March is Endometriosis Action Month, and this year it arrives alongside some particularly significant new data.

A survey by Endometriosis UK has revealed that the average time to receive an endometriosis diagnosis in the UK has increased to 9 years and 4 months, up from 8 years in 2020.

As Emma Cox, chief executive of the charity, commented: ‘It is unacceptable that those living with endometriosis have to endure years of pain and uncertainty before receiving a diagnosis.

The survey found that 39% of respondents needed to visit their GP ten times or more before endometriosis was even suspected, and 55% had attended A&E with their symptoms, yet nearly half of those were sent home without treatment. Perhaps most troubling of all, 83% of respondents reported being told by a healthcare practitioner that they were making a fuss about nothing.

It is little wonder that more women are choosing not to wait. Increasingly, they are turning to private healthcare for an endometriosis diagnosis. Private care can offer faster access to specialist consultations, advanced imaging and modern diagnostic tools.

What is endometriosis?

Endometriosis is a chronic condition in which tissue similar to the lining of the womb grows in other parts of the body, most commonly around the ovaries, fallopian tubes and the tissue lining the pelvis. It affects around one in ten women from puberty to menopause, making it one of the most common gynaecological conditions in the UK, yet it remains consistently under-recognised.

The condition is not simply about painful periods. Left undiagnosed and untreated, endometriosis can progress, causing worsening symptoms and, in some cases, affecting fertility and causing organ damage.

Recognising the symptoms

Symptoms vary from person to person, and this variability is part of what makes endometriosis so difficult to identify through a standard GP appointment. Common signs include pelvic pain that is persistent or cyclical, periods that are unusually heavy or painful, pain during or after sex, pain when using the toilet during a period, difficulty conceiving and fatigue that feels disproportionate to your circumstances.

Because many of these symptoms overlap with other conditions, such as irritable bowel syndrome or ovarian cysts, they may be attributed elsewhere. This is one reason why the diagnostic journey is so long for so many women.

When should you seek help?

The straightforward answer is: if something does not feel right, trust that instinct. Pain that regularly disrupts your daily life, sleep or work is not something you simply have to endure. Fertility concerns, particularly if you have been trying to conceive for some time, are also worth exploring in the context of endometriosis.

Endometriosis is diagnosed through a combination of symptom evaluation, pelvic exams and imaging, such as an ultrasound or MRI. A definitive diagnosis requires a laparoscopy – a surgical procedure to visualise pelvic tissue with a camera.

What are the treatment options?

There is currently no cure for endometriosis, but there are several effective ways to manage it, and the right approach depends on your symptoms, your age and whether you are hoping to conceive.

Pain management is often the first step, using anti-inflammatory medications alongside hormonal treatments such as the combined pill, the hormonal coil or hormone-modulating medications that reduce oestrogen levels and help slow the growth of endometrial tissue.

For more significant cases, surgery may be recommended. Laparoscopy, a minimally invasive procedure, is currently the only way to definitively diagnose endometriosis and can also be used to remove or reduce deposits of tissue which are causing symptoms. When fertility is affected, a referral to a fertility specialist is important to discuss your fertility preservation or treatment options.

Taking the next step

If you have been managing unexplained pelvic pain, difficult periods or other symptoms that feel out of proportion, you deserve answers. At GP London W1, our women’s health team offers thorough, unhurried consultations and can refer you promptly to trusted gynaecology specialists.

To book an appointment, please contact us at 25 Harley Street or via the website.

Many of us find the winter months hard to deal with emotionally, but for those living with chronic skin conditions like eczema or psoriasis, the cold brings with it physical problems too, as the combination of harsh winds and extreme fluctuations in temperature, as you go from indoor heating to outside cold, can play havoc with your already-sensitive skin.

Although eczema and psoriasis are different skin conditions, with psoriasis being characterised by areas of thickened scaly skin, while eczema causes reddened, itchy patches, they do share many triggers, with cold weather being a major consideration.

Why is the cold so triggering for eczema and psoriasis?

Cold air contains less moisture than warmer air, and since both eczema and psoriasis are triggered by dryness, this can lead to flare-ups. And while you might think central heating would reduce this problem, it can actually exacerbate it, as this kind of heat lowers air humidity.

And to make things worse, more traditional winter warmers, such as woollen clothing, can irritate sensitive skin, causing itching and further discomfort.

So, what can be done to reduce the impact of cold weather on chronic skin conditions?

