Tinnitus can be described as a sound in one or both ears that does not have an external source, meaning that it comes from inside the ears. It can also be heard in the head. Tinnitus can be intermittent or present all the time.
Tinnitus can be described or heard as ringing, noise, roaring, buzzing, whooshing, humming, throbbing or hissing sounds.
If there are no other associated symptoms, tinnitus is unlikely to be a sign of anything serious.
The exact cause of tinnitus may not always be obvious, and it can be related to an ear infection or a build-up of earwax. These can easily be treated.
The other common causes are ear conditions such as Ménière’s disease or hearing loss, diabetes, thyroid disease, and medications like ibuprofen and aspirin.
Multiple sclerosis, stress, anxiety or depression, some antibiotics and chemotherapy, recreational drugs, excess noise exposure, and alcohol are among other possible causes.
Very rare causes include vestibular schwannoma, stroke, cholesteatoma, and glomus jugulare tumour.
Tinnitus can be improved by trying to relax and deep breathing, with better sleep, by avoiding aggravating factors, and with stress and anxiety reduction.
It is not advisable to have total silence or focus on tinnitus. Listening to soft music or sounds may distract tinnitus and be beneficial. This is known as sound therapy.
If the cause of tinnitus is not known or cannot be treated, there are various other therapies that can be considered. Digital tinnitus-related cognitive behavioural therapy or CBT, tinnitus counselling and tinnitus retraining therapy can be beneficial.
Tinnitus retraining therapy involves using sound therapy to retrain the brain to tune out and be less aware of the tinnitus. It is not clear if this therapy works for everyone.
Group-based tinnitus related psychological interventions including mindfulness based cognitive therapy, acceptance and commitment therapy or ACT, and joining support groups can also be useful.
Some people may find neuromodulation devices like Lenire or Neuromod useful for tinnitus but the effectiveness of these is not clear and they may not work for everyone.
There are no specific medications, herbal remedies or supplements that are proven or licensed to cure tinnitus.
The general advice is to see a doctor in person for further assessment if tinnitus is constant or getting worse and if it is affecting daily life or sleep.
Feeling tired sometimes is normal and almost everyone feels tired or fatigued at times due to various daily activities. But, feeling tired all the time may not be normal, and this could be due to various reasons.
The common causes of tiredness and fatigue are sleeping difficulties, insomnia or sleep apnoea, sedentary lifestyle with unhealthy diet and lack of exercise, dehydration, recent illness, stress, or excess caffeine.
The other possible causes are thyroid disease, anaemia, vitamin deficiencies, depression, anxiety, and hormone imbalances.
Hormonal changes that occur during puberty, pregnancy or menopause can lead to unusual tiredness.
There are rarer causes of feeling tired all the time and these include heart or kidney disease, diabetes, chronic fatigue syndrome, fibromyalgia, and rheumatoid arthritis.
If the tiredness is usually during the day because of frequent waking up at night and gasping for air or snoring, this may be related to sleep apnoea.
Lack of energy with pale skin, heart palpitations and shortness of breath could be due to iron deficiency anaemia.
Diabetes can cause excessive tiredness, weight loss, increased thirst, and frequent urination, particularly at night.
Symptoms of tiredness with nervousness, anxiety, irritability, and muscle weakness may suggest possible overactive thyroid or hyperthyroidism.
Extreme tiredness combined with problems thinking, memory and concentration issues, and flu-like symptoms could be due to chronic fatigue syndrome or CFS.
The treatment for tiredness and fatigue depends on the underlying cause. It may therefore be necessary to have routine blood tests to check for anaemia, vitamin deficiencies, diabetes or thyroid disease.
Iron deficiency anaemia can be treated with iron supplements.
Thyroid disease could easily be treated with appropriate thyroid medication.
If sleep apnoea is suspected, it is advisable to go to sleep apnoea clinic for further assessment and confirmation studies. This may be treated with lifestyle changes or a CPAP machine used at night.
Sleeping tablets may be considered if the underlying cause is insomnia.
The other possible treatment options for tiredness and fatigue are talking therapies such as CBT or cognitive behavioural therapy, and lifestyle changes.
Tiredness and fatigue can be improved by having a healthy diet and doing regular exercise.
It is recommended to have a good sleep routine and aim for 6 to 9 hours of sleep a day. A couple of hours of relaxing before sleep time can also be beneficial. It is best to choose a comfortable room without excess light, noise and heat.
It is advised to avoid smoking, excess alcohol and caffeine, and smartphones or screens in the hour before sleep.
One of the other causes of abnormal vaginal discharge is an infection called trichomoniasis. This is a sexually transmitted infection or STI, and it is caused by a parasite called Trichomoniasis vaginalis or TV.
It can affect both women and men, although it is more common in women.
In women, Trichomoniasis usually infects the vagina and the urethra. The infection is spread by having unprotected sexual intercourse. It can also be spread by sharing uncleaned sex toys.
Trichomoniasis is not thought to be spread through oral or anal sex, kissing, hugging, sharing cups, plates or cutlery, or through toilet seats.
