Ask Dr. Kate - December 2023

Last week, we launched our new series ‘Ask Dr. Kate’, which sees our in-house GP answer questions that are submitted by our members. Each month, Dr. Kate answers questions from the talkhealth community and uncovers key trends that she is witnessing in surgery.

If you would like your questions answered, you can submit them via this survey. If you missed the event, here are the key questions answered…

My fibromyalgia symptoms have worsened since I stopped taking sertraline, is this normal? 

‘Sertraline is an antidepressant and there is some evidence that shows that antidepressants can be effective in supporting people with the symptoms of fibromyalgia. Antidepressants affect our neurotransmitters in the brain, and some of these are involved in the symptoms of fibromyalgia. So, it makes sense that there might be some benefit from taking such a medication. 

‘What we know is that the effectiveness of antidepressants on fibromyalgia is independent of any effect that they might have on comorbid depression.’

‘If you are wondering whether you should restart the medication to help with your symptoms, I would say that it’s probably worth restarting. It is a very safe medication that you can take long term.’ 

What are Varicoceles? And, how do they affect male fertility?

‘Varicoceles are actually very common, we probably see them in around 15% of the male population. Most of the time they go unnoticed, but men might come across them when they are performing regular testicular self-examination.

‘They are often described as feeling like a bag of worms, and they are an abnormal swelling of the testicular veins. They are felt in the scrotum, but they separate from the testicles. 

‘In my knowledge, there is very limited evaluation of the impact of varicoceles on sexual function. The only sexual symptom which seems to have significant association with  varicoceles is actually premature ejaculation.’ 

Is the PSA test accurate for flagging prostate cancer? 

‘The Prostate Specific Antigen Blood Test (PSA), which is usually the first step in a diagnosis, is not nearly accurate enough as a primary screening test. It is not sensitive or specific enough to pick up cancer and differentiate between what might be cancer, and what isn’t. 

‘Currently, it can miss a lot of cancers and it can also be raised when there is no cancer, resulting in people going through invasive investigations. The PSA blood test has never really met the criteria as a screening test.

‘If you have no symptoms, it is still reasonable to ask for a PSA blood test as long as you understand the limitations of the test and possible following investigations if it comes back positive.’ 

How do I treat a persistent cough?

‘I have been seeing a lot of persistent coughs in surgery at the moment, particularly if it is keeping people awake at night. This is most likely to be a post-infectious cough. I would very much promote the support that people can get from pharmacists, over the counter preparations can be very helpful if a cough has lasted between two and eight weeks. 

‘If the cough persists longer than two months, I am always keen to re-examine patients and be questioning quite carefully where the cough might stem from.’


If you would like your questions answered, you can submit them via this survey.

Information contained in this Articles page has been written by talkhealth based on available medical evidence. The content however should never be considered a substitute for medical advice. You should always seek medical advice before changing your treatment routine. talkhealth does not endorse any specific products, brands or treatments.

Information written by the talkhealth team

Last revised: 15 December 2023
Next review: 15 December 2026