Pregnancy is accompanied by a lengthy list of do's and don'ts—take prenatal vitamins, no alcohol, exercise carefully, and eat well. But what about when an unplanned health issue presents itself, such as the necessity for a mammogram? For most women, this might not even be something they think about until they are in a position where breast cancer screening is an option.

Perhaps you're over 40 and in need of your yearly mammogram, or perhaps you have a history of breast cancer in your family and you want to keep your screenings current. More emergently, you've found a lump in your breast. So, can you have a mammogram when pregnant? The answer is yes, but there are several things to consider.

Pregnancy creates substantial hormonal changes that affect the body, as well as breast tissue. Estrogen and progesterone's rise causes the breasts to expand and condition to produce milk, which results in denser tissue. This increased density is more challenging to detect any abnormalities with using mammograms. Even post-delivery, should the woman be breastfeeding, milk-filled glands can also make the breasts denser and, as a result, make mammogram readings less clear.

While 3D mammograms have improved imaging technology to help navigate dense breast tissue, doctors often suggest postponing routine screening mammograms until after pregnancy if there are no symptoms or high-risk factors. However, if a lump or abnormality is found, your doctor may recommend immediate diagnostic imaging.

When Is a Mammogram Necessary During Pregnancy?

Mammograms are not done routinely if a woman becomes pregnant, yet there are specific situations where one might be unavoidable. Breast cancer in pregnancy does occur—1 in 3,000 times—but it's not common. If a lump is detected by a woman, she has constant breast pain and no explanation, or she is at high risk (e.g., strong history of breast cancer in her family or genetic defect such as BRCA1 or BRCA2), a physician will order a mammogram.

The process itself takes very little radiation exposure. The radiation employed by a mammogram is concentrated on the breast, and there is little to no radiation that reaches other areas of the body. A lead apron is also placed over the belly to shield the unborn child.

Alternative Breast Imaging Options During Pregnancy

For pregnant women requiring breast imaging, physicians may initially suggest an ultrasound. In contrast to a mammogram, an ultrasound is not done with the use of radiation and is deemed safe for pregnant women.

An ultrasound of the breast can establish whether a lump is a fluid-filled cyst or a solid tumor that needs further investigation. Yet ultrasounds are not always diagnostic, and in certain instances, a mammogram or biopsy is needed to determine or rule out cancer.

Magnetic Resonance Imaging (MRI) is also an imaging choice but has some drawbacks. The majority of breast MRIs employ a contrast material called gadolinium, which is able to pass through the placenta and to the fetus. Although risks are not entirely clear, physicians usually do not use MRI with contrast unless necessary. Some practitioners may offer an MRI without contrast as an option.

What If You Find a Lump In Your Breast During Pregnancy?

Breast changes throughout pregnancy are normal, but finding a lump should never be taken lightly. If you notice a lump, alert your medical provider right away. They will conduct a clinical breast exam and potentially have you get an imaging study such as an ultrasound or mammogram to see whether anything needs to be done.

If imaging indicates a suspicious mass, a biopsy can be suggested. Core needle biopsy is the most frequently used and is safe during pregnancy. It consists of numbing the skin with local anesthetic and inserting a hollow needle into the area to obtain a small sample of tissue to be tested.

Breast Cancer Treatment During Pregnancy

In the extremely uncommon event of a diagnosis of breast cancer while pregnant, therapy will be determined by the nature and extent of cancer and by how far along in pregnancy one is. The most frequent form of treatment is surgery—either mastectomy (surgical removal of the entire breast) or lumpectomy (surgical removal of the lump)—which is usually safe while pregnant.

Chemotherapy is also possible but usually only attempted after the first trimester, when it can damage developing fetal tissue. Radiation therapy is not used during pregnancy and is typically deferred until after giving birth. Hormonal therapy and targeted therapies are also omitted until after giving birth.

Can I Get a Mammogram While Breastfeeding?

Yes, you can have a mammogram while you are breastfeeding. The radiation in a mammogram does not impact breast milk or hurt the baby. But breast density is still high during lactation, and this might complicate detection of abnormalities. To enhance image quality, physicians usually advise breastfeeding or pumping 30 minutes prior to the mammogram.

Routine screening mammograms are usually delayed in pregnancy unless there is a high-level concern.

If a lump is detected, an ultrasound is typically the initial imaging study done, with a mammogram being a consideration if additional assessment is necessary.

• Pregnancy mammograms utilize minimal radiation and are safe when required.
• Breast MRI with contrast is usually avoided in pregnancy.
• Breast biopsy, when necessary, is safe during pregnancy.

If breast cancer does develop during pregnancy, there are available treatment options that can be adjusted to keep the mother and infant safe.

