NETWORK SHEP 49 Since turning 40 my periods have become heavier. I still have a regular cycle but find that I pass clots and often flood during the first few days of my period. What could be causing this? It is very common for women in their 30s and 40s to experience heavier periods. Most commonly there is no underlying cause for this and it is called Dysfunctional Uterine Bleeding. It is important to see your GP for them to exclude other causes such as infections or fibroids and to discuss the treatment options available to you. I have permanent " goosebumps" on my upper arms and legs. I am very self conscious about the appearance and feel of my skin and always avoid wearing short sleeve or vest tops. What can I do? It sounds like you have Keratosis Pilaris which is a very common condition caused by the hair follicles being blocked with keratin plugs. It is hereditary and usually at its worse in childhood and adolescence often getting less obvious in adulthood. It can be improved by regular moisturising and exfoliation. If this doesn't work your GP could prescribe Salicylic Acid 2- 4% in Emulsifying Ointment or Soft White Paraffin. I am a 36 year old working mother with two young children. For the past 3 months I feel exhausted no matter how much I sleep. Should I take some multivitamins? Persistent tiredness could have several causes. It is worth speaking to your doctor about any changes in your lifestyle or any other symptoms that you are experiencing which may suggest an underlying cause for the tiredness. Physical causes include anaemia, diabetes, infections, increased alcohol intake and be an adverse effect of certain medications eg betablockers. The source of the problem may be psychological as in cases of anxiety, depression or continual stress. Tiredness may also have a physiological origin such as over- exercising, sleep deprivation, dieting or following prolonged heightened emotion – commonly experienced in the first week of annual leave as the stresses of the daily routine fades. My son has been diagnosed with chickenpox. How long do I need to keep him off school? The Department Of Health recommend exclusion from school for 5 days after the first lesions appear however Great Ormond Street Hospital advised 6 days exclusion from the onset of the rash. I have very noticeable thick dark hairs on my chin. I am extremely embarrassed when out in public. I have tried shaving and electrolysis with minimal effect. Are there any other treatments available? Hirsutism is defined as excessive hair growth in a male distribution ie beard area, around the nipples or abdomen. Usually there is no obvious cause for this, however, it can be a sign of underlying conditions like Polycycstic Ovarian Syndrome or certain endocrine disorders. Many women try waxing, bleaching or plucking the hairs. Increasingly laser treatment for hair removal has become more widely available. This is not offered on the NHS and it is important to check the qualifications, training and experience of the therapist before going ahead with treatment. Alternatively your GP may be able to prescribe one of the combined pills such as yasmin or dianette which provide the added benefit of contraceptive cover. Occasionally a diuretic ( water tablet) called spironolactone is used. Recently a new topical treatment has been launched to be used in conjunction with other methods. Vaniqua ( Eflornithine) cream can be applied sparingly twice daily for a trial of up to 4 months, however, initial studies suggest that only about 30% of women notice a marked improvement. Dr. Karen Harrisonlives on the outskirts of Wrexham, with husband Nick and children, Jack and Beth. Karen qualified as a doctor in 1991 at the University of Wales College of Wales, Cardiff. She has worked as a GP in the Wrexham area for the last 14 years setting up her own practice in 2006. She has a special interest in Dermatology, Family Planning and Sexual Health. Ask Dr. Karen... Dr Karen Harrison is unable to to enter into correspondence other than through this feature, please send your questions to, Ask Dr Karen, Network She, PO Box 142, Llandudno, LL30 9BL. Should you have serious concerns or an acute condition we urge you to seek immediate medical advice from your own doctor.

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