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Fasting may reset your body, but can it reset your mind? The new trend of dopamine fasting claims it can. And wait, there's more. This trend also works against dopamine resistance, implying that things that did not make you happier before will now do. You see, dopamine is a part of the brain's reward system and plays an important role in your pleasure reception. While this neurotransmitter is not directly linked to an individual's happiness, it triggers feelings of satisfaction, motivation and pleasure.
However, a person can also reach a stage of dopamine resistance if they continue to indulge in activities that trigger its frequent or constant release. In this case, the individual stops feeling the impact of this neurotransmitter and thus, does feel good or happy.
So does dopamine fasting work?
Dopamine fasting is a practice where individuals limit their exposure to activities or stimuli that typically provide a surge of dopamine. The idea behind dopamine fasting is to reset or recalibrate the brain's reward system. This is usually done by abstaining from gratifying things or experiences like social media, junk food, and even sex. Proponents of dopamine fasting argue that continual overstimulation from digital devices, social media, and easily accessible indulgences has numbed our brain's reward pathways. By regularly denying ourselves these dopamine triggers, the idea claims, we might restore our ability to acquire fulfilment from life's basic pleasures.
Having low levels of dopamine can make you less motivated and excited about things. In Parkinson's disease, there is not enough dopamine in the areas of the brain important for movement. This leads to problems with muscle stiffness and movements such as walking.
The symptoms of a dopamine imbalance depend on what is causing the problem. They include physical symptoms such as:
Adjusting dopamine levels is complicated, as it is involved in many different roles in the brain. Your doctor won't measure your dopamine levels directly, and there is no simple test to measure it. Your symptoms will be the clues that tell your doctor if you have too much or not enough dopamine. They will then prescribe medicines to adjust your dopamine level, based on your symptoms, and make adjustments based on how your body responds and how you feel.
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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.
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.
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.
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.
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
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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.
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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.
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.
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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.
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.
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.
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
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.
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
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