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NEW! Ask a Consultant Gynaecologist | Dr Giada Frontino

Giada FrontinoGiada Frontino Posts: 35 Consultant Gynaecologist
edited September 24 in Ask a Healthcare Professional

Do you have a question about sexual health and the menopause? Get practical advice on irregular bleeding, vaginal dryness, period changes, pelvic pain and menopausal wellbeing. Post your questions now and Dr Frontino will get back to you within 72 hours!


We're so excited to welcome Dr Frontino to our Expert Q&A Hub!


  ". . .The secret of the care of the patient is in caring for the patient.” - FW Peabody, 1925

About Dr Frontino 👩‍🏫

Giada Frontino is a Consultant Gynaecologist with over twelve years of experience in caring for women from adolescence through their postmenopausal years. She has a strong interest in improving quality of life in all of its aspects, especially in the delicate phases of the perimenopause and postmenopause.

Giada is known to truly engage with her patients in order to achieve wellbeing. She believes in tailored care and has a holistic approach, both of which are often commended by her patients. Giada's training in adolescent gynaecology and in adolescence-related conditions means that she has a caring and empathetic approach to easing all patients' anxiety and fears.

Giada carries out preventative work including wellwoman checkups and gynaecological ultrasound scans. Giada also speaks French and Italian.

When she is not working, Giada enjoys spending time with family and friends. She loves swimming, traveling and trekking in nature. 


💬 Simply post your questions below and she'll get back to you within 72 hours with a personalised response. 💬 


GMC Full Specialist Registration # 7468911 

Website: https://www.doctify.com/uk/specialist/dr_giada_frontino 

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Comments

  • DmingoiaDmingoia Posts: 1

    I am not sure I am in perimenopause. I am 51 with irregular periods that started about 6 months ago. I am having panic attacks and heart palpitations pretty severe. ( went to e/r and heart is fine). I have at least 30 other symptoms. The panic attacks are the worst. Went to endo and they said my thyroid is not functioning properly so they increased my synthroid meds. I asked for a hormone panel but was told I can’t have one until I am officially menopausal. I don’t know what to do. The attacks happen when I am sleeping or just trying to go out. Help

  • Julie20Julie20 Posts: 345 mod

    This lady will be an absolute God send to this page.

    Perfect ❤️

  • Giada FrontinoGiada Frontino Posts: 35 Consultant Gynaecologist

    @Dmingoia Dear Dmingoia, I am very sorry to hear you have not been feeling well for so long. With regards to these symptoms, it is important that your thyroid function is normal and that your heart has been checked. Another very common cause of anxiety panic attacks is deficiency in vitamin D and B12, so please have speak to your GP and have these tested as soon as possible.

    GMC Full Specialist Registration # 7468911 

    Website: https://www.doctify.com/uk/specialist/dr_giada_frontino 

  • VincentVincent Posts: 5

    Dear dr Frontino, Thank you so much for this opportunity. I'm 57 and I think I'm menopausal, although I haven't been tested by the GP. I can't sleep, my entire body aches and I keep forgetting things all the time. However my biggest problem is dryness down there. Sex is so painful I don't even want to be intimate with my husband anymore which of course affects our marriage. Do you have any advice please? Thank you so much. Sophie

  • Giada FrontinoGiada Frontino Posts: 35 Consultant Gynaecologist

    @Vincent Dear Sophie,

    Thank you for your questions, as these symptoms you mention are shared with many other patients I see. Because low sleep quality, aches and forgetfulness can often be caused by underlying issues, I would recommend to first of all see if your GP can run blood tests to check vitamin D levels as well as thyroid function and glucose. Once these tests show up normal, then we can think of taking specific nonhormonal treatments that are effective in balancing your hormones and therefore your wellbeing.

    With regards to the local dryness and pain I can suggest using Replens MD Moisturiser three times weekly morning applications.

