Why you MUST tell your doctor about your itchy groin: It’s the symptom so many patients are too embarrassed to ask about but this is why you can’t ignore it… and how to deal with it for good, writes DR ELLIE

I’m a man in my 50s and my groin is always itchy. What could be the problem?

Dr Ellie answers: Persistent groin itching may be caused by a fungal infection.

This is a very common problem but many men and women are often embarrassed to mention it to their GP.

The skin in this area is particularly hot and moist, making it prone to irritation and infection. The most likely cause is simple skin irritation that is not triggered by any insects.

Instead, tight or tight underwear and pants can cause permanent chafing. Shower gels, soaps and laundry detergents are also common triggers.

Switching to loose-fitting underwear and using a soothing hydrocortisone cream, available from most pharmacies, are sensible first steps.

The groin is also a key site for thrush, a fungal infection that thrives in warm, humid conditions. This causes chronic itching and the skin may appear red, although not always. An over-the-counter antifungal cream such as clotrimazole used consistently for two to four weeks will usually clear it up.

Those who suffer from eczema or dermatitis anywhere on their body may find that the same condition affects this area as well. The same emollient and care creams used in other parts of the body can be safely applied here.

For patients who have not had eczema or dermatitis before, look for patches of red, scaly skin.

Less commonly, itching in this area may be caused by lice acquired through close physical contact. These tiny insects attach to coarse body hair and lay eggs. Patients may notice small brown or gray spots moving around in their hair or small white eggs, known as nits, attached to hairs close to the skin.

You can obtain treatment creams from pharmacies and sexual health clinics.

It is worth noting that recurrent thrush can sometimes be an early sign of undiagnosed diabetes, so persistent symptoms deserve a GP evaluation.

If the problem does not resolve within a month, a GP should examine the area to rule out any underlying cause.

I am 86 years old and use amitriptyline for my neck arthritis. However, I was told that this medication may increase my risk of dementia. Should I consider getting rid of this?

Dr Ellie answers: The benefits of amitriptyline for an 86-year-old arthritis patient outweigh the risks.

Every medical treatment involves weighing the pros and cons, and that applies here as well.

Amitriptyline is particularly effective for a type of deep, persistent neck pain that does not respond well to standard painkillers such as paracetamol. It also helps with sleep, which is crucial for cognitive health.

Concerns about dementia are understandable. Amitriptyline belongs to a class of drugs called anticholinergics that have been associated with a modest increase in the risk of dementia due to their effects on memory. This is worth taking seriously. But the risk remains relatively low. Moreover, sleep disruption is almost certainly more dangerous because it can cause daytime sleepiness and significantly increase the risk of falls.

Unmanaged pain carries its own physical and mental health consequences. Patients should always discuss stopping or changing medication with their doctor. This is especially important for a drug like amitriptyline, which can trigger unpleasant withdrawal symptoms such as nausea, headaches, and insomnia.

I have peripheral neuropathy in my foot. Now it’s climbing up my legs. What can I do to stop its progression?

Dr Ellie answers: The most important step in managing peripheral neuropathy is finding out what causes it because treating the underlying cause is the best chance of slowing progression.

Peripheral neuropathy (damage to nerves outside the brain and spinal cord) causes a tingling sensation under the feet and pain radiating down the legs.

It can be a debilitating condition, but there are steps that can be taken.

The most common causes are diabetes and a deficiency of vitamin B12, an important nutrient for nerve health, as are meat and dairy products. Both can be diagnosed and treated. B12 injections, for example, can make a significant difference if the cause is deficiency.

Meanwhile, diabetes, in which excessively high blood sugar harms the body, can be managed with dietary changes, regular exercise and prescription medications.

Other known causes include certain medications (chemotherapy and some antibiotics), as well as chronic kidney disease, autoimmune conditions such as lupus, and excessive alcohol use.

Each of these requires its own management.

For the pain itself, tablets such as gabapentin and pregabalin are usually used.

It is worth resorting to physiotherapy to build muscle strength in the affected areas.

A daily walk is also really beneficial. The NHS website offers further guidance on possible exercise routines that may help.

Why isn’t summer drinking fun in the sun?

I’m enjoying the heatwave, but as a nation of drinkers, I can’t help but worry about the damage we’re doing to our livers when the sun comes out.

Many don’t realize that even a short period of binge drinking can lead to serious damage, sometimes even potentially fatal liver disease.

If anyone is concerned about drinking in the summer months, they should request a liver function test from their GP.

I advise my patients to pace themselves when drinking in the sun. Enjoy it, of course, but you can switch between alcoholic and non-alcoholic drinks, for example.

If anyone is concerned about drinking in the summer months, they should request a liver function test from their GP.

Have you struggled with binge drinking in the summer? Have you had your liver checked? Please write to the email address above to let me know.

Name change means a lot

I was very pleased to see that the common female hormone disorder PCOS has been renamed.

It is known that this health problem triggers menstrual irregularities, excessive hair growth and fluid-filled sacs called cysts in the ovaries.

It was previously known as polycystic ovary syndrome, or PCOS, but experts argued that it gave the impression that it was primarily linked to cysts, when in fact many women never developed these cysts.

It was instead renamed polyendocrine metabolic ovarian syndrome, or PMOS, because it is more strongly linked to blood sugar levels; Metabolic refers to how the body processes energy, such as blood sugar.

It’s certainly a mouthful, but with a focus on treating blood sugar issues, women can now experience some significant improvements with their treatments; especially because it will meet their real needs.