I'm a healthy woman but I sweat so heavily after a workout, I'm dripping wet. DR MARTIN SCURR replies

I am a recently retired, healthy woman who rarely gets ill. However, I was slightly overweight and I now train and swim about four times a week, but while the extra weight has gone, I sweat really heavily during exercise — I'm dripping wet by the end of a workout. It's embarrassing and I'm also worried it could be related to a medical issue.

Julie Smith, Blackpool.

Dr Scurr replies: Congratulations on losing that extra weight — a lesson to others.

Excessive sweating, or hyperhidrosis, is common. The first step is to ascertain whether it's primary excessive sweating, where there is no obvious cause, or secondary sweating, where it is due to an underlying and potentially treatable condition.

Excessive sweating may also be linked to anxiety, certain types of medication (such as steroids) and problems such as diabetes and an overactive thyroid

One of the most common triggers of sweating in an older woman is the menopause, in the form of hot flushes. The decline in oestrogen levels affects the control mechanisms of small blood vessels in the skin, triggering random bouts of sweating, typically at night, but often in the day too, even when the woman is at rest.

Excessive sweating may also be linked to anxiety, certain types of medication (such as steroids) and problems such as diabetes and an overactive thyroid.

But in your case it occurs only after strenuous exercise — it also sounds like you are in good health, no longer overweight, exercising regularly, toned up and enjoying your exercise regimen.

I suspect that what you have is simply a normal physiological variant of sweating after exercise and that perhaps this is new to you because of your recently increased activity.

You're not alone; I've been running with others who experienced drenching sweats while some of us hardly perspired at all.

As you say, it is embarrassing, but as this is the only symptom, it does not sound like it's due to an underlying diagnosis — rather, it seems to be part of your constitution.

Ten years ago, I had a heart attack, after which I was prescribed numerous drugs, including aspirin. But it caused gastric problems so I was switched to clopidogrel. Recently, I've struggled to swallow dry food (such as sandwiches or pastries) and wondered if prolonged use of clopidogrel could be to blame?

Sylvia Honey, by email.

Dr Scurr replies: Like low-dose aspirin, clopidogrel is prescribed to reduce the stickiness of blood cells called platelets. This improves blood flow and reduces the risk of clots forming on blood vessel walls that have already been damaged by a build-up of cholesterol deposits.

The atorvastatin you're also taking (mentioned in your longer letter) helps by minimising further accumulation of cholesterol and this combination of medications has helped keep you free from further heart trouble over the past decade.

But like aspirin, clopidogrel can have serious side-effects — the main one, bleeding from the lining of the stomach — and it's not unusual to experience blood loss when taking it, though this is normally too small to prompt any obvious change in stools (heavy bleeding, usually an emergency, causes black, tarry stools).

But over time this can lead to iron-deficient anaemia and low levels of haemoglobin (a protein in red blood cells vital for carrying oxygen round the body).

One consequence of this lack of iron is Plummer-Vinson syndrome, which affects the muscles involved in swallowing.

This syndrome creates a web of membranes that partially obstructs the upper part of the gullet. One theory is that iron has a key role in controlling the turnover of cells lining the inner surface of the gullet, and that without enough of it, this process goes haywire and excess tissue forms.

This reaction is more common in women and develops gradually over months or years but can be reversed with intravenous or oral iron supplements.

Speak to your GP, who may order blood tests, and will also be able to propose an alternative anti-clotting treatment.