    GMC Full Specialist Registration # 7468911 

    Website: https://www.doctify.com/uk/specialist/dr_giada_frontino 

  • Djdros52Djdros52 Posts: 14

    Hello Dr. Frontino, I am 52 and have been through a lot this year health wise. In Feb I had pnemonia, in April I had a infected tooth pulled, in July had a stomach infection, sinus infection, all at same time menopause issues. I have been feeling very not like myself. My Dr. Did blood work and found out my vitamin D was low, and was put on vitamin D2, buspirone for anxiety. I have hot flashes, weird feelings in my scalp, headache's, chills, panicke attacks, whole nine yards. Now I am feeling warm feeling on my left side from my but down my thigh. Is that something that goes along with menopause?

  • Giada FrontinoGiada Frontino Posts: 35 Consultant Gynaecologist
    edited September 23

    @Djdros52

    The feeling running down your thigh is unrelated to the menopause.

    With regards to the vitamin D deficiency, you should be taking Vitamin D3 instead of Vitamin D2, as the former is effective.

    Has your GP checked the thyroid function on the bloodwork?

    GMC Full Specialist Registration # 7468911 

    Website: https://www.doctify.com/uk/specialist/dr_giada_frontino 

  • MonicaMMonicaM Posts: 206 mod

    @Giada Frontino

    Welcome to the group

  • Giada FrontinoGiada Frontino Posts: 35 Consultant Gynaecologist

    @MonicaM thank you!

    GMC Full Specialist Registration # 7468911 

    Website: https://www.doctify.com/uk/specialist/dr_giada_frontino 

  • VincentVincent Posts: 5

    Thank you so much dr Frontino, I’ll certainly mention vitamin D to my GP. I looked up Replens online as Ive never heard of it. I’ll get it from my local boots tomorrow. Can I please ask for any recommendations to cope with low libido? I’ve been researching online a lot but all these supplements are just so overwhelming. Thank you so much once again, it’s great having the opportunity to speak with an expert now.

  • VincentVincent Posts: 5

    Oh I forgot to say I unfortunately can’t have HRT. Thank you

  • Giada FrontinoGiada Frontino Posts: 35 Consultant Gynaecologist

    @Vincent With regards to low libido, it is extremely important that your bloodwork checks your thyroid function. This is because thyroid disorders strongly affect libido, and can cause chills, headaches, etc.

    If your thyroid function does indeed show normal, then you can take bee pollen extract FEMAL, which has been shown to be very effective on improving sexual desire.

    GMC Full Specialist Registration # 7468911 

    Website: https://www.doctify.com/uk/specialist/dr_giada_frontino 

  • betsy_9betsy_9 Posts: 23 ✭✭

    Hello, would like a bit of advice please. I haven't had a period for 4 years, but yesterday and today I have been getting really bad stomach cramps and some light bleeding. It lasted for about 2 hours and then it stopped. I'm very worried, is this normal or should I call my doctor? Thank you

  • Giada FrontinoGiada Frontino Posts: 35 Consultant Gynaecologist

    @betsy9 Dear Betsy, any bleeding appearing after menopause should be investigated first of all through a pelvic ultrasound scan. Speak to your GP about this.

    GMC Full Specialist Registration # 7468911 

    Website: https://www.doctify.com/uk/specialist/dr_giada_frontino 

  • ToniGToniG Posts: 7

    I recently had an ultrasound which showed that my endometrium had thickened to 7mm. I now have to have a further exam to determine type of hyperplasia. When I look up causes for hyperplasia it is attributed to taking oestrogen without progesterone and furthermore, that hyperplasia does not occur when on continuous combined HRT. yet I have been on continuous combined HRT for @ 1 year. I don’t understand why this has happened. I also note that the treatment for hyperplasia is progesterone which of course I already take. I take 100g of Utrigestan every night and 1.5mg oestrogen gel.

    i am so confused and hope you can explain. Thank you

  • Giada FrontinoGiada Frontino Posts: 35 Consultant Gynaecologist

    Dear @ToniG,

    Thanks for your question. One of the most frequent causes of endometrial hyperplasia is overweightedness, which causes an excess of production of estrogen and thus causes abnormal changes in the endometrium as well as in the breast tissue.

    Other common causes are diabetes and thyroid disease.

    Given the endometrial thickening it would be best to discuss with your GP reducing the dose of estrogen you take.

    I hope this helps and please let me know if you have any other questions.

