Ask the Doctor - May columns

Sunday 30th May - Sperm donor

I have always donated blood and have been considering becoming a sperm donor for some time now. What does this involve? James, Perth

Caitlin Delaney is Lead Embryologist at IVF Scotland, Spire Shawfair Park Hospital, Edinburgh.

The UK is suffering a major shortage of donor sperm and is looking for more men to step forward and help couples and women complete their family. Just like organ or blood donation, becoming a sperm donor is an altruistic act and can be very rewarding. To be a sperm donor, you need to be in good health and aged between 18-45. You must undergo rigorous screening tests, including those for STDs, before, after and during donation to ensure that you have no infections or genetic diseases that could be passed on. All donors must also see a doctor for a thorough medical examination and have a session with a counsellor to discuss the implications of donation. It is important to note that you will not be the legal parent of any children conceived from your donation, and your sample can only be used to father 10 pregnancies, or fewer if you wish. To find out more about becomming a sperm donor, visit the IVF Scotland website: www.spirehealthcare.com/ivfscotland

Sunday 23rd May - Thyroid 

I seem to be putting weight on and I’m not sure why. Could I have an under active thyroid gland? Graham, Edinburgh

Dr Anthony Toft is a Consultant Physician with an interest in Endocrinology at Spire Murrayfield Hospital.

The thyroid gland has the vital task of controlling our metabolism by making and maintaining the levels of two chemicals, thyroxine and triiodothyronine. In about one in twenty of us, the thyroid gland goes wrong. It may become overactive, or in the majority of cases, can become underactive, making too few hormones. This results in symptoms such as weight gain, tiredness, low mood, constipation and dry skin and hair. These complaints are common among people with normally working thyroid glands but a simple blood test can determine if the thyroid is responsible. The laboratory will measure hormone levels in the blood. If you do have an underactive thyroid, thyroxine levels will be low and the level of triiodothyronine high. Despite the claims of some eccentric practitioners it is not possible to have an underactive thyroid if the levels of these hormones are unequivocally normal, and in this country the measurements are very reliable.

The great majority of those with an underactive thyroid are restored to good health through medication but in some cases, patients may require referral for specialist advice on the best treatment plan.

Sunday 16th May - Skin cancer

A friend was recently diagnosed with a malignant melanoma. I am covered in moles and worried I may have one too.  What am I looking for? Eric, Edinburgh

Dr Daniel Kemmett is a Consultant Dermatologist at Spire Murrayfield Hospital.

It is important to realise that although the rate of melanoma is rising, it is still uncommon.  We all have moles and the risk of a mole turning cancerous is very small.  It is common for moles to slowly change over the years often becoming more prominent.  They can also be itchy or even bleed if they are caught by clothing.

Get to know where your moles are and check them every 3 or 4 months. It is difficult to examine your back so ask someone to check for you.  Look for increase in area of a mole, note any new change in colour or shape or if there is unexplained bleeding.  If you think there has been a change in size, measure with a ruler and repeat this in 6 weeks.  If there is a further change, go to your GP for a check-up. 

Sunday 9nd May - Pelvic pain

I suffer from painful periods and chronic pelvic pain, what can I do? Joanne, Edinburgh

Dr Tahir Mahmood is a consultant Gynaecologist with Special interest in Endometriosis and Pelvic Pain.

Endometriosis of the pelvis is a relatively common condition affecting around 25% of females with a peak incidence between the ages of 30 and 50 years. It is a benign condition but in the majority of cases it appears to be progressive. Symptoms to watch for are painful periods unresponsive to pain killers, heavy menstrual periods lasting more than 5 days, chronic pelvic pain, discomfort during intercourse and failure to conceive despite normal investigations. The incidence of endometriosis tends to be higher in Caucasians than non-Caucasians. There is a high incidence of disease in first order relatives, those who are obese, infertile, and prolonged users of intra-uterine contraceptive devices. Conversely prolonged use of hormonal contraceptives appears to be protective.

Endometriosis mainly affects the lining of the pelvic cavity, uterus, ovaries and fallopian tubes. The diagnosis is usually made by telescopic inspection of the pelvic cavity (laparoscopy) when blue/black implants are seen. Healthy lifestyle, active management of obesity and regular exercise are important. Early diagnosis gives an opportunity to diagnose and treat this debilitating condition at an earlier stage.  

Sunday 2nd May - Acne

My child has a very spotty face and back, which really upsets him. What is the best treatment? Andrew, Edinburgh

Dr Michael J. Tidman is a Consultant Dermatologist at Spire Murrayfield Hospital.

The principal reason for actively treating acne is to minimise the risks of physical and psychological scarring to which this condition predisposes. There is a variety of treatments and, for a particular individual, the ‘best’ treatment depends on the severity of the acne and how adversely it is affecting that person’s quality of life. The medications for adult acne range, in order of increasing potency, from over-the-counter preparations, to exfoliant and antibiotic applications, oral antibiotics, and then hormonal treatment (for females only). The most potent treatment for acne is isotretinoin, an oral medication derived from vitamin A: although this drug has the potential for a number of side effects, such as lowering of mood and problems with vision, it is, when monitored closely, really very safe and extremely effective. Nowadays, if acne is treated without delay, very few people should have to suffer from the immediate and long-term problems associated with this distressing condition.