lungs. In particular, TB can trigger night sweats.
Other symptoms include a cough that lasts more than three weeks and a high temperature. Once diagnosed it can be treated with antibiotics.
Hot flushes can be a side-effect of medicines, including strong opioid painkillers, antidepressants and some blood pressure pills.
Sometimes, hot flushes in men can be triggered by low testosterone – also known as male hypogonadism. Patients can also experience reduced libido and erectile dysfunction.
Hot flushes can also be a sign of tuberculosis (TB) – a contagious infection that affects the lungs
Low testosterone is often associated with ageing and obesity. If a blood test showed that testosterone levels were low enough, patients might be sent to a specialist who can prescribe regular testosterone injections to bring it back up to normal levels.
I have had a terrible pain in my upper arm for months. What could be the cause?
Pain in the upper arms is often caused by a rotator cuff injury.
The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint.
They hold the upper arm bone in the shoulder socket and help lift and rotate the arm – hence the name. When the rotator cuff is damaged, this can trigger pain in the shoulder or upper arm.
Wear and tear is the most common cause of this problem. This usually affects people over the age of 50, particularly those whose work involves lots of repetitive overhead movements, such as manual labourers.
The rotator cuff can also tear, causing discomfort. There is also a problem called an impingement where a tendon becomes pinched between bones in the shoulder.
Whatever the cause, treatment tends to be the same. In the short term, resting the arm is helpful. Pain-relief tablets, like ibuprofen and paracetamol, may also help.
However, in the long term, physiotherapy is the best option. This typically involves daily exercises that are designed to strengthen the rotator cuff and restore full movement.
These would usually be done with the help of a physiotherapist.
In most parts of the country, patients no longer need a GP referral to get a physiotherapy appointment. Unfortunately, wait times for NHS physiotherapy are particularly long at the moment. As a result, many choose to go private – this typically costs between £70 and £100 a session.
I’ve been told I might benefit from amitriptyline for my nerve pain problem. However, I’ve read online that these tablets can cause dementia – is this true?
There is evidence that amitriptyline may raise the risk of dementia. However, for many patients, the benefits of these drugs outweigh the risks.
Amitriptyline is a type of drug known as a tricyclic, which
were designed in the 1950s as antidepressants. However, in the past few decades, research has shown they can help with chronic pain conditions.
These conditions can make life miserable for patients. In many cases, tricyclics are some of the only medicines that help.
However, studies have linked long-term use to an increased risk of dementia. It’s thought the drugs block a brain chemical called acetylcholine, which helps with memory and attention. This risk seems most pronounced in those who have taken the tablets for 15 or more years.
While this is concerning, there is an important caveat. Chronic pain conditions impact sleep,
the ability to exercise and to socialise. And all research shows that, over time, this markedly raises the risk of dementia – arguably more than a long-term course of tricyclics does.
We tend to avoid prescribing tricyclics to older, frail patients with memory and thinking issues. It’s also why we encourage patients to not stay on them for a long time.
However, for many patients who are suffering with pain, these tablets can be life-savers.
Parkinson’s is on the rise… let me know if you’re affected
Sixty-four-year-old actor Michael J. Fox was diagnosed with early-onset Parkinson’s when he was only 29
I’m worried about the growing number of Parkinson’s disease patients.
The degenerative brain disease, which causes tremors, stiffness and slow movement, is the fastest growing neurological disease in the world.
This is, in large part, due to our aging population – the condition is more common later in life. However, pollution, industrial chemicals, poor diet and a lack of exercise may also be pushing up the figures. Actor Michael J. Fox, who is now 64, was diagnosed with early-onset Parkinson’s when he was only 29.
Some research suggests that exposure to viruses, such as Covid, can increase the risk. Have you received a Parkinson’s diagnosis? Were you surprised by the news? Please write in and let me know.
Do you have a question for Dr Ellie Cannon? Email DrEllie@mailonsunday.co.uk