Happiness is influenced by a complex interplay of various chemicals in our brain, particularly four key neurotransmitters, D.O.S.E or Dopamine, Oxytocin, Serotonin, and Endorphins. These chemicals, often referred to as "happiness chemicals," are responsible for creating feelings of joy, motivation, connection, and calm.

However, when there's a deficiency in any of these, it can significantly affect our mood, energy, and overall well-being. Let’s dive into what these four neurotransmitters are, how their deficiency impacts us, and how we can boost their levels naturally.

Dopamine: The Motivation and Reward Chemical

Dopamine is often called the "motivation molecule." It plays a major role in enabling motivation, learning, and the pleasure-reward system in the brain. When we accomplish something — whether it’s finishing a project, completing a workout, or achieving a goal — dopamine gives us that sense of satisfaction and determination to continue.

Deficiency Effects:

When dopamine levels are low, it can lead to procrastination, low self-esteem, lack of focus, and general fatigue. A person might feel anxious, hopeless, or experience mood swings because the brain isn’t getting the reward signals it needs.

Boosting Dopamine:

You can increase dopamine levels by setting and achieving small goals, exercising regularly, eating foods rich in L-Tyrosine (such as almonds, avocados, and eggs), and practicing mindfulness or meditation. Engaging in creative activities like writing or drawing also helps boost dopamine levels.

Oxytocin: The Bonding Chemical

Oxytocin is often referred to as the "love hormone" or "cuddle hormone" because it plays a major role in social bonding and trust. It’s released when we hug, touch, or engage in other forms of physical affection. Oxytocin fosters feelings of connection and emotional intimacy, making it essential for relationships, family bonding, and even team cooperation.

Deficiency Effects:

A lack of oxytocin can lead to feelings of loneliness, stress, anxiety, and difficulties in forming or maintaining relationships. Low oxytocin levels are associated with feelings of isolation and disconnection from others.

Boosting Oxytocin:

You can raise your oxytocin levels through physical touch, socialising, spending quality time with loved ones, and even engaging in activities like massage or listening to soothing music. Acts of kindness, such as helping others or volunteering, also help release oxytocin.

Serotonin: The Mood Stabiliser

Serotonin is responsible for feelings of well-being and contentment. It helps regulate mood, sleep, digestion, and even social behavior. People who have balanced serotonin levels often feel calm, confident, and emotionally stable. Serotonin is crucial in helping people feel valued and significant among their peers.

Deficiency Effects:

Low serotonin levels are linked to depression, low self-esteem, irritability, and mood swings. Individuals may feel overly sensitive to criticism, experience panic attacks, or struggle with social phobias when serotonin is deficient.

Boosting Serotonin:

You can boost serotonin by getting regular exercise, exposing yourself to sunlight, engaging in cold showers or massages, and practicing mindfulness. Simple activities like walking in nature, meditating, or doing yoga are also effective serotonin enhancers.

Endorphins: The Pain Reliever

Endorphins are the body’s natural painkillers. Released in response to stress, pain, or intense physical activity, they help alleviate discomfort and promote a sense of euphoria. Endorphins are what make you feel good after a workout or a hearty laugh, often referred to as the "runner's high."

Deficiency Effects:

Without enough endorphins, people may experience anxiety, depression, chronic pain, and insomnia. A deficiency in endorphins can make daily life feel overwhelming and physically draining.

Boosting Endorphins:

To boost endorphins, engage in laughter, exercise, and stretching activities. Eating spicy foods or dark chocolate can also stimulate endorphin production. Regular massage therapy and meditation are other ways to naturally elevate endorphin levels.

For a patient with advanced heart failure, there comes a point when medicines, devices and repeated hospitalisations can no longer control the disease. For some, a heart transplant may offer the only realistic path to long-term survival. Yet in India, the challenge often begins much earlier than the waiting list: many patients who could potentially benefit from transplantation never reach an advanced heart-failure or transplant centre for evaluation.

The scale of the problem is enormous. A recent study found that 83,000 heart transplantations were required annually in India in 2021, although only a very small proportion of that need was met. In comparison, according to the National Organ and Tissue Transplant Organisation (NOTTO), 221 heart transplants were performed in 2023.

