Question: I’m very concerned about my son. He’s in his 20s and lives at home after returning from university. He has a job, but spends most of his free time at the gym. He’s obsessed with working out, and often seems very angry. I found some pills in his room. What could be going on?
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Answer: Although keeping physically active and eating a balanced diet in general is considered to be healthy, there has been a recent rise in a number of conditions, including orthorexia, when ‘clean eating’ and exercise can become harmful, and can have a concerning impact on physical and mental health.
Body dysmorphic disorder and eating disorders can also be very serious issues.
Question: It’s also possible that your son has been taking anabolic steroids, which may be the pills that you found in his room, although these can also be injected. These are prescription-only medications and, although personal use when prescribed by a doctor is not illegal, manufacturing and supplying them without a licence are.
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It is thought that at least half a million people use these medications to change their body shape, but there are both physical and psychological side effects. These include erectile dysfunction, low sperm count, anxiety, depression and irritability, and mood swings. In the long term, they can affect the liver.
The first thing to do would be to talk to your son, in an open manner, so that if he is struggling, whether that be with medication, body dysmorphic disorder or more, he can get the help that he may need.
I used to be on the combined contraceptive pill, but my doctor decided to switch me to a mini pill when I was 50, saying that it would be safer due to my age. I’m now 52, haven’t had a period for six months, and I have just started on HRT – can I stop taking the mini pill now?
Answer: The answer depends on many factors – and it can get very confusing! If you go through the menopause and have your last period before the age of 50, you need to continue to use contraception for two further years.
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If your last period is over the age of 50, you need to use contraception for one more year. HRT does not act as contraception, so you will need to continue to use contraception for the required length of time.
If you are using the Mirena coil as the progesterone component of your HRT, this doubles up as contraception.
The mini pill is safe to use after the age of 50, so many people will be on a form of HRT, such as an oestrogen gel and Utrogestan, and then continue to take the mini pill at the same time. Alternatively, a copper coil or condoms could also be used.
Question: I seem to read a lot about preventing cancers, and screening programmes for bowel, breast and cervical cancer. Why aren’t there more of these for other cancers, such as lung cancer?
Answer: In order to create a screening programme, certain criteria have to be met – there needs to be a relatively simple, safe and accurate screening test, as well as treatments available for people identified during screening. Unfortunately, at the moment, there’s simply not an easy and accurate test for lung cancer. But research is ongoing and, recently, the UK National Screening Committee has called for lung cancer screening to be made available for everyone who currently smokes, or who has previously smoked, between the ages of 55 and 74. This would involve a CT scan with the aim of picking up any cancers at an earlier stage, before they can cause symptoms.
Cancers that are diagnosed at an earlier stage are more likely to be treatable with better outcomes, so hopefully we will have more screening programmes in the future.