• Moisturise regularly – all eczema and psoriasis sufferers will know that regular moisturising is key to staying on top of their condition, and in winter this becomes even more essential. Look for thicker, petroleum-based moisturisers that can provide an actual barrier between your skin and its environs, and avoid anything heavily fragranced. Your hands will need particular attention, as regular exposure to water can make things worse. Moisturise after every wash, and consider applying an extra-thick layer of lotion before bed and wearing cotton gloves overnight to help the skin absorb the moisture.
• Manage your environment – it is unrealistic to think you can avoid turning on the heating all winter, but there are ways you can make it less harmful to your skin. Using a humidifier can help to optimise the moisture levels in the air, which in turn will help to keep your skin hydrated. You will need to clean your humidifier frequently to prevent mould, and you should aim for a humidity level of about 40-50%.
• Think about what you wear – we’ve already mentioned the dangers of wool, but just switching to jumpers made of synthetic fabrics won’t necessarily help, as these thicker fabrics can trap heat and sweat, aggravating skin conditions. Layers of thinner, breathable fabrics like silk or cotton will help prevent flare-ups. Remember to use fragrance-free, dye-free, hypoallergenic detergent for your laundry.
• Avoid long, hot baths or showers – when it’s cold outside, the temptation to linger in a hot bath can be overwhelming, but prolonged exposure to hot water can play havoc with skin conditions like eczema or psoriasis. Stick to quick showers with lukewarm water, and use gentle, fragrance-free, soap-free cleansers. Pat skin dry afterwards and remember to moisturise!
• Seek help from your GP if needed – even if you are a long-term eczema or psoriasis sufferer, that doesn’t mean you won’t sometimes need extra help to manage your condition. Your GP can help you find new treatments or identify new ways to adjust your lifestyle to reduce exposure to irritants. Sometimes a change in diet can help, or even meditation, to combat stress. New treatments for eczema and psoriasis are being developed all the time, and you never know which might be the one to work for you.

For more information on managing chronic skin conditions or to book an appointment with one of our GPs, please contact us.

If you’ve struggled with insomnia, you will know the frustration of not being able to fall asleep and you’re aware of the short-term impact it has on your brain’s ability to function. But did you know it has been linked to memory problems in later life?

A new study has been looking into the theory that there may be a link between chronic insomnia and dementia and found that the condition increases the risk of developing dementia by 40%.

The study

Several previous studies have found a link between insomnia and various health concerns – both physical conditions like obesity, type 2 diabetes and high blood pressure, and neurological ones like Alzheimer’s disease and dementia.

For this study, a team of researchers at Minnesota’s Mayo Clinic, set out to find out more about the link between insomnia and dementia.

The team recruited 2,750 adults with an average age of 70. No participants had any cognitive decline at the beginning of the study, and 16% suffered from chronic insomnia. They were tracked for 5.6 years on average, during which time they underwent cognitive function and memory tests, answered questions about their sleeping patters and had regular brain scans to check for markers of Alzheimer’s disease, including white matter hyperintensities and beta-amyloid plaques.

At the end of the study, it was found that those participants suffering from chronic insomnia were 40% more likely to develop dementia or cognitive impairment than their better-rested peers.

What does this mean for insomnia sufferers?

Firstly, it is always important to remember that correlation is not causation – just because there’s a link, that does not mean that insomnia causes dementia. But such a high-risk increase does warrant concern, and if you do have serious sleeping problems this is one more reason to do something about it.

Another key thing to note about this study is that the patients with increased risk of dementia had chronic insomnia, which is defined as having serious difficulty sleeping for three or more nights every week over a minimum period of three months.

What can be done to treat insomnia?

There are various insomnia treatments, and the right one for you will depend on which type of insomnia you suffer from – this could be sleep onset insomnia, where you struggle getting to sleep at the beginning of the night, or sleep maintenance insomnia, where you may not have a problem falling asleep at bedtime, but then wake up in the night and have difficulty getting back to sleep.

Or you might have terminal insomnia, which is when you wake up long before your alarm and can’t get back to sleep. Or any combination of the above! Importantly, sometimes insomnia occurs because of an existing medical condition, such as anxiety or depression, and this is known as comorbid insomnia. If this is the case for you, it’s a good idea to seek help for the underlying medical condition before treating the insomnia.

Insomnia treatments might involve Cognitive Behavioural Therapy (CBT), to help you control any negative thoughts that might be keeping you awake, or you might choose to go down a more hi-tech route, using one of the many sleep apps that are available to help you drift off using techniques such as guided meditations and sleep trackers.

If you’re struggling with insomnia and would like to speak to a medical expert about your concerns, please contact us to book an appointment today.

Anybody who suffers from migraines will know that they can be pretty debilitating, and that you would try anything that promised to offer relief. So, it’s hardly surprising that when a new TikTok trend emerged suggesting that fast food might be the answer, migraine sufferers the world over were prepared to give it a go.

But is there any truth behind the trend? In this post we’re going to break down what a migraine is – and how it differs from a standard headache – and what, if anything can be done about it.

What is a migraine?

