With the holiday season high, there is festive cheer, family gatherings and also an undeniable increases in alcohol consumption that fills the air. Christmas and New Year's Eve celebrations to spring break and bachelor parties and sporting events that bring together huge crowds for celebrations mean that drinking becomes synonymous with partying. But behind the revelry lies a much darker behavior: high-intensity drinking.

Alcohol is the most widely used substance in the United States; it has been reported that 84% of adults aged 18 and older reported lifetime use. Moderate drinking is socially acceptable, but high-intensity drinking is an alarming trend. The behavior of consuming eight or more drinks over a few hours for women and 10 or more for men exceeds binge drinking and significantly increases risk for harm.

High-intensity drinking is far from being just a mere passing concern; it is instead a public health crisis. The burden is even greater as 29 million people in the United States suffer from alcohol use disorder. That has caused over 140,000 deaths annually while accounting for 200,000 hospitalizations and 7.4% of visits to emergency departments in the United States. However, only 7.6% of these affected get treated, thus forming a glaring gap in handling this concern.

What Is High-Intensity Drinking?

High-intensity drinking is a dangerous escalation from traditional binge drinking, characterized by consuming double or triple the standard binge amounts. While binge drinking involves four or more drinks for women and five or more for men, high-intensity drinkers often surpass these levels, leading to blood alcohol concentrations (BAC) exceeding 0.2%—a level that significantly impairs judgment and motor skills.

According to Dr. George Koob, the director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), high-intensity drinking is one of the factors that intensify the risks of injuries, overdose, and death. It is also very highly associated with the onset of AUD, since the chance of addiction increases with increased alcohol consumption per occasion.

Blackouts and Memory Loss Risks

One of the most troubling consequences of high-intensity drinking is alcohol-induced blackouts, periods of amnesia where individuals may appear functional but are incapable of forming memories. Blackouts occur when alcohol disrupts the hippocampus, the brain region responsible for memory formation.

Blackouts are often categorized into two types:

1. Fragmentary Blackouts: Characterized by spotty memory, where recalling certain details can trigger partial recollection.

2. En Bloc Blackouts: Significant amnesia for hours, wherein no memory is created at all, even if tried to be recalled.

Aside from memory loss, intense binge drinking is linked with poor decision-making, violence, injury, and conflicts in personal relationships.

Why Holidays and Special Events Are Hotbeds for Excessive Drinking

Holidays and celebrations create the perfect storm for high-intensity drinking. According to research, adults drink nearly double the amount of alcohol during holidays like Christmas and New Year's Eve than they do at any other time of the year. It is during these periods of social gathering, holiday stress, and seasonal sadness that people drink in excess.

For college students, experiences like spring break and 21st birthdays increase the danger. Some studies indicate that students, especially those who travel with buddies to spring break, indulge in more alcohol and make more serious decisions than any student who remains at home or goes with their family to other destinations. Sporting events are, too, notorious for promoting drunk consumption, especially among male customers. Alcohol consumption usually goes high during Super Bowl Sunday, thus leading to games day violence and arrests.

Consequences of Heavy Intensity Drinking

High-intensity drinking impacts not only physical health and mental well-being but also social relationships.

Acute Risks

- Alcohol poisoning

- Severe dehydration and electrolyte imbalances

- Hypoglycemia

- Risky sexual behavior

- Injuries and accidents

Chronic Risks

- Liver damage, alcoholic hepatitis, and cirrhosis

- Cardiovascular diseases such as arrhythmias and cardiomyopathy

- Neurological damage, including memory deficits and blackouts

- Progression to alcohol dependence or AUD

Psychological Impact

High-intensity drinking is strongly linked with increased risks of depression, anxiety, and suicidal ideation. Poor decision-making during episodes can lead to long-lasting consequences, including damaged academic, professional, or personal outcomes.

How to Address the Problem

Combating high-intensity drinking requires education, early intervention, and accessible treatment options. The NIAAA has defined high-intensity drinking to be distinct from binge drinking and has called for targeted approaches to decline prevalence and associated harms.

