A Question of Health

Is there a safe way to get a tan? And can I regain my interest in sex?
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Bronzing quandary

Bronzing quandary

For our Christmas cruise to the Caribbean, I want to get pre-tanned. I would prefer the sunbed, because no chemicals are involved and the tan lasts longer and looks more natural. But there is skin cancer in my family. I have also heard that the chemicals used in tanning lotions can cause cancer. Is there any safe way of getting a tan?

There is no doubt that sunbeds increase the risk of several types of skin cancer. The risks are higher if you have fair skin and blond or red hair - so-called Type 1 skin. Darker-skinned people seem less susceptible to sun-induced skin cancers. The damage to skin is caused by ultraviolet (UV) rays. There are two types of UV light, UVA and UVB, and there is now evidence that both UVA and UVB can cause harm. Sunbeds tan the skin in exactly the same way as the sun itself, so the risks from sunbeds are similar to the risks from real sunlight. The most serious type of skin cancer, malignant melanoma, is becoming more common in Britain, and the reason is thought to be increased exposure to sunlight. The other two types of skin cancer, squamous cell carcinoma and basal cell carcinoma, are also now linked to sun exposure. However, spending a few hours on a sunbed once or twice in a lifetime is unlikely to make much difference to your cancer risk - although it is not a wise thing to do if you have Type 1 skin. Fake tanning lotions mostly contain vegetable dyes; they do not protect you from getting a sunburn, and their effect is short-lived, but I do not know of any evidence that they cause cancer.

A lack of desire

I'm in my early forties but hardly ever feel like having sex. I had a partial hysterectomy a couple of years ago following problems with my second pregnancy. My lack of sexual appetite is putting a strain on my marriage. Is the problem all in my head or could it be physical? Is there any point in visiting my doctor or are there other sources of help?

The problem could be physical, but it is more likely to be emotional and psychological. Reliable statistics are difficult to come by, but probably one in three couples have at least one partner who is worried about their lack of interest in sex. There is even a medical name for it: Hypoactive Sexual Desire Disorder (HSDD). I am concerned that you see this as an individual problem, rather than a problem for both of you. Often, the subject of sex becomes a taboo within a relationship where one partner is not interested. This leads to a situation in which each partner begins to imagine - sometimes quite incorrectly - that their other half doesn't want to have sex because they no longer love them. So it is very important to open the lines of communication between you and your husband. This may be easier with the help of a professional counsellor, such as someone from Relate. If the real problem is because of relationship difficulties, some frank talking may improve things. You can access Relate's services face to face, online or by phone. They even offer an E-consultation service, with a personalised e-mail reply. Visit their website at www.relate.org.uk.

Cox-2 controversy

Following two articles in The Independent about Cox-2 inhibitors, I visited my GP and said that I was not happy about continuing with Celebrex tablets. We had rather a ding-dong discussion/argument about this, but he was adamant that I continue to take them. Am I wrong to think that some sort of compromise could have been offered? I'm quite upset about it.

I'm amazed that your doctor was so adamant. One of the other Cox-2 inhibitors, Vioxx, has just been withdrawn from the market because of concerns about its effects on the heart. The Cox-2 inhibitors are used to treat arthritis and other painful conditions. Initially it was claimed that they had fewer side-effects than other treatments, like ibuprofen, but more recent evidence shows that Cox-2 inhibitors are not significantly better than older, more established drugs. If you are not happy to continue taking Celebrex, you should not be taking them. There are plenty of alternatives.

Send your questions and suggestions to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182; or e-mail health@independent.co.uk.