AS the weather gets colder, GPs expect to see more people with conditions that are triggered by indoor pollution.
Yes, that’s right, the air in your own home from cooking, open fires, inefficient stoves and candles, counts as indoor pollution.
NHS GP Dr Zoe Williams answers health questions sent in by readers
What’s more, mould and dust mites can thrive in the winter, as people dry their washing indoors without ventilating the home.
Lung diseases such as asthma, COPD and lung cancer have been linked with poor air quality, and those already with these conditions may see them worsen.
There are various ways to improve air quality at home, such as using an airing cupboard to dry clothes or an extractor fan when cooking.
Opening windows for a few minutes each day or using air-purifier devices can help, also have house plants, vacuum regularly and avoid the use of aerosols.
And fix insecure windows, which may contribute to condensation and trigger mould outbreaks.
Your GP can also advise further if you suspect your home is a danger to your health.
Here’s a selection of what readers asked this week . . .
Q) I’M a woman of 67 and I’m suffering from pain in my vagina. It’s so sore.
The doctor has given me a cream for the internal part but nothing for the outer.
I have tried lots of creams but nothing helps.
When I wee it stings. This has been going on for five months.
A) It sounds as though your doctor may have given you either an anti-fungal pessary to treat presumed thrush, or an oestrogen pessary to treat possible menopause-related symptoms.
If you have symptoms externally, on the vulva, it’s important for a clinician to examine you.
Thrush or other infections are one possibility but there are many other causes.
You are 67, and this makes me consider lichen sclerosus, which causes chronic inflammation of the skin and affects the vulva and area around the anus.
People tend to report itching but pain can also be present, especially if the person has been scratching.
Stinging on urination is a common feature too.
Your GP or practice nurse may see a white, crinkled appearance of the skin and sometimes scarring.
There is no permanent cure but the symptoms can be managed with prescribed steroid creams.
It is important to get this diagnosed as there is also a small increased risk of people developing vulval cancer.
If what I have written here correlates with your symptoms, do mention lichen sclerosus to them.
Other causes for your condition could include herpes, vulvodynia, sensitivity or allergy to soaps or cosmetics or, in very rare cases, Behçet’s syndrome or Sjögren’s syndrome.
Q) I GET ulcers in my mouth – at least once a month and often more. I thought stopping vaping would help, but it hasn’t.
I take B vitamins and I’m not iron deficient. I use toothpaste without SLS.
My dentist didn’t seem worried when I saw him last month, but the NHS says to see the GP if “your mouth ulcer keeps coming back” – does it mean in the same position?
My mouth ulcers are varied but usually inside my lips.
A) You’ve helpfully covered the first couple of things that I would want to know.
It is reassuring that the ulcers only last about a week, this is normal for aphthous ulcers, which is the medical term for the common ulcer, which we all get at times.
Some people who give up smoking develop recurrent mouth ulcers and the reason for this is unclear.
A mouth lesion that persists for longer than two to three weeks could be linked to oral cancer and should be assessed by a doctor or dentist without delay.
Getting lots of new mouth ulcers can be down to anaemia, vitamin B or iron deficiency, so even though you are supplementing, it might be worth asking your GP if they would do a blood test.
Trauma can cause ulcers too, such as from sharp teeth or ill-fitting dentures, biting the inside of your mouth when you sleep or even a hard piece of toast.
Stress can also be a cause, as can viral, bacterial or fungal infections, medication and even spicy foods.
It’s definitely worth pursuing this with your GP as they can give you a full assessment.
If you can do an online consultation you can send them pictures.
If you have to wait for an appointment, keep a diary of when and where the ulcers occur and any foods that exacerbate them to show to your doctor.
I can’t lift my arm above my head
Q) FOR the past six months or so, I’ve had pain in my left shoulder, which sometimes goes into my upper arm and restricts its use.
I can no longer fasten my bra nor can I lift my arm above my head.
I’m also experiencing pins and needles in my left hand.
The doctor said it was wear and tear.
The pain is starting to keep me awake at night.
I’ve Googled the symptoms and they keep coming back to a rotator cuff injury.
Would an X-ray confirm this?
A) X-rays are good at showing bone and some joint issues but when it comes to rotator cuff injuries, which involve muscles and tendons, then ultrasound scans tend to be better at revealing any abnormalities.
The rotator cuff contains four muscles which work to stabilise and control the movement of the shoulder.
Tendons attach the muscles to the arm and when one of these tears, it’s usually the supraspinatus one at the top of the shoulder, which is why it can hurt to lift your arm above your head.
You don’t mention an accident or fall that started the pain but inflammation or tears can also happen without trauma, especially as we get older.
Depending upon the severity of a tear, sometimes surgery is advised, especially if it is caused by a traumatic injury.
But most commonly they are treated with anti-inflammatory medication, physiotherapy and sometimes steroid injections.
However, at this stage, you do not know for certain that a rotator cuff injury is the cause.
There are many other things that could be causing your pain, including arthritis, a frozen shoulder, or a pinched nerve in the neck, which can cause pain along the route of the particular nerve all the way to the hand.
As you mentioned the pins and needles in the hand, I would suggest a thorough assessment by a physiotherapist.
You may be able to self-refer to physio, or you may require a referral from your practice, and of course, you can also pay to see one privately if you can afford it.
There’s a good video on the NHS website (nhs.uk), just search shoulder pain and scroll down to the bottom.