Your heatlh questions answered

MORE THAN JUST 'GRISTLE'

My daughter has a lump in her neck, which affects her breathing when lying down. The doctor said it was just gristle, but now she has one on the other side. Can you help?

All lumps in the neck need to be taken seriously. The idea that a lump in your daughter's neck, which interferes with her breathing, is just " gristle" is ridiculous and possibly downright dangerous. You don't give me much information to work on, but the lumps could be enlarged thyroid gland, which can press on the windpipe. Other possibilities include swollen glands and even cancerous growths. I don't really know what her doctor means when he uses the term "gristle". I think of gristle as fibrous tissue that you find in the middle of a piece of steak. There is certainly no gristle in a healthy human neck. I urge your daughter to get some good medical advice as soon as possible. An ultrasound scan is a good way of looking at lumps in the neck. But a careful examination by a sensible doctor is pretty good, too.

SEX AFTER MENOPAUSE

How long after the cessation of a women's menstrual cycle is it possible to have unprotected sex without the fear of pregnancy?

Menopause is defined as the time when menstrual periods cease. But the end of periods does not always coincide with the end of hormonal activity within the ovaries. Studies have shown that some women have hormonal levels in the six months after menopause that are indistinguishable from the levels before their last period. This means that the ovaries may still be capable of releasing an egg, which could result in pregnancy. Most women experience the menopause between 47 and 53. But for some women the age of menopause can be much earlier or a few years later. The usual advice is that a woman should wait one year after her last menstrual period before she stops using contraception. If the last period is under the age of 50, she should use contraception for a further two years. Fertility falls off from the late thirties, but there are plenty of stories of women in their late forties who go to see their doctor about hormone replacement therapy because their periods have stopped, only to find that they are pregnant.

Please send your questions and suggestions to A Question of Health, 'The Independent', 191 Marsh Wall, London E14 9RS; fax 020-7005 2182, email health@independent.co.uk. Dr Kavalier regrets that he is unable to respond personally to questions.

Readers write

DM wonders if his twin's penicillin allergy is genetic: My brother and I both had penicillin in the Fifties to treat ear infections. About 13 years later he had another course but suffered a serious and painful reaction. A few years later he suffered a similar reaction to anti-tetanus. I subsequently avoided both. Do you think this was wise?

Dr K replies: It was cautious, but probably unnecessary. Being unprotected from tetanus is riskier that having a tetanus booster. Avoiding penicillin is unlikely to do any harm, because there are plenty of alternative antibiotics.