    GMC Full Specialist Registration # 7468911 

    Website: https://www.doctify.com/uk/specialist/dr_giada_frontino 

  • ToniGToniG Posts: 7

    Dear Dr Frontino

    Thank you for replying to my query. My GP will not advise as she tells me she doesn’t know about menopause or HRT. I was originally seen by a private doctor but I’m afraid it became too expensive for me. My GP agreed to prescribe the HRT, but can’t advise or help further than that.

    I too was wondering if oestrogen was too high. Apparently, one of my ovaries is still releasing eggs so I am still peri menopausal, which I expect means there is some oestrogen left. Also, my period had just started when I had the last scan.

    The Gyno I saw last week and who is doing my hysteroscopy has offered to fit a coil at the same time. My concern about the coil is that it can take a while to settle in causing spotting and pelvic pain for up to 6 months. I am already dealing with hip pain and can’t bear the thought of having more pain in that general area.

    i should probably add that since I switched to continuous HRT @ 1 year ago, I am having 2 periods per month. This seems odd to me as surely increasing progesterone would lessen bleeding? This was the main reason for the ultrasound test. Would the coil actually help? My current gyno thinks this will help but was vague about the alternatives. She wouldn’t discuss HRT dosage as she feels that the bleeding issue is the priority. Obviously they are linked but I feel that everything is looked at in isolation rather than as a whole.

    I don’t want to have 2 periods per month, and I am afraid that thickened endometrium will become cancerous unless I deal with it.

    i am a little over weight, BMI 26. I have never been diagnosed with diabetes but I do have hyperparathyroidism.

    Sorry for long message. Thank you for reading.

  • Giada FrontinoGiada Frontino Posts: 35 Consultant Gynaecologist

    Dear @ToniG,

    I suggest discussing the HRT oestrogen dosage with the Consultant Gynaecologist who is carrying out the hysteroscopy for you, as this is also a key factor in managing hyperplasia.

    The only Intrauterine device that has shown to improve endometrial hyperplasia is Mirena, which never causes pelvic pain and usually also reduces the menstrual bleeding. On the other hand, the copper coil is not ideal for endometrial hyperplasia and often causes chronic pelvic pain and heavier bleeding.

    Last but not least, the most effective way of reducing the risk for abnormal endometrial changes is to reduce sugar intake and improve your BMI to reach 23. This is key to avoid recurrences as well.

    With regards to hyperparathyroidism, have you had a blood test to check vitamin D levels? Vitamin D deficiency is often present in hyperparathyroidism, and tailored vitamin D3 supplementation can improve/treat hip pain.

    GMC Full Specialist Registration # 7468911 

    Website: https://www.doctify.com/uk/specialist/dr_giada_frontino 

  • ToniGToniG Posts: 7

    Thank you for the advice. I will try to talk to Gynocologist before the procedure and reconsider the coil. Initially I was offered a different type of coil but I did ask for it to be Mirena and she agreed I could have that.

    I do take vitamin D and I’m thinking of trying Magnesium too. Endocrinologist said that would be ok. I had blood tests last week but not vitamin D. Calcium level had increased. I’m pinning a lot of hope on operation helping with hip/groin pain. I don’t have a date yet. It’s very frustrating as exercises I can do are limited because of this.

    I reduced oestrogen from 1.5 to 1 last night but have woken feeling nauseous.

    thanks again for your help.

    Toni

  • FloooooFlooooo Posts: 4

    Hi dr Frontino, thank you for the opportunity. I wante to ask if you can recommend any vegan lubricants? I tried so many and most of them make me super itchy and very uncomfortable. I'm 56 and just started HRT, I hope it will help as the dryness is such an issue for me and my hubby :( Thank you in advance

  • Giada FrontinoGiada Frontino Posts: 35 Consultant Gynaecologist

    Dear @Flooooo

    I'm sorry to hear that. HRT will definitely improve that within a few months.

    In the meantime try Hyalo Gyn gel, which is based on hyaluronic acid, a strong moisturizer.