One promising treatment option is naltrexone, which a medication helps control alcohol cravings. Encouraging in preliminary evidence, more extensive clinical trials will be necessary to ascertain its efficacy more specifically in high-intensity drinkers.

As we head into the holiday season and other special occasions, it is important to heighten awareness of the dangers of high-intensity drinking. A good understanding of long-term consequences and seeking help when alcohol-related issues arise can be the difference between life and death. Celebrations should be about joy and connection, not about the gateway to harm.

If you or someone you know drinks at dangerous levels or have an alcohol use disorder, there is help available. Remember, for suspected cases of alcohol poisoning, dial 911. In this way, we can foster healthier relationships with alcohol and create safer environments for everyone.

Every month, millions of women endure painful periods and convince themselves that it is normal. However, the statistics tell a different story. Endometriosis affects about 247 million women worldwide, and nearly 42 million of those are in India alone. Yet, most of them suffer in silence for years before they get diagnosed.

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, on the ovaries, fallopian tubes, bowel, or nearby pelvic areas. India accounts for nearly 25% of the global burden of this condition. Even with this staggering number, it remains one of the most underdiagnosed issues in women’s health.

When Is Period Pain "Too Much"?

Some discomfort during menstruation is to be expected. But these signs should not be ignored:

- Pain severe enough to disrupt daily activities, work, or school

- Cramping that starts days before your period and continues after it ends

- Pain during or after intercourse

- Painful bowel movements or urination around your cycle

- Heavy or irregular bleeding

- Unexplained fatigue, bloating, or lower back pain

These are your body's warnings, not signs of weakness or something to just endure.

The Cost of Waiting

The statistics on diagnostic delays are alarming. On average, there is a 7 to 9-year delay between the first symptoms and a confirmed endometriosis diagnosis worldwide. Endometriosis affects 10–15% of all women of reproductive age and up to 70% of women with chronic pelvic pain, yet many spend nearly a decade seeing multiple doctors before anyone identifies the true cause.

This delay leads to serious consequences. The monthly natural conception rate in women with endometriosis drops to just 2–10%, compared to 20% in women without the condition. Longer delays are directly linked to more severe disease, greater psychological distress, and tougher fertility challenges.

Listen to Your Body

Too many women come to me after years of being told their pain is normal. By the time they reach us, many are already dealing with advanced-stage disease.

Your pain is real, and it deserves a real answer. Do not wait, consult a specialist. Early diagnosis truly changes everything.

If your periods are affecting your quality of life, your body is asking you to listen. The sooner you seek help, the better your outcomes. Consult a specialist today. Take the first step towards a pain-free life.

India, which carries the world's second-largest population of hemophilia cases—a genetic blood disorder—must shift towards prophylaxis care for the bleeding disorder, said health experts today on the occasion of World Hemophilia Day.

World Hemophilia Day is observed every year on April 17 to raise global awareness of hemophilia and other inherited bleeding disorders.

This year’s theme of “Diagnosis: First step to care” highlights the critical importance of diagnosis—the essential first step in treatment and care.

According to the World Federation of Hemophilia (WFH), 75 percent of people suffer from hemophilia, without even knowing it, simply because they don’t have access to basic healthcare.

What Is Hemophilia?

Hemophilia is a rare bleeding disorder where blood does not clot properly, even for minor injuries. It is caused by an error in a specific gene on the X chromosome, leading to a deficiency or absence of clotting factors.

While the condition mainly affects males, women are the genetic carriers. In people with hemophilia, the blood lacks sufficient clotting factors -- which are proteins essential for stopping bleeding.

Whether the bleeding is external, such as cuts, or internal, such as bleeding into joints or muscles, the blood does not clot. So, it can be a very serious disorder.

Without consistent care, repeated bleeding into joints can lead to

• chronic pain,
• deformity,
• loss of mobility.

