I wake up coughing every morning – I don’t know what to do
STRUGGLING to get an appointment with your GP?
If you have any niggling health concerns, or have noticed new symptoms, then I am here to help.
GPs are under huge pressure and the situation has only got worse since the pandemic.
We want to see patients face-to-face and all my colleagues at my London surgery are working as hard as we can to do that. But there are some conditions that can be well managed by speaking to a pharmacist or calling NHS 111.
If you have any mild illnesses, or ailments it can often be a good place to start. And if you are worried about a problem, or want to know who is best to see, send me your questions and I’ll answer as many as I can each week.
Here’s a selection of letters from readers this week . . .
READ MORE ON DR ZOE
Q) FOR many years I have suffered with a morning cough that lasts around 30 minutes. I’m in my fifties, I don’t smoke or work in any industry with fumes and don’t know why I have to clear my lungs every morning.
It is a productive cough but it’s a healthy phlegm. I’ve used various mucus remedies and throat sweets but nothing works.
I drink plenty of water every day and don’t know what else to try. It becomes embarrassing if I’m away. I don’t know what else to do.
I have been in touch with the GP in the past but nothing came of my visit. I feel a bit of a fraud taking up an appointment for a cough.
Most read in The Sun
A) Firstly, you must never feel a fraud for taking up an appointment for a cough. In fact, my message to anybody reading this who has been experiencing a cough, without an obvious cause, for more than three weeks is to please contact your GP as this needs to be checked out.
In your case, you have seen your GP and it doesn’t sound as though there are any worrying symptoms. But I hear what you’re saying in that this symptom is embarrassing and causing you some worry.
Conditions that can contribute to excess mucus include allergies, asthma and bronchitis. Smoking and conditions such as chronic obstructive pulmonary disease (COPD) and cystic fibrosis can also cause this symptom, and sometimes this can happen without any specific cause.
It’s definitely worth returning to see your GP, who may consider further test such as a chest x-ray and a sputum sample.
If all is normal, then your pharmacist may be able to advise certain decongestant or cough medications that may help. Look out especially for an ingredient called guaifenesin.
Q) I AM 55 years old and since starting hormone replacement therapy four months ago, I now have dark brown patches on my face.
I understand this is chloasma due to hormone changes but they are getting bigger, quite dark, very prominent and unsightly.
I also have brown patches on my upper arms. I am currently using the HRT gel – I tried patches but was allergic. Apart from stopping HRT, which I obviously don’t want to do, is there anything I can do? I have pale skin so don’t go out in the sun as I burn easily.
I already use protective moisturising cream. Would laser treatment work or would there be a risk of it coming back?
A) The description does sound very much like melasma, which is sometimes referred to as chloasma or “pregnancy mask”.
It is thought to be because of pigment- producing cells in the skin called melanocytes producing too much pigment, called melanin, and so can give an appearance of brown or greyish patches. They are usually on the face but also some other areas of the upper body.
Several factors can contribute to developing melasma, the most common being elevated oestrogen hormones of pregnancy — hence the name pregnancy mask — as well as hormone medications such as HRT and contraceptives.
Rarely, thyroid problems may cause melasma, as well as some other medications, such as antiepileptics. It may bring some comfort to know that while the appearance of melasma can cause distress and obviously this can impact on mental health and quality of life, it does not have any physical symptoms or dangers.
The most effective way to treat the melasma would be to stop the HRT. But you have highlighted that this is something you don’t wish to do and I understand that. Another consideration would be to try taking HRT in a different form, but I also note you have already tried patches. Unfortunately these two issues leave you stuck between a rock and a hard place.
I think the next step would be for you to see a dermatologist privately, if you have the means to do so. There are a number of treatments, creams and procedures they would be able to discuss with you.
But unfortunately, this is not available on the NHS, as melasma is considered a cosmetic condition.
Read More on The Sun
Covid’s impact on our periods
Q) IS it possible for Covid to affect your menstrual cycle?
A) One of the interesting things about Covid is how it affects us all differently and seems to be able to affect just about any system in the body.
So it is completely plausible and fair to say that it could temporarily affect our hormones too, and therefore our menstrual cycles. There have been many reported cases of menstrual cycles being affected by Covid infection and changes in menstrual cycle have also been reported following Covid vaccinations.
It is not known for certain whether the infection, or the immune response to the vaccine, is the actual cause of the changes, or whether these changes would have happened anyway and they coincided, timing-wise, with either the infection or the vaccination.
Menstrual cycle changes are common. It’s something we see in general practice all the time, and this was also the case long before the pandemic.
These changes can cause disturbance and distress, especially in people who are monitoring their periods for contraceptive or fertility purposes.
But the good news is that periods tend to return to normal, for most, after one or two cycles and there is no medical evidence of any impact on a woman’s fertility.