My skin is crawling

Q I am a 57-year-old post-menopausal woman; I have been on HRT for three years which controls the hot flushes, but I suffer from creepy-crawly skin that, I believe, is called formication. It feels as if I am plugged into an electric socket, is extremely unpleasant and has been going on for more than a year. I am in very good health otherwise. My doctor says that I should have a more positive outlook and she refuses to refer me to a menopause clinic as they just hand out more hormones. Any suggestions?

A I was fascinated by your letter, especially since I had never heard of "formication". Apparently it means an unpleasant sensation of ants or other small insects crawling over your skin. Freud experienced it when he used cocaine, which he was partial to and prescribed to his patients. It can also be a side-effect of other drugs such as benzodiazepines, including Valium and the sleeping pill Temazepam. Changes in the way your skin feels and looks are common after the menopause. Women often say that their skin feels itchy or dry and perhaps your formication (love that word!) is linked to that. If you are on any non-vital drugs, consider discontinuing them. Moisturising dry skin and taking an antihistamine at night to soothe itches are worth a try. If the formication started when you went on HRT, you could come off HRT for a bit, and restart it if the hot flushes return. And if you want to go to a menopause clinic to talk to an expert, insist on a referral.

Bedtime is a battle

Q My 10-year-old will not go to bed until we do; normally about 11pm. He isn't tired or suffering but has to get up at 7am. Is there any harm in not sleeping for longer?

A Two reasons to get him to bed earlier: one is a new American study that measured 77 nine-12-year-olds' reactions and behaviour after varying amounts of sleep. They showed that an extra hour's sleep a night was advantageous to the kids. Arguably more important is your own psychological wellbeing. No one has done the study, but any parent will testify to the benefits of at least an hour of child-free down time before you collapse into bed yourself. I have no idea how you get a reluctant 10-year-old to bed and would greatly welcome readers' tips.

Is testosterone safe?

Q I am 48, male, and during the past few years have had much less energy, found it hard to concentrate and take control of situations, and noticed that I put on weight easily, especially round the chest - my breasts have developed embarrassingly. A hormone test three years ago showed my testosterone level to be just within normal levels; it may well be lower now. I am wondering if testosterone patches or gel would help me. If so, are there any risks? I don't want to become over-sexed and aggressive. I know testosterone is available on the internet - is this safe and reliable?

A Lots, perhaps most, men in their late 40s will relate to your question. Ask yourself whether you were fitter, leaner and more driven in your 30s than you are in your late 40s. For most of us, male or female, the answer is usually "yes". Scientists know that hormone levels fall as we age. For women, there is a dramatic fall in oestrogen levels after the menopause. And women who take oestrogens as HRT, often notice their symptoms - such as hot flushes - improve rapidly. For men, the hormonal decline is more gradual and it is much less certain whether the falling testosterone causes the sort of changes you have noticed in yourself. The acid test is whether taking testosterone makes you feel better. A few men have abnormally low testosterone levels because their testicles are small and don't make much of the stuff. For these men, testosterone supplements are a good idea and should boost energy, mood, sex drive, erections and muscle bulk. For men like yourself whose testicles are probably a normal size and testosterone level normal for your age, you may not get that boost.

Testosterone is no free lunch - there is an increased risk of hormone-dependent cancers (such as prostate cancer) if taken for long periods. Viagra works better for flagging erections. And other hormonal changes, such as diabetes and an underactive thyroid may be responsible for your symptoms and are easy to treat. What you do next depends on how risk averse you are. To live dangerously, order some testosterone from the internet, suck it and see. To play it safe, see your GP or be referred to a urologist, for specialist advice and a prescription. Or take the boring but safe route by losing weight and doing plenty of physical and mental exercise.

Vertigo cure terrifies me

Q I have benign positional vertigo. In order to arrive at this diagnosis my consultant had to make me extremely dizzy, causing me to vomit and feel dreadful.

I am now very apprehensive because I understand that to cure the condition, more of the vertigo-inducing exercises will be necessary. Can you offer me any reassurance? Is there an alternative treatment?

A Vertigo is ghastly - like being seasick all the time. Your type is the commonest type, if that's any comfort. A wave of dizziness and nausea is set off by turning you head in one direction or looking up. The wave usually lasts a few seconds then passes.

There are lots of other causes of vertigo, such as Meniere's disease - in which you also get hearing loss and ringing in the ears (tinnitus). Drugs, anxiety, poor blood supply, head injuries and tumours in the ear can all make you dizzy, too. But the key to your condition is that attacks are triggered by moving your head. If your vertigo is severe, you may not be able to drive and need to be careful on ladders, scaffolding or when swimming. Drugs that settle the nerve of balance running from the inner ear to the brain, can work well; prochlorperazine (Stemetil) is most widely used.

Exercises and head manoeuvres that retrain your balance can work wonders. You may feel dizzy while being shown what to do, but for many people it can solve the problem without the need for drugs. The exercises should not be as bad as the original diagnosis was.

· These answers are intended to be as accurate and full as possible, but should never be used as a substitute for visiting a doctor and seeking medical help. If you have a question for Dr Robinson, email drann@dircon.co.uk or write to her c/o The Health Editor, The Guardian, 119 Farringdon Road, London EC1R 3ER. She regrets that she cannot enter into personal correspondence.