The main symptom of trichomoniasis is yellow-green vaginal discharge that can be thick, thin or frothy. The discharge may have an unpleasant fishy smell.
Trichomoniasis can cause swelling, itching and soreness around the vagina. There could also be pain or discomfort on urination and when having sexual intercourse.
The symptoms may not occur immediately after exposure, and they usually develop within a month of infection. It should be noted that half of those infected with Trichomoniasis do not show any symptoms, but they can still pass the infection on to others.
Trichomoniasis is usually diagnosed after an assessment and examination of the genitals and a swab test taken from the vagina or penis.
The treatment for Trichomoniasis is with a course of antibiotic called metronidazole. This antibiotic is usually taken for 5 to 7 days to clear the infection. The course should be completed without any interruption to ensure complete and effective clearance.
Sexual intercourse should be avoided while on the treatment until the infection clears up to prevent reinfection.
Current and recent sexual partners should also be treated to prevent the spread of the infection.
Trichomoniasis infection does not usually cause any complications or major health issues. However, it is advised to see a doctor if the infection occurs in pregnancy as there may be a risk of prematurity or low birthweight.
Trichomoniasis is less common in men compared to women. Men often have fewer symptoms or may be asymptomatic.
In men, it typically affects the urethra, although it can also affect the head of the penis or prostate gland.
The symptoms in men are pain on urination and ejaculation, urinary frequency, thin, white discharge, swelling and redness around the head of the penis or foreskin.
The treatment for men is the same as for women and is with a course of metronidazole.
Urinary tract infection or UTI may involve the urethra, bladder, kidneys or ureters which are the tubes between the bladder and kidneys. Infection of the bladder is known as cystitis. If the infection involves the urethra, this is called urethritis.
The common symptoms UTI are pain or burning sensation while urinating, urinary frequency, cloudy urine, needing to urinate more urgently, lower abdominal pain, high temperature, and rarely blood in the urine.
If the infection is higher up or in the kidneys, there could be pain in the back where the kidneys are located.
If the urine is dark colour and has an unusual odour and there are no other symptoms, this could be due to dehydration rather than infection. This can easily be managed by drinking plenty of fluids.
The main cause of urinary tract infections is bacteria that enters the urethra from stools. Since the urethra is shorter in women, the risk of infections is higher in women.
If the bacteria move higher up in urinary tract, it can cause cystitis in the bladder and kidney infection in kidneys.
There are certain factors that can increase the risk of UTI, and these include sexual intercourse, pregnancy, kidney stones, enlarged prostate in men, weak immune system, diabetes, urinary catheters, dehydration, and poor genital hygiene.
There are urine test kits at pharmacies that can be used to check for the infection if there are any doubts.
If the symptoms of UTI in females are quite mild, over the counter remedies such as Cystopurin, Cystoplus, Hiprex or AZO urine infection medication can be tried first. Plenty of fluids including cranberry juice can also help clear the infection.
The effectiveness of these is not clear and they may be more effective at preventing the infection rather than treating it.
Paracetamol can be taken if there is pain or a high temperature.
More severe symptoms of UTI require treatment with a course of antibiotics.
It is recommended to see a doctor in person if it is the first presentation of UTI, if the infection affects a child, man or pregnant woman, or if the symptoms return after treatment.
Kidney infection can present with a very high temperature, blood in the urine, back or kidney pain and confusion. This type of infection requires urgent assessment and treatment.
Children with urinary tract infection can have a high temperature, vomiting, bed-wetting and can look unwell. Children with these symptoms should be taken to see a doctor for early diagnosis and appropriate treatment.
UTIs can be prevented with simple measures. It is advised to wipe from front to back when going to toilet to prevent the bacteria from entering the urethra. Good genital hygiene, washing the skin around the vagina with water before and after sex, and urination after sexual intercourse can also help.
It is recommended to drink plenty of fluids to prevent dehydration which can increase the risk of infections.
It is best to avoid scented soaps and tight synthetic underwear as these can cause irritation leading to infection. Excessive amounts of alcohol can irritate the bladder and sugar can encourage bacteria to grow, so these should be avoided.
It is advised to use condoms and a diaphragm with non-spermicidal lube to reduce the risk of infection.
If there is history of UTIs coming back, D-mannose and cranberry products can be beneficial, although the evidence is not strong for these, and they may not work for everybody.
It should be noted these contain a lot of sugar, and cranberry products should not be taken if on warfarin medication.
Urine culture tests may not always pick up the infection. The decision to start antibiotics is usually based on whether someone has symptoms of UTI. So, if someone has symptoms of UTI and has normal urine test and culture, they may still require treatment with antibiotics.
Chronic UTIs may require long-term treatment with antibiotics and a referral to see a specialist doctor.
Vaginal discharge is normal, and it is due to fluid or mucus that the body produces to keep the vagina clean and moist and to protect it from infections.
Most women and girls produce vaginal discharge, and there may be normal changes in the colour, texture and amount depending on the age of the person and stage of their menstrual cycle.
If the discharge is clear or white colour, slippery, wet and sticky and if it does not have an unpleasant smell, it is likely to be normal.
Vaginal discharge can get heavier during pregnancy, during time of sexual arousal and if on contraception.
White, odourless, thick and sticky discharge is common at the beginning and end of the periods.
Clear and wet discharge is normal around ovulation. If the discharge becomes stretchy and mucus-like rather than watery, this indicates that ovulation is taking place.
Brown and bloody vaginal discharge can happen during and right after periods.
Slight yellowish discolouration of vaginal discharge can occur when exposed to air and it is not always due to an abnormality.
Dark yellow or green discharge which is thick and has an unpleasant odour may indicate infection.
There are several infections that can cause abnormal vaginal discharge.
Vaginal thrush is a common fungal or yeast infection affecting women. This is not classified as a sexually transmitted infection or STI.
The common symptoms of vaginal thrush are white creamy discharge that does not usually smell, redness, itching and irritation around the vagina, vaginal soreness or pain, and soreness when urinating or during sexual intercourse.
There are self-test kits available at pharmacies and these can be used to confirm the infection.
Vaginal thrush can be treated with a pessary or cream, a combination of pessary and cream, or an oral tablet.
A commonly used treatment is clotrimazole pessary and cream combination that is available at pharmacies without a prescription. This is used only once.
Applying Canescool Soothing Cream Gel, Vagisil or Sudocrem can soothe the area and help with itching, burning, irritation and swelling.
If clotrimazole pessary and cream do not work, the next step is to take fluconazole 150 mg oral capsule, or fluconazole capsule plus external clotrimazole cream.
Thrush can take 7-14 days to clear. There is no need to treat partners if they do not have symptoms.
Some women may get recurrent vaginal thrush infections. Getting more than four infections in 12 months is usually considered recurrent infection.
There are various causes of getting recurrent vaginal thrush and these include using irritants that can change the pH of the vagina, hormonal changes, poor vaginal hygiene, genetic predisposition, stress, tight clothing, or being on antibiotics.
The other causes are rare yeast infection such Candida Glabrate, diabetes, immunosuppression or weak immune system.
Recurrent vaginal infections may require treatment with an antifungal medication up to 6 months.
Some women may suffer from vaginal thrush after having sexual intercourse. This could be due to several reasons.
Semen has an alkaline pH and this can temporarily disrupt the natural acidic environment of the vagina, leading to vaginal thrush.
Friction during intercourse can cause microscopic injuries to the vaginal lining and this can facilitate yeast growth and infection.
Candida is not considered a sexually transmitted infection, but a partner who has a yeast infection may transfer Candida during intercourse.
Some lubricants, spermicides, or latex in condoms can irritate the vaginal lining, increasing susceptibility to thrush. These should be avoided when having sexual intercourse.
Wearing tight or non-breathable clothing after intercourse may create a moist environment leading to yeast growth, so these should also be avoided.
The usual antifungal thrush treatments can be taken to treat the thrush that occurs after sexual intercourse.
If these do not work, oral antifungal medication may be required.
Oral or vaginal probiotics may help restore the natural balance of bacteria and these can be beneficial.
It is recommended to use fragrance-free soaps and personal care products, and to avoid douching or using scented products in the vaginal area. Water and an emollient such as E45 cream can be used to wash the affected area.
It is advisable to urinate after intercourse to flush out potential irritants, and to wear loose, breathable cotton underwear, and to maintain good hygiene without over-washing.
The general rule is to see a doctor in person if vaginal thrush occurs for the first time or in those under 16 or over 60, if it happens in pregnancy and breastfeeding, if treatment has not worked, or if there is history of weakened immune system.
The most common cause of vomiting and diarrhoea is viral gastroenteritis. The other names commonly used are stomach bug and food poisoning.
Vomiting and diarrhoea are common in adults, children and babies. This is usually a self-limiting condition meaning that it settles down on its own without any treatment.
There is no specific treatment for gastroenteritis and the important thing is to drink plenty of fluids to avoid dehydration. Fruit juice and fizzy drinks are not recommended as they can worsen diarrhoea.
The recommendation is to avoid heavy diet and to have light diet including soup and dry toast. Fluids should be consumed in smaller amounts and more often to prevent nausea and vomiting.
Paracetamol is available for abdominal pain, cramps and aches. Over the counter Dioralyte and Pedialyte are oral rehydration fluids and are thought to help with symptoms of gastroenteritis.
It is best to avoid ibuprofen and similar medications as they can aggravate stomach pain.
Vomiting usually lasts about 24 hours and diarrhoea can last up to 7 days.
Loperamide or Imodium is available at pharmacies to help with diarrhoea, however, it is advised to be cautious with this as it can cause constipation which can be difficult to manage. Loperamide is not suitable for children under 12 years of age.
Gastroenteritis is contagious and it is advised to wash hands with soap and water frequently. It is not recommended to prepare food for other people, or to share towels, cutlery or utensils.
It is advised to stay off school or work until there have not been diarrhoea or vomiting for at least 48 hours.
If the symptoms are severe, or if there is severe abdominal pain, dizziness or fainting, it is advised to see a doctor for more urgent assessment.