Pregnancy is a period of significant change, and health issues particularly those involving breast health, are anxiety-provoking. Routine mammograms are typically postponed until after giving birth, but diagnostic testing can be done if necessary. The best you can do is discuss changes you notice in your breasts with your healthcare provider in an open manner. Early detection and prompt treatment can make a very big difference in the health of both mother and fetus.

Delhi's air quality deteriorated significantly after Diwali. Several monitoring stations recorded ‘severe’ air quality on Monday morning (November 9) after a night of Diwali festivities which resulted in widespread emission of firecracker smoke. It worsened the situation in a city already grappling with soaring air pollution due to vehicular exhaust, construction dust and stubble burning in neighbouring states.

Due to this, Delhi residents, who continue to breathe polluted air, may face symptoms like scratchy throat, coughing and irritation. But how can you tell whether your sore throat is caused by pollution or an infection that needs medical attention?

How Does Air Pollution Cause A Sore Throat?

Polluted air contains particulate matter, including PM2.5, as well as gases and other irritants. When inhaled, these pollutants come into contact with the lining of the nose, throat and respiratory tract, triggering irritation and inflammation.

Dr. Rahul Sharma, Director, Pulmonology & Critical Care, Fortis Greater Noida told HealthandMe, “People exposed to high levels of pollution may experience throat irritation, dryness, a burning sensation, frequent coughing and discomfort while swallowing. These symptoms may be more noticeable in people who spend long hours outdoors and are difficult to control.”

People with asthma, allergies or existing respiratory conditions may be more sensitive to these pollutants.

Dr Sharma added, “Pollution can also aggravate existing respiratory conditions like asthma and allergic airway disease. It is important to remember that a sore throat is not always due to infection; environmental exposure can also be a cause.”

Also read: El Niño Could Worsen Dengue, Malaria And Heat Illness: Why WHO Declared A Health Emergency

Pollution-Related Sore Throat Or Infection?

The symptoms can overlap, so a sore throat alone cannot establish its cause. However, certain accompanying signs may offer clues. Experts help us understand when a sore throat is a result of inhaling particulate matter.

Dr. Sushil Upadhyay, Consultant Pulmonologist, Kailash Deepak Hospital, Delhi told HealthandMe, “Throat irritation as an early sign. A scratchy throat is the canary in the coal mine for lung inflammation. It is the first sign that your airways defenses are overwhelmed and deep inflammation is starting.”

A pollution-related sore throat is more likely to involve dryness, scratchiness, coughing and irritation of the eyes or nose.

Dr Samir Garde, Director of Dept of Pulmonology and Lung Transplant, Gleneagles Hospital, Parel, told us, “Pollution-related irritation usually causes a dry or scratchy throat, coughing and eye irritation, which may worsen outdoors or during periods of poor air quality.”

An infection, on the other hand, may be accompanied by fever and other symptoms. They may include body aches, swollen lymph nodes, painful swallowing, tonsil inflammation or white patches on the tonsils. Viral infections can also cause a runny nose, cough and fatigue.

Dr Upadhyay said, “The flu brings high fever, body aches, and extreme exhaustion. If staying inside an air-conditioned, filtered room clears your throat, it's pollution. Otherwise, think of it as flu.”

A bacterial infection such as strep throat may cause sudden throat pain, fever and difficulty swallowing, sometimes without a cough.

Also read: New COVID-19 Variant PJ.2.1 Spreads Globally: WHO Says Symptoms Resemble Cold, Flu

When Should You See A Doctor?

A mild sore throat often improves within a week. However, medical evaluation is recommended if you have difficulty breathing, cannot swallow, are drooling because you cannot swallow, or experience rapidly worsening symptoms.

Dr Upadhyay said, “Do not ignore a sore throat if it moves to your chest. If you develop wheezing, severe breathlessness or a fever, you need a medical evaluation immediately. Seek help right away if you are gasping for air or cannot finish a single sentence in one breath.”

Persistent hoarseness, a lump in the neck or a mouth ulcer lasting more than three weeks should also be evaluated.

Dr Garde recommended, “Seek medical attention if there is chest tightness, high fever or persistent symptoms. Severe breathlessness, bluish lips or difficulty speaking due to breathing problems require immediate emergency care.”

Also read: Delhi AQI Crosses 2,000 Mark After Diwali: What Happens To Your Body Within Hours Of Exposure?

How Can You Protect Your Throat During Severe Pollution?

According to the doctors, while pollution levels remain high, reducing exposure is important. They recommend:

• Avoid outdoor exercise and limit unnecessary time outside.
• Wear a well-fitting N95 or N99 respirator when going outdoors.
• Keep windows closed during periods of high outdoor pollution and use a HEPA air purifier if available.
• Drink enough water to prevent throat dryness.
• Gargle with warm salt water to soothe irritation.
• Avoid smoking, incense and other indoor sources of smoke.