Hemophilia is mainly of three types:

• Hemophilia A: This is the most common type. People with this condition have low levels of clotting factor 8 (factor VIII).
• Hemophilia B: People with this type don’t have enough clotting factor 9 (factor IX).
• Hemophilia C: Also known as factor 11 (factor XI) deficiency. It’s the least common type of hemophilia.

The Burden Of Hemophilia In India

Hemophilia A, the most common type, affects about 1 in 5,000 male births, underscoring the urgent need for improved detection and awareness.

Hemophilia B, on the other hand, is an X-linked genetic disorder affecting 1 in approximately 25,000 male births.

India bears a significant burden from Hemophilia A. Estimates suggest around 136,000 individuals are affected, but only a small fraction are diagnosed and registered due to unequal access to essential care.

Dr. Varun Kaul, Professor, Dept of Pediatrics, Guru Gobind Singh Medical College & Hospital, Faridkot, told HealthandMe that in India, systemic gaps, ranging from limited diagnostic access to unevenly distributed treatment centers, continue to restrict access to RRT, especially beyond metro cities.

In contrast, more than 50 per cent of persons with hemophilia globally benefit from regular replacement therapy (RRT) as the standard of care.

Routine replacement therapy (RRT), commonly known as prophylactic care or prophylaxis, is the standard treatment for severe hemophilia.

It involves the regular intravenous (IV) infusion of clotting factor concentrates to maintain factor levels above 1 per cent to prevent spontaneous bleeding, particularly into joints and muscles.

Need For Prophylaxis Care For Hemophilia

Most Indian patients currently rely on reactive, on-demand therapy to manage bleeds after they happen.

Dr. Kaul said that although this may help prevent the immediate crisis, it fails to stop the cumulative joint damage that often results in permanent disability.

“Providing regular, scheduled infusions to maintain sufficient clotting factor levels can prevent bleeds entirely, reducing annual bleed rates by 90 per cent and enabling a life free from chronic pain and constant fear of the next bleed,” Dr. Kaul said.

Some progress is visible, as States like Karnataka, Kerala, Jammu and Kashmir, to name a few, have pioneered state-sponsored RRT programs.

“It is now imperative to transition from mere crisis management toward implementing preventive care as a National Health priority,” Dr Kaul added.

Hemophilia: The Need To Focus On Women

Dr Rahul Bhargava, Principal Director & Chief - Hematology, Hemato-Oncology & Bone Marrow Transplant, Fortis Memorial Research Institute, Gurugram, stressed the importance of focusing the treatment on females.

"Carrier testing in hemophilia remains largely focused on affected males, while women who may be carriers are often not included in routine screening,” Dr Bhargava told HealthandMe.

As an X-linked inherited disorder, hemophilia can present in women with low clotting factor levels, leading to

• prolonged bleeding,
• heavy menstrual cycles,
• complications during surgery and childbirth.

Most of the cases remain undiagnosed until a clinical event occurs.

"Identifying carriers through timely testing enables appropriate counselling and informed reproductive decisions. It also supports early diagnosis in families and reduces the risk of severe bleeding complications in future generations,” the doctor said.

How To Manage Hemophilia?

Dr Tulika Seth, Professor of Haematology at All India Institute of Medical Sciences (AIIMS) in New Delhi, in a post on social media platform X, stressed the importance of testing for hemophilia.

"If a child gets prolonged bleeding from a minor cut or injury, or if there are spontaneous painful swellings in the joints after minor falls, or sometimes even by somebody holding the baby, or there's a lot of bruising, people should get the baby tested or the adult tested for hemophilia," Dr. Seth said.

She noted that in mild cases of hemophilia, sometimes a person may not be aware that they have a deficiency, and then when they go for a tooth extraction or any surgery, they may have a problem.

"So, it's important to know your family history, and if you've had any prolonged bleeding after any pain, then you should tell your doctor and get tested," the doctor said.

Dr Bhargava also called for a broader approach that includes women in screening programs to help strengthen prevention and long-term management of hemophilia across families.

Hemophilia management requires attention beyond hospital care to prevent long-term complications.

