I’m a GP – here’s why you need to stop being embarrassed and use the right words for your bits

The weather is still a bit bad in May.
It may shift from sunshine to clouds and showers, but you still need to protect your skin.
Even when it’s cloudy, you can get sunburned in the UK.
Yes, really!
Everyone should apply sunscreen with SPF 30 or higher to their face and exposed skin daily.
Also look for sunscreen with at least 4-star UVA protection.
Make a habit of putting it on so you’re ready for summer.
Here’s what readers asked me this week. . .
Q: I have noticed an itchy feeling downstairs and have been given ClobaDerm cream by my doctor.
I also went to a gynecologist and they gave me the same thing and told me to use it for two months.
But I’m worried it might be cancer.
What should I do?
A: I am assuming that by “below” you mean your vulva, the outer part of the female genitalia.
The clues were that you saw a gynecologist, which means you have to write about women “downstairs” and use a topical cream.
I say this to emphasize how important it really is, when we know it, to use the correct terminology to describe parts of our bodies, especially with the rise of e-consultation and increasing online searches for medical information.
So I hope that by writing this, people will become more confident that the use of words like “vulva”, “vagina”, “penis”, “testicles” and “clitoris” is correct.
There’s no shame and it’s not rude.
ClobaDerm is a brand name for a powerful steroid drug called Clobetasol.
It is used on the skin to reduce swelling, itching and irritation associated with a number of conditions including eczema, psoriasis, lupus and lichen planus.
There is also a condition called lichen sclerosus that most commonly affects the genital skin.
Women with LS can experience severe itching of the skin of the vulva, anus, and the area connecting them, the perineum.
The skin may also be inflamed or appear whitish or pale.
Sometimes it can become very sore from scratching.
When the doctors treat this, they should have told you the name of the condition.
The cause is unknown, but the condition is not dangerous and is not a cancer. However, if left untreated, LS can cause scarring and tightening of the affected area over time.
The vulva can shrink, often affecting the clitoral hood and labia minora (inner lips) around the vaginal opening.
This type of scarring and tightness can cause discomfort when peeing, pooping, and having sex.
You may need to use the cream regularly for a few months to get your symptoms under control.
Two months is a good starting point to see how effective it has been.
If your symptoms keep coming back, you may need to keep using it from time to time.
Very rarely, women with LS can develop vulvar skin cancer.
If the treatment is recognized early, it is very successful. Therefore, it’s important to let your doctor know of any lumps or unusual changes in your symptoms.
In Sun Health last week, we spoke to women suffering from gynecologic cancers, including Clare Baumhauer, who suffered from vulvar cancer caused by LS.
To read her story, visit Sun Health at thesun.co.uk/health/22212377/gynaecological-cancers-nothing-to-be-ashamed-of/.
Q: I was referred to a long covid clinic. I worry about what will happen.
A: The NHS has launched 90 post-Covid syndrome (Long Covid) services.
Although they all operate in different parts of the country, their aim is to provide appropriate assessment, diagnostic testing and management or referral for post-Covid rehabilitation, treatment and other support.
They also help us to better understand the post-Covid syndrome.
Typically, your first appointment will be with a doctor who is experienced in this area, and there is nothing to worry about.
You’ll likely be offered a range of tests on the same day, based on your individual physical and mental health symptoms – such as questionnaires, blood tests, blood pressure and fitness tests.
At a later date, the doctor will recommend a plan of action.
Specialists, nurses, psychologists, physiotherapists and other therapists will work together to help you as best as possible.
The National Institute for Health and Care Excellence’s definition of post-Covid-19 syndrome is: “Signs and symptoms that develop during or after an infection related to Covid-19, lasting longer than 12 weeks and not caused by a alternative diagnosis can be explained.”


Common symptoms include fatigue, difficulty concentrating, muscle aches, shortness of breath, chest tightness or pain, palpitations, and changes in heart rate.
Patients may also experience joint, back or shoulder pain, brain fog, amnesia, hallucinations, headache, dizziness, anxiety, depression, nausea, persistent cough and sore throat.
The heart rate drops
Q: I have always had a low heart rate (usually 40 beats per minute or more) and low blood pressure.
I suffered from heart palpitations during menopause and still do occasionally.
Recently my heart rate has dropped to 36 beats per minute with an irregular heartbeat that takes my breath away at times.
I’m 62. It’s so hard to get a doctor’s appointment.
Should I bother them or can I live with it?
A: What you describe is called bradycardia, a slow heart rate with a pulse rate of less than 60 beats per minute.
We call a normal rate a value between 60 and 100.
Some people have a naturally low heart rate, and this is common in elite athletes.
However, if the rate is below 40, blood pressure is low (systolic below 90), or the person is showing symptoms, urgent medical attention is needed.
Symptoms include chest pain, dizziness, confusion, shortness of breath, palpitations, feeling cold, or tiredness.
There may be a problem with the way your heart’s natural pacemaker works.
The irregular heartbeat could be due to “ectopic beats,” where the heart uses a different process to generate the heartbeat, in this case because the signal from the pacemaker takes so long.
This condition is called sick sinus syndrome, but it can also be caused by heart block or atrioventricular block.
You urgently need an EKG to determine the cause. My advice would be to talk to your GP or contact the emergency room if you have any other symptoms.