    GMC Full Specialist Registration # 7468911 

    Website: https://www.doctify.com/uk/specialist/dr_giada_frontino 

  • Mary78Mary78 Posts: 25 ✭✭

    Hi there, I need some advice please. I have almost all the classic symptoms, hot flushes, cant sleep, anxiety, irritated all the time and now I started to have absolutely no interest in sex whatsoever. Is this normal? Would HRT help? Is there anything natural I can take that will help? I'm on antidepressants and I feel like they just made it all worse... any advice would be greatly appreciated, Mary

  • Giada FrontinoGiada Frontino Posts: 35 Consultant Gynaecologist
    edited October 19

    Hello @Mary78,

    Are your cycles regular? This information would be useful in terms of the treatment options. In the meantime, you can take Femal (a nonhormonal treatment made of extracted and purified bee pollen and pistil). As with all natural products, you should try it for at least two months in order to truly understand how you feel with it.

    GMC Full Specialist Registration # 7468911 

    Website: https://www.doctify.com/uk/specialist/dr_giada_frontino 

  • ViviVivi Posts: 1

    Hi Dr Giada

    Could you please tell me, can uterus polyps be triggered by lack of estrogen? And can they grow on HRT? How often to check?

    Also how does menopause (im post menopause) affect glucose and insulin levels?

    My glucose is now consistently higher despite being on a low carb diet and triglycerides now normal to low. Could it be from stress from menopause as I've had horrific symptoms recently from menpause which landed me in the ER due to diet transition(too fast apparently) but now left with severe anxiety and on HRT but wondering if this recent stress on body despite eating a diabetic diet could be cause of continuous higher glucose levels or could it even be the HRT?

    I read high progest can increase insulin and estrogen improve insulin sensitivity. Could it he thyroid?

    Trying to work out why my glucose level are not improving despite low triglycerides. And wonder if HRT or menopause can have this kind of affect.

  • EllesmereportEllesmereport Posts: 3

    I have not been on hrt throughout the menopause over 18 years. I can’t seem to find a way to manage my symptoms anymore can I ask to go on hrt. Will it cause my vulvadynia to flare again is my main concern

  • Giada FrontinoGiada Frontino Posts: 35 Consultant Gynaecologist

    Hello @Vivi

    Endometrial polyps are actually triggered by excess estrogen (an increased BMI, diabetes, etc).

    Menopause can cause hormonal fluctuations that can make glucose levels be more difficult to manage with diet alone. If your glucose levels are abnormally high despite your diet, I strongly recommend speaking to your GP in order to investigate this, as this is also crucial to your wellbeing and cardiovascular health.

    GMC Full Specialist Registration # 7468911 

    Website: https://www.doctify.com/uk/specialist/dr_giada_frontino 

  • Giada FrontinoGiada Frontino Posts: 35 Consultant Gynaecologist

    Hello @Ellesmereport

    Which symptoms are you suffering from that you would like to be treated?

    GMC Full Specialist Registration # 7468911 

    Website: https://www.doctify.com/uk/specialist/dr_giada_frontino 

  • EllesmereportEllesmereport Posts: 3

    The vaginaL atrophy which causes red inflammation in The vulva as well . It’s a constant cycle of pain and discomfort working out is it vulvadynia is it inflammation is it thrush is it something I’ve eaten or drunk is it IC . I’ve got oestrogen cream but can’t insert it at all and when I use it the best I can, I get thrush . It’s a never ending cycle which is never going to get any better. I dread getting older

  • Giada FrontinoGiada Frontino Posts: 35 Consultant Gynaecologist

    Dear @Ellesmereport , Firstly I would suggest taking care of and strengthening the genital immune system with the following oral probiotic: Optibac For Women one capsule to be taken before breakfast for 90 consecutive days. I would also use Multigyn Floraplus to be applied locally at bedtime for ten days each month. This treatment will show great improvement in your symptoms if you can allow it to work gradually. Also, reducing the sugar intake will be crucial in stopping the flare-ups.

    Please do update me in a couple of weeks!

    GMC Full Specialist Registration # 7468911 

    Website: https://www.doctify.com/uk/specialist/dr_giada_frontino 

  • Jj19Jj19 Posts: 2

    Hello thank you for helping us ladies out .. I have constant UTI and still having periods at 54 is that normal sometimes they last 10 days

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