To reduce bleeding episodes, it is important to:

• regularly follow up,
• adhere to treatment,
• maintain joint health.

Other measures include

• safe physical activity,
• balanced nutrition,
• avoiding trauma

"Integrating medical treatment with lifestyle practices supports functional independence and improves overall disease control,” Dr. Bhargava told HealthandMe.

Hemophilia is a rare genetic bleeding disorder, usually inherited, wherein blood cannot clot properly due to low levels of clotting factors, causing prolonged bleeding or spontaneous internal hemorrhages.

Symptoms include easy bruising, joint pain/swelling, and excessive bleeding. While not curable, it is treated with factor replacement therapy and gene therapy.

India has the world's second-largest population of hemophilia patients, with estimates suggesting over 70,000 to over 1,36,000 cases of Hemophilia A and B. However, while around 13,000 to 19,000+ patients are registered, many remain undiagnosed.

This World Hemophilia Day, Dr. Sheikh Bilal, Head of Department, Pathology, Government Medical College, Srinagar, Kashmir, exclusively told Healthandme that the primary reason why thousands of Indians remain undiagnosed and unable to access proper care is due to budget constraints, lack of awareness among policymakers, and the need for technocrats to advocate boldly for regular replacement therapy.

Despite having the second-largest hemophilia population, only 9-10 percent receive treatment as compared to 80-100 percent in some European countries.

The expert explained: "Money plays an important role. Every center in India has, at their own level, their own policymakers and the people who are at the helm of affairs. We are the second home for the hemophilia and we can change the lives of these people by having the regular replacement but it is all depending upon the perception of individual centers."

He also noted that the government needed to introduce policy reforms endorsing regular replacement therapy as the gold standard to help ensure equitable access to patients.

The median age at diagnosis for severe hemophilia in India stands at 60 months—five full years—compared to under 12 months in high-income countries. This delay is not just a matter of time but one that poses a risk of serious clinical consequences. Late diagnosis often means repeated, unmanaged bleeding episodes during early childhood, particularly into joints, before appropriate treatment begins.

Early Warning Signs

The three types of this condition include :

• Hemophilia A: This is the most common type. You may develop this condition because you have low levels of clotting factor 8 (factor VIII).
• Hemophilia B: You may have this type if you don’t have enough clotting factor 9 (factor IX).
• Hemophilia C: Hemophilia C is also known as factor 11 (factor XI) deficiency. It’s the least common type of hemophilia.

Recognizing the early warning signs can be critical in preventing long-term complications. Symptoms such as recurrent nosebleeds, heavy menstrual bleeding in females, and prolonged bleeding after minor injuries are often overlooked or dismissed. Common signs include:

• Bleeding into the joints. This can cause swelling and pain or tightness in the joints. It often affects the knees, elbows, and ankles.
• Bleeding into the skin (which is bruising).
• Bleeding into the muscle and soft tissue, which can cause a build-up of blood in the area (called a hematoma).
• Bleeding of the mouth and gums, including bleeding that is hard to stop after you lose a tooth.
• Bleeding after circumcision.
• Bleeding after having shots, such as vaccinations.
• Bleeding in the head of an infant after a difficult delivery.
• Blood in the urine or stool.
• Frequent and hard-to-stop nosebleeds.

The condition is much more common in people who were born male since they can get it with a change to the gene on one X chromosome. People who have a family history of hemophilia are also at higher risk.

Treatment Options

The treatments for haemophilia have never been more effective, but they work only for patients who have been diagnosed. In a condition where every missed bleed moves a joint closer to permanent damage, the most important clinical act is also the most basic one: recognition.

The main treatment for severe hemophilia involves replacing the clotting factor you need through a tube in a vein. This replacement therapy can be given to treat a bleeding episode in progress. It can also be given on a regular schedule at home to help prevent bleeding episodes. Some people receive continuous replacement therapy.

Replacement clotting factor can be made from donated blood. Similar products, called recombinant clotting factors, are made in a laboratory, not from human blood.