Why Patients With Advanced Heart Failure Miss Out

The first issue is delayed referral. Patients with advanced heart failure may continue to be treated repeatedly for breathlessness, fluid retention or hospital admissions without being assessed early for advanced therapies.

A transplant evaluation is not a last-minute decision. It requires time to assess the patient's medical condition, other organs, infection risk, nutrition, psychosocial circumstances and ability to undergo lifelong follow-up.

The second challenge is the limited availability of donor hearts. Heart transplantation depends almost entirely on deceased organ donation. India has made substantial progress in transplantation overall, but the national deceased organ donation rate remains less than one donor per million population.

How Geography And Cost Affect Access To Transplants

Geography and affordability also matter. Advanced heart-failure programmes and transplant centres are concentrated in selected regions, meaning that patients from smaller cities and rural areas may face substantial travel, financial and logistical barriers.

The cost of evaluation, repeated hospitalisations, mechanical circulatory support and post-transplant medicines can further influence whether a patient can realistically pursue transplantation.

Also read: “You’ve Got A Pig’s Heart!” Genetically Modified Pigs with Human-like Organs Transforming Organ Donation; Details Inside

When Should Patients Be Referred To A Transplant Centre?

We therefore need to change the way advanced heart failure is recognised. A patient with recurrent hospitalisations, persistent symptoms despite optimal therapy, progressive kidney or liver dysfunction, low blood pressure limiting medications, or dependence on intravenous therapies should trigger consideration of referral to an advanced heart-failure centre.

Early referral gives specialists more time to evaluate the patient, assess treatment options and determine whether transplantation or another advanced therapy is appropriate.

Heart Transplant Is Not The Only Advanced Treatment

Importantly, transplantation is not the only advanced therapy. Left ventricular assist devices (LVADs) can serve as a bridge to transplantation or, in selected patients, as long-term therapy.

These devices can help support the heart's pumping function in patients with advanced heart failure who meet the criteria for their use. The appropriate option depends on the patient's condition, overall health and treatment goals.

India has demonstrated that transplantation can grow rapidly when infrastructure, coordination and public awareness improve. The next step is to ensure that patients are identified early enough to be evaluated, and that a shortage of donor organs does not remain the only reason they never get the opportunity to reach the transplant list.

By Dr. Pravin Kulkarni, MBBS, MS (General Surgery), MCh (Cardiovascular and Thoracic Surgery), Fellowship in CTS, Director, Advanced Cardiac Surgery and Heart and Lung Transplant Program

According to the latest National Family Health Survey (NFHS-6), 30.7% of women aged 15-49 years in India are reported as overweight or obese, highlighting the growing importance of lifestyle factors in women’s reproductive and overall health. Along with nutrition and physical activity, sleep is another important factor for overall menstrual health and the ovulation cycle.

Ovulation is controlled by a complex interaction between the brain, pituitary gland and ovaries. This reproductive hormone system is closely connected to the body's circadian rhythm, which regulates the sleep-wake cycle and influences the timing of several hormonal processes. When sleep becomes consistently irregular or insufficient, these signals may become disrupted, potentially affecting the hormonal coordination required for normal ovulation.

How Sleep Disturbances May Affect Reproductive Hormones

Also read: Andrew Huberman’s Sleep Trick: Can Eye Movements Help You Fall Back Asleep?

One of the ways this may occur is through interference with the functioning of the hypothalamic-pituitary-adrenal (HPA) axis. The reproductive system relies on communication between the hypothalamus and pituitary gland to regulate the hormones involved in follicle development and egg release.

Melatonin is another hormone linked to sleep and circadian rhythm. It also has antioxidant properties in the ovaries. This is why the relationship between sleep and fertility may involve more than simply the number of hours a woman sleeps.

A 2025 study published in Chronobiology International found that a later chronotype, or a tendency to sleep and wake later, was associated with a higher risk of sporadic anovulation among women with regular menstrual cycles.

Each one-hour increase in later chronotype was associated with a 5% higher relative risk of anovulation (RR 1.05; 95% CI 1.00–1.11), while women in the third chronotype tertile had a 33% higher relative risk compared with those in the second tertile (RR 1.33; 95% CI 1.05–1.68).

Interestingly, sleep duration itself was not associated with anovulation, suggesting that sleep timing and circadian patterns may also matter.

