Ask the Pharmacist

Our highly experienced pharmacy panel tackles your questions on common health problems that affect women.

I'm in my mid-30s and have a few varicose veins in my leg. They aren't painful but they look awful. What would you recommend?

I've had regular periods all my life but now, at the age of 46, they are becoming less frequent. Could it be the start of the menopause? And if so, are there any pharmacy products I can use to make things go smoothly?

I tend to get a bad migraine each month – it always happens during the week of my period. Is there anything I can do apart from take painkillers?

Are there any vitamins that help alleviate PMS symptoms, especially mood swings and irritability?

Can I buy the morning-after pill without a prescription?

What's best for period pain?

My partner says that my smoking could be affecting my fertility. We are currently trying for a baby, so is he right?

I'm in my mid-30s and have a few varicose veins in my leg. They aren't painful but they look awful. What would you recommend?

Varicose veins are quite a common problem, especially in women. If they aren't painful, then treatment isn't normally recommended. You can, however, prevent varicose veins getting worse – and help prevent new ones appearing – by wearing properly-fitted compression stockings.

Ways to help prevent varicose veins include avoiding standing for long periods of time, and when you are resting, keep your legs raised. Taking regular exercise is also important. On a more general note, if you notice any changes in your skin's appearance, always see your doctor immediately. DA

I've had regular periods all my life but now, at the age of 46, they are becoming less frequent. Could it be the start of the menopause? And if so, are there any pharmacy products I can use to make things go smoothly?

In medical terms, menopause officially begins once you haven't had a period for 12 consecutive months. This usually happens between the ages of 45 and 55. However, women may go through premenopause and perimenopause – stages before reaching the menopause itself. During these stages, hormone levels – especially oestrogen – start to drop, which triggers symptoms such as irregular periods, mood swings, hot flushes, night sweats and vaginal dryness.

There are several pharmacy products that may help. First, home test kits can confirm whether or not you are going through the menopause. Then once menopause is confirmed, multivitamin and mineral supplements may help, since studies suggest the various stages of menopause may trigger nutritional imbalance. Vaginal dryness may also be alleviated by using products that replace lost moisture. Ask your pharmacist for their recommendations. YA

I tend to get a bad migraine each month – it always happens during the week of my period. Is there anything I can do apart from take painkillers?

Some women have migraines during their periods, the main cause being the fall in the level of oestrogen in the blood. Menstrual migraine attacks usually start from two days before to three days after your period starts. There are two types:

• Pure menstrual migraine occurs only around periods and at no other times (affects one in seven women)
• Menstrual-associated migraine occur around periods and at other times too (affects six out of 10 women).

Some women have menstrual migraine during or around the pill-free week of a combined contraceptive pill course, triggered by the fall in blood oestrogen levels.

As well as treating with painkillers, women who suffer with this condition respond particularly well to over-the- counter anti-inflammatory painkillers, such as naproxen and ibuprofen (or mefenamic acid and diclofenac on prescription).

Oestrogen supplements may help too (available as patches, gels and tablets). Changing your contraceptive pill may also be a good idea – ask your pharmacist or GP for more information. DD

Are there any vitamins that help alleviate PMS symptoms, especially mood swings and irritability?

For mild-to-moderate PMS symptoms, making lifestyle changes is the best course of action.

For instance, cutting down on the amount of salt you eat, drinking more water and eating at least five portions of fruit and vegetables will all impact positively on PMS.

Studies have also shown that exercising regularly may help improve mood swings and irritability. The evidence for using vitamin supplements in PMS is, however, inconclusive. But anecdotal reports suggest some women benefit from taking magnesium, calcium, vitamin B6 and vitamin E. Ask your pharmacist to recommend a supplement – they may be worth trying. TS

Can I buy the morning-after pill without a prescription?

The morning-after pill – or emergency contraception (EC) – is available to buy at pharmacies, but only after consultation with a pharmacist. Here's what your pharmacist will need to know:

• Your age and approximate date of your last period s When did you have unprotected sex (since EC is not effective 72 hours afterwards)?
• Are you on any other medication (and if so, what are you taking)? s Do you suffer from any underlying health conditions?
• Could you already be pregnant?
• Have you already taken EC during your current menstrual cycle?
• Have you taken EC before, and did it cause any side-effects?

Once a pharmacist has decided to sell you EC, they will also advise you about potential side-effects – particularly nausea (if you're sick within two hours of taking EC, you may need another dose) – as well as your ongoing contraception needs if appropriate. DA

What's best for period pain?

Most mild-to-moderate period pain can be easily managed by various options that are available in pharmacies:

• Heat pads Application of heat can be soothing. Most pharmacies offer a choice of heat pads that can treat period pain.
• Anti-inflammatories Drugs called NSAIDs reduce inflammation and pain as well as bleeding. There are three types available – ibuprofen, naproxen and diclofenac.
• Paracetamol Two tablets taken four times a day can – in some cases – be sufficient for managing period pain.
• Combined products For some women, the best period pain relief may come from combining paracetamol with an anti-inflammatory or with codeine.

To find out which type of product is suitable for you – especially if you have any other medical condition – ask your pharmacist. YA

My partner says that my smoking could be affecting my fertility. We are currently trying for a baby, so is he right?

Yes, he is. As well as affecting your general and long-term health, smoking is believed to prevent ovulation – which will make it more difficulty for you to get pregnant. So if you do plan to have a baby, there are many good reasons to quit smoking.

Many pharmacies now offer help to people who want to give up – ask your pharmacist what help is available to you. Good luck. TS