Do not start antibiotics just because your throat hurts. Antibiotics do not treat throat irritation due to pollution or viral infections. They should only be used when prescribed for a confirmed bacterial infection under doctor’s supervision.

Delhi AQI After Diwali

The city's average Air Quality Index (AQI) reached 406 on November 9, placing it in the 'severe' category, according to the Central Pollution Control Board (CPCB).

But private monitoring platform AQI.in reported an AQI of 2,283, classifying the air quality as ‘hazardous’. The reading showcased a grim post-Diwali pollution peak, an issue that has turned into an annual environmental crisis.

The stark difference in readings is because India’s AQI scale is limited to 500 while other private air quality monitoring platforms measure higher readings. So even if CPCB’s data shows 500 AQI, it can mean that the amount of harmful pollutants could be much higher.

The Supreme Court had implemented restrictions on celebrating Diwali with firecrackers by limiting time between 6 am and 7 am and 8 pm and 10 pm on November 7 and 8 and allowing only green crackers. However, firecrackers were reportedly burst beyond permitted hours.

Ahead of World Diabetes Day observed on November 14, singer Nick Jonas recently opened up about living with type 1 diabetes for almost 21 years. Diagnosed at the age of 13, Jonas spoke about his daily decision-making that revolves around managing the condition. From monitoring blood glucose levels to adjusting insulin doses around meals and physical activity, Jonas expressed the emotional challenges of living with the disease.

In an open letter written for Dexcom's A Letter to Diabetes campaign, Jonas described the condition as an ongoing part of his everyday life. “Twenty-one years, and you haven’t changed a bit,” he wrote, addressing diabetes.

He also explained how frequently he has to monitor his glucose levels and make treatment decisions. “Staring at my phone to see where my glucose is. Reaching for my pump to bolus because I’m about to eat something with 17 carbs. Those are just a couple of the hundreds of little decisions I make every week,” Jonas wrote.

He described diabetes as “an ongoing conversation between your body, your mind, and your devices.”

The singer also recalled the emotional challenges of living with a chronic condition. However, he said that speaking openly about diabetes helped him find a sense of community and connect with others experiencing similar challenges.

What Is Type 1 Diabetes?

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Type 1 diabetes is a chronic autoimmune condition in which the body's immune system mistakenly attacks and destroys beta cells that produce insulin in the pancreas.

Insulin is a hormone that helps move glucose from the bloodstream into cells, where it is used for energy. When the body produces little or no insulin, glucose builds up in the blood, resulting in high blood sugar levels.

Type 1 diabetes is different from type 2 diabetes as the latter occurs due to insulin resistance and can be a result of genetic and lifestyle factors. In short, type 1 diabetes is not caused by eating excessive carbohydrates and sugar, obesity or leading an inactive lifestyle.

Type 1 diabetes can also develop at any age, although it is frequently diagnosed during childhood or adolescence.

Symptoms Of Type 1 Diabetes

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Symptoms can develop quickly, sometimes over a few weeks. Common warning signs include:

• Excessive thirst: Constantly feeling thirsty even after drinking water.
• Frequent urination: One may feel the urge to urinate frequently as the kidneys attempt to remove excess glucose through urine.
• Unexplained weight loss: The body starts breaking down fat and muscle for energy when it cannot use glucose properly.
• Increased hunger: Cells are unable to access enough glucose for energy.
• Extreme fatigue: High blood glucose and reduced energy availability can cause chronic tiredness.
• Blurred vision: Changes in blood glucose can affect the fluid balance in the eyes.

If type 1 diabetes is not diagnosed and treated on time, it can lead to diabetic ketoacidosis (DKA), a life-threatening complication.

Warning signs including nausea, vomiting, abdominal pain, deep or rapid breathing, fruity-smelling breath and confusion need immediate medical attention.

Management Of Type 1 Diabetes

Managing type 1 diabetes involves maintaining blood glucose levels within a specific target range to reduce the risk of both high and low blood sugar. Treatment includes:

1. Insulin Therapy

People with type 1 diabetes need insulin throughout their lives. It may be administered through multiple daily injections or an insulin pump which delivers insulin continuously.

2. Regular Glucose Monitoring

Blood glucose can be monitored using instant finger-prick tests or continuous glucose monitoring (CGM) devices. CGM systems use a sensor to track glucose levels throughout the day and night.

3. Dietary Management

People with type 1 diabetes need to understand how carbohydrates affect blood glucose levels so they can adjust insulin doses accordingly.

4. Physical Activity

Exercise is encouraged, but physical activity can affect glucose levels depending on its intensity, duration, timing and the amount