MEDICAL tests and screenings can be daunting.
You may be worried about what will be involved, what clothing you might need to remove and who will be in the room.
Dr Zoe reveals unusual menopause symptom as she answers your health questions
Then there’s having to wait for results.
Just remember that us GPs are not phased by bodies at all and you are always welcome to request a chaperone, or bring someone you trust along with you to any appointment.
Whatever makes you feel most comfortable.
Here’s what readers have asked me this week…
Q) I HAD my smear test last week and the nurse mentioned I have a small polyp or skin tag on my cervix.
I wasn’t aware of it as it has never caused any bleeding or pain, even though I cycle a lot.
She looked up my last test five years ago and it was mentioned on that, but no one told me I ought to see the GP to check it.
This time she made an appointment for me, but the GP was unable to get hold of it and twist it off, as it is pretty small. I have now been referred for a routine outpatient appointment at gynaecology.
Surely, if it is not causing a problem, it is better left alone? Will it be frozen off? What is likely to happen? It was pretty painful when the GP was trying to get at it.
A) A small percentage of polyps – between two and 15 in every 1,000 – are what’s considered “abnormal” and may develop into cancer if left, so this is the reason why it’s usually best to remove it.
While you have no symptoms currently from the polyp, some people do, and these can present as bleeding after sexual intercourse or in between periods. The removal of the polyp can return these symptoms back to normal.
Please don’t worry about the upcoming appointment though.
Even though it was a bit too tricky for your GP to get a good grasp of it, the specialist who will be treating you will have dealt with much more difficult ones.
They will have special equipment called polyp forceps which are used to grasp the base of the polyp where it attaches to the cervix. The polyp is then removed with a gentle twisting motion.
Sometimes, if the doctor or clinician can’t see the base, a hysteroscopy is performed.
This involves passing a small camera through the neck of the womb to see if the polyp starts in the cervix or in the womb, but should this be needed it will be explained in more detail before the procedure.
When the polyp is removed, it’s sent to the laboratory for examination to make sure that the tissue is normal.
I’m sure it will be relatively straightforward for them to remove the polyp and you are more likely to feel discomfort than pain. You may feel a period pain-like ache afterwards, so taking some painkiller medication before the procedure is a good idea if you’re feeling a bit worried.
Q) I AM a 57-year-old woman. I have experienced several urinary tract infections over the years and I’ve had blood in my urine recently.
I have seen my GP and had various tests at the hospital last year, which included a CT scan, blood tests and a cystoscopy. All results came back OK.
I’ve had courses of antibiotics but I’m thinking of trying Lucovital D-Mannose for UTIs, which I have seen on a chemist website and have researched. It claims to prevent recurrent UTIs and cystitis.
I was also wondering if it could be anything to do with the menopause, although I am not experiencing any symptoms right now. Can you please advise what else I can do to help myself?
A) As you’re already under specialist care, there isn’t too much extra that I can advise and it sounds as though you have had appropriate investigations for this.
It’s reassuring you’ve had a cystoscopy, which is when a small camera is inserted into the bladder, through the urethra, as this test is vital to look for any sinister causes of the bleeding into your urine, and especially to rule out bladder cancer, which would be visible during a cystoscopy. I’d add that recurrent UTIs can present as the first or only symptom of menopause.
The impact of lost oestrogen can start to affect the tissues of the vagina, vulva and urinary tract even after menopause, and recurrent UTIs can be a result of this.
You could ask your GP to prescribe, or you can buy, an over-the-counter oestrogen topical cream or pessary to see if that makes a difference. I’d recommend a two to three-month trial of it initially.
Recurrent UTIs are unfortunately getting more common and as GPs, we see them being less responsive to antibiotics as time goes by because of the highly concerning issue of antimicrobial resistance.
Regarding the D-mannose supplement you mention from the chemist, there is some evidence to support it, just do bear in mind that it is a sugar.
It’s best to trial the oestrogen and the supplement separately so you know which one has been effective. It’s also a good idea to keep a symptom diary so you monitor any changes.
As the supplement is relatively expensive, a couple of months is likely long enough to know whether it’s working for you and whether you would like to continue taking it.
Can I ask for cancer test?
Q) I AM 79 and no longer receive a poo test. Is it worth me requesting that I have one at my age?
NHS bowel cancer screening checks are automatically sent to 60 to 74-year-olds. They are designed to detect bowel cancer.
The good news is that – in a win for The Sun’s No Time 2 Lose campaign – the programme is expanding to make it available to people aged 50 to 59 years, too, in England. (It is already available from the age of 50 in Scotland).
This is happening gradually over four years and started in April 2021.
If you’re 75 or over, you won’t be offered or sent one routinely, but you can ask for a kit every two years by phoning the free bowel cancer screening helpline on 0800 707 60 60.
Currently the guidelines recommend stopping cancer screening at the age of 75. This isn’t because bowel cancer is less common – in fact, it gets more likely as we age – but simply because the risks of investigating are higher, especially for those who are frail and may not tolerate a colonoscopy well.
However, for fit, healthy people who are over 75, it’s likely that screening remains beneficial.
The majority of research looking into this concludes that screening between age 75 and 85 years must be decided case by case, which is why individuals can opt in to screening if they wish.
So if you see yourself as a fit, healthy 79-year-old, then please do call the helpline.