DR ELLIE CANNON: Is it safe for my GP to stop me taking the pill after 36 years?

I am 52 years old and have been taking the combined contraceptive pill since I was 16, initially for heavy menstrual bleeding, but then for contraception.

In February I ordered my repeat prescription as usual.

A new GP at the practice who I didn't know called to say I couldn't have it anymore as I was over 50.

I'm worried if I stop my body will go into shock.

What do you think?

What GPs can and cannot treat with each medication is determined by national prescribing guidelines.

These are based on evidence from clinical trials and other types of scientific research. So we know as best we can what works and what doesn't for a particular type of patient with a particular disease or condition.

For contraception, but also for heavy menstrual bleeding or skin problems, we can prescribe the combined contraceptive pill, which contains synthetic versions of the hormones estrogen and progesterone. National guidelines allow it to be offered to women up to the age of 50.

After this age, the risks of possible side effects such as blood clots and breast cancer increase.

If a woman still needs contraception, we can offer the mini-pill, which contains progesterone but no estrogen - it is the estrogen that is associated with the increased risks.

A coil would be another option.

It's safe to stop taking the pill - you don't have to taper off.

The average age at which menopause begins varies, but it is usually between 47 and 52 years old.

A woman who stops taking the pill at 52 is unlikely to have heavy uncontrolled periods, and if menopausal symptoms occur when stopping the pill at this age, hormone replacement therapy (HRT) should be considered.

While HRT usually contains estrogen, the dosage is completely different than the pill and the safety of HRT during menopause has been proven.

I suffer from terrible irritable bowel syndrome and have always been told that no one knows what causes it. But recently I read that it could be due to something called SIBO, which can be diagnosed with a breath test. Can I get this on the NHS?

Irritable bowel syndrome, or IBS, is a very common condition characterized by regular abdominal pain, bloating, and diarrhea or constipation. It should only be diagnosed if other conditions such as Crohn's disease or colitis have been ruled out. Diseases such as endometriosis, a hormonal pain disorder, and even ovarian cancer can also cause similar symptoms.

SIBO stands for small intestinal bacterial overgrowth and occurs when the upper part of the intestine becomes overgrown with bacteria that are normally only found in the lower part of the intestine. Symptoms are very similar to those of IBS, including diarrhea, bloating, and pain. There are tests available, including the breath test, which can be carried out upon request from a gastroenterologist on the NHS.

If a GP thinks this condition is possible, it may be worth pursuing treatment for SIBO without doing the tests: this involves treatment with specific antibiotics, and improvements can begin within a week.

For anyone diagnosed with irritable bowel syndrome, but especially older people, it is crucial to rule out colon cancer. Even if the bowel has been abnormal for years, cancer can be masked by the symptoms. This can be checked with stool tests at your family doctor, with a FIT test and with general blood tests.

I have been suffering from itching in my pubic area. At first everything looked normal and I thought it was a bit of dermatitis, but last week I discovered some dark, pimple-like bumps around my vulva.

I'm not embarrassed to see my primary care doctor, but I'd rather not.

Should I be worried?

I am 66 years old.

New symptoms in the pubic area or vulva in a woman over 60 should always be clarified.

Vulvar cancer is rare, with just over 1,300 cases diagnosed in the UK each year. But it is mostly seen in women over 60.

Symptoms include persistent itching of the vulva, thickened, raised or darkened patches on the vulva, and moles that change shape or color.

An examination by a gynecologist or family doctor is crucial if these symptoms occur.

However, many non-cancerous conditions can cause itching and skin changes.

Dermatitis or eczema can occur in this area and requires the same treatment as elsewhere, with moisturizers and possibly steroids.

Thrush is widespread in the intimate area and causes itching and skin changes due to scratching: These can be easily treated with cream from the pharmacy.

Menopause is also associated with irritation of the vulva.

Decreasing estrogen levels lead to thinner, dry skin that is prone to itching.

An estrogen cream can be used to improve things.

Lichen sclerosus is a skin condition that causes itchy patches on the genitals, especially in women over 50. The patches are often paler rather than dark and typically appear on the vulva.

It is an important condition that must be treated to prevent longer-term damage from scarring of the genitals, and it also carries an increased risk of cancer.

All women who suffer from genital itching should remember to avoid soap, bubble baths and heavily scented detergents, including fabric softeners and organic laundry detergents.

Beware of sharks offering you money for care

I have heard worrying reports of companies charging older, vulnerable people thousands to “help” them arrange NHS-funded home care.

It refers to something called NHS Continuing Healthcare – cash earmarked to pay for care at home for some patients with extremely complex needs.

Accessing this can be a tricky process, and there are online companies that claim to be able to handle the paperwork, but for a huge upfront fee.

I was told that these companies target people who are clearly not entitled to further care and then when they fail to provide care they do not provide reimbursement.

I want to put a stop to this. If anyone has been contacted by such a company, please write to me and tell me. For real advice on NHS continuing healthcare, contact your GP.

Don't ignore a lung scan letter

If you receive a letter or text inviting you to a lung health check, please go!

The NHS recently launched the first lung cancer screening program.

Over the next few weeks, large trucks equipped with mobile lung scanners will be stationed in supermarket parking lots across the country to make it easy for smokers and ex-smokers to get a quick and potentially life-saving chest inspection.

There are now highly effective treatments for lung cancer, but most of them are only available to patients if their disease is detected early. A pilot of the program launched last summer, with 600 people diagnosed earlier.

Around 23 trucks are currently doing the rounds and another 20 are ready for use. If you are eligible, you will receive an invitation. It could save your life.