A migraine can be different things for different people – some mainly experience visual symptoms, while others are bedridden for days in excruciating pain. The following are the most common types of migraine:

• Migraine with aura – this type of migraine is usually preceded by visual disturbance, tingling, or difficulty speaking that warns the sufferer a migraine is imminent
• Migraine without aura – these migraines come on suddenly with no warning, just immediate, throbbing pain in the head, and often around the eyes
• Chronic migraine – this term is used for patients who suffer from migraines for 15 or more days per month
• Menstrual migraine – as the name suggests, these migraines are linked to hormonal changes, such as puberty, pregnancy and menopause, and can be triggered by certain contraceptive pills
• Vestibular migraine – this type of migraine is characterised by the additional symptoms of vertigo, dizziness and loss of balance
• Hemiplegic migraine – this is the rarest type of migraine and is often confused with a stroke, as it tends to involve temporary weakness on one side of the body

Crucially, a migraine is not the same as a headache. Sufferers are often highly sensitive to light while in the throes of a migraine and are physically unable to continue life as normal.

Most over-the-counter painkillers won’t touch a migraine, and it is very common for patients to need to retreat to a darkened room on their own until the pain has passed, while a standard headache can usually be easily treated with paracetamol.

What causes migraines?

The truth is that no one is exactly sure what the mechanism is that causes some people (around one in seven) to suffer migraines and others not. However, we do know that there are some things that can trigger a migraine attack. Frequent triggers are:

• Hormonal changes (see menstrual migraine, above)
• Changes in the weather – some people are more prone to migraines when the weather is heavy and thundery, for example
• Certain foods – commonly dairy produce, caffeine or alcohol
• Stress
• Lack of sleep
• Dehydration
• Hunger

Can fast food help?

It is unlikely that eating fast food will cure migraines long term – and eating it regularly is likely to cause more problems than it solves – but there may be some short-term relief from consuming something that is high in salt and sugar, particularly if your migraines are triggered by hunger or thirst.

However, it is worth considering that, while TikTokkers might recommend a full fat cola and a portion of fries to treat your migraine, the advice on caffeine in the cola is mixed. Caffeine is a nerve disruptor and an ingredient in some migraine relief medication, but, for some people, caffeine can actually trigger migraine attacks.

So, what can be done?

If you suffer from migraines, the first step is to book a consultation with your GP to discuss the type of migraine you experience and what you consider to be the triggers. There are plenty of medications available that can effectively treat migraine pain, but the right treatment for you will depend on several different factors, which can be discussed in consultation. Studies show that a close relationship between doctor, patient and pharmacist is the best way to provide an effective migraine treatment plan.

For more information or to book a consultation with one of our GPs, please contact us.

There has been a lot of talk recently about the UV index, and how it can be used to assess the risk from sun exposure. But how much do you really understand about what the UV index is and how it works? And can you really use it as a measure to indicate how much sun protection you need. We answer your frequently asked questions:

What is the UV index?

The UV index is a standardised measurement to show the intensity of UV (ultraviolet) radiation in a specific location and at a specific time. It was a joint development from the World Health Organisation (WHO) and the World Meteorological Organisation (WMO), to help people understand the level of UV radiation on any given day and take the precautions necessary to protect themselves.

How do I read the UV index?

The UV index is generally reported as a number between 0 and 11(+). As you might expect, 0 is the lowest level of UV – which only occurs at nighttime – and 11 is the highest. When the UV index is reported at 11, burn can occur within just ten minutes of exposure to the sun.

What’s the difference between the UV index and the weather forecast?

Many people think that the UV index is higher on a hot day and lower when it is cold. And this might be true, but the UV index is dependent on more than just temperature. Cloud cover can make a difference, as can altitude, because the atmosphere is thinner the higher up you go – which is why skiers are so prone to sunburn. In countries like New Zealand, which sits beneath a hole in the ozone layer, the UV index tends to be higher all year round than it is in Europe.

If the UV index is low, do I still need to protect my skin from the sun?

Absolutely. The UV index is great to give us an idea of the level of sun protection we need – if the reading is 11, for example, you may want to consider not going out into the sun at all unless it’s absolutely necessary – but it certainly shouldn’t be used as an indicator of whether we need to protect our skin at all. If you have very pale or sensitive skin, you could still burn even if the UV index is 1, depending on how long you are in the sun. And even those with darker skin tones can burn at level 2, if they stay outside for long enough.

What is the point of the UV index?

We are all at risk from excess UV exposure, but some people’s risk is greater than others. If you have previously had skin cancer, for example, protecting your skin from the sun becomes vitally important.

What is the bottom line?

The UV index is a fantastic tool to help us consider how much time we should be spending outdoors, or the level of sun protection we need. However, UV exposure can be harmful whatever the number, and we should all be wearing SPF 30+ – and topping it up at regular intervals – every day.

If you have any concerns about your risk from sun exposure or would like to discuss anything else with one of our team, please contact us.