Poor Sleep Quality May Also Matter During IVF

Sleep may also be relevant during fertility treatment. A 2025 prospective cohort study of 174 women undergoing IVF/ICSI reported that women with poor sleep quality had 22.89% fewer retrieved oocytes and 22.01% fewer matured oocytes after adjustment for relevant factors.

The study also reported associations between certain sleep patterns and other IVF outcomes. However, these findings are observational and do not establish that poor sleep directly causes poorer fertility outcomes.

Breast cancer is often thought of as a disease that affects older women. However, younger women can develop breast cancer too, and receiving a diagnosis in your 20s or 30s can come as a shock, particularly when there is no known family history or obvious risk factor.

While breast cancer is less common at a younger age, being young should not mean dismissing a breast change. Here is what young women should know.

Being young doesn't mean a breast lump isn't worth investigating

Most breast lumps are benign, but a doctor should evaluate any new or persistent breast change. This includes a lump in the breast or under the arm, a change in breast size or shape, dimpling or puckering of the skin, changes in the appearance or position of the nipple, or unusual nipple discharge, especially discharge that is bloody.

Breast changes can occur because of hormonal fluctuations and several non-cancerous conditions, particularly in younger women. However, it is important not to assume that a change is harmless simply because of age.

Know your individual risk

Age is one of several factors that influence breast cancer risk. Having a close relative, such as a mother or sister, with breast or ovarian cancer can increase risk, particularly when the cancer occurred at a younger age. Certain inherited genetic changes, including BRCA1 and BRCA2 mutations, can also increase the risk of breast and ovarian cancers.

Previous radiation exposure to the chest at a young age is another recognised risk factor.

This is why knowing your family history matters. If breast or ovarian cancer has affected several close relatives, discuss your family history with a doctor. Depending on the pattern of cancers in the family, genetic counselling or testing may be recommended. Genetic testing, however, is not necessary for everyone and should be guided by an individual's risk profile.

Also read: ‘Feels Like I’m A Few Days From Death’: Olympic Sprinter Beth Dobbin Says She Is Bedbound 22 Hours A Day

Don't wait for a lump to become painful

Breast cancer does not always cause pain, and early-stage disease may not produce noticeable symptoms. At the same time, breast pain or tenderness and lumps can occur with several benign conditions.

In India, particularly across warmer and more humid regions, breast discomfort can also be aggravated by wearing very tight, heavy padded or underwired bras for prolonged periods. Such bras may cause pressure, friction and discomfort and can contribute to breast pain or mastalgia in some women, especially when the fit is not appropriate.

It is important to clarify that there is no scientific evidence that wearing tight, padded or underwired bras causes breast cancer. However, an uncomfortable or poorly fitting bra can contribute to breast discomfort. Choosing a well-fitted, supportive bra and avoiding prolonged pressure or friction may help reduce symptoms.

The important thing is to pay attention to changes that are new, unusual or persistent rather than trying to diagnose them yourself. Young women should be familiar with how their breasts normally look and feel so they can recognise when something has changed.

Also read: Dr Rachna Shroff: Indian-American Cancer Researcher Who Turned Her Diagnosis Into Advocacy

Screening should be based on risk, not age

Most women in their 20s and 30s who are at average risk do not need routine mammography screening. However, women with a higher-than-average risk may need to begin screening earlier and may require additional tests, such as breast MRI or mammography, depending on their individual circumstances.

Screening recommendations should therefore be based on personal and family history rather than age alone. Women who are concerned about their risk should discuss an appropriate screening plan with their doctor.

What can young women do?

Know your family history and share any significant concerns with your doctor. Maintain a healthy lifestyle by eating a balanced diet, exercising regularly, avoiding smoking and limiting alcohol consumption.

Most importantly, do not dismiss a breast change simply because you are young. Breast awareness is about understanding what is normal for you and recognising when something is different.

A breast lump or other change does not automatically mean cancer, but getting it checked can provide clarity and ensure that any condition requiring treatment is identified at the appropriate time. For young women, awareness is not about living in fear—it is about being informed, attentive and proactive about their health.

By Dr. Tapti Sen, Sr. Consultant - Breast Surgery, RG Hospitals, Kolkata