I recently had a severe bout of vertigo as I got out of bed. The room started to spin and I felt sick. It has improved, but I still get dizzy when I move suddenly – will it ever completely clear up?
Pam Murphy, Kent.
Dr Martin Scurr replies: Your symptoms are a textbook case of benign paroxysmal positional vertigo (BPPV). It’s due to a problem in the inner ear, which plays a key part in our sense of balance, causing dizziness (or vertigo, as it’s known medically).
The sensation is triggered by any major movement of the head, such as when getting up from or rolling over in bed, looking up or down, or bending over.
The dizziness itself usually lasts for a minute or so, but symptoms can also include longer-lasting nausea and vomiting. Half of those affected also experience some unsteadiness on their feet between attacks.
BPPV occurs when tiny calcium crystals from the inner ear become dislodged and aggravate the hair cells in the inner ear when you move your head – this in turn disrupts signals to the brain and causes a spinning sensation, akin to sea sickness. Why it happens isn’t clear, although it may be linked to another inner-ear problem such as labyrinthitis (an inflammation of the channels in the inner ear); it can also occur after a fall or sports injury.
Benign paroxysmal positional vertigo (BPPV) is due to a problem in the inner ear, which plays a key part in our sense of balance, causing dizziness
Another cause may be a lack of vitamin D – the crystals are formed of calcium, and vitamin D helps calcium metabolism.
BPPV is treated with the Epley manoeuvre, a series of targeted movements to guide the crystals back into place. Most GPs and physiotherapists can instruct patients how to perform this and it is normally very effective.
Medications that suppress motion sickness sensations can help as an emergency measure, while people who have recurrent episodes should be tested for vitamin D deficiency as research suggests supplements can help.
Although BPPV is benign, it can have a significant impact on quality of life as well as bringing the increased risk of injury and falls. So I’d urge you to see your GP and ask about a referral to a neurotologist (a doctor who specialises in inner ear and balance problems).
I’m 82 and can’t get an erection. I’m on blood pressure pills, a statin and a blood thinner, but otherwise in OK health.
Name and address supplied.
Dr Martin Scurr: Unfortunately the strongest risk factor for erectile disorder is your age – even being healthy.
At 82, your blood vessels may well be furred up to some degree; your testosterone levels will be lower; and your nervous system not functioning as well.
Inevitably, psychological and other factors will also play a role and your anxiety about the loss of normal sexual function cannot be ignored as an important causative factor.
Studies show that 65 per cent of men aged between 70 and 80 have some degree of erectile dysfunction, increasing to 75 per cent in men over the age of 80.
To put this another way, only 25 per cent of men over the age of 80 experience normal erectile function. So you are not alone. I don’t think your medications are to blame, indeed there’s evidence that statins can slightly improve erectile function.
You could ask your GP about taking tadalafil, which won’t interfere with your other medications and can improve erectile function in some men.
It works like sildenafil (i.e. Viagra), with the advantage that you can achieve an erection for up to 36 hours, compared with four to six hours with sildenafil.
I’d also suggest asking if your blood sugar levels are normal, as even mild diabetes can have a significant impact on the nerves that are so key for an erection.
Another suggestion is checking your testosterone level – if this is low, supplementation could help. But if your level is normal, testosterone treatment won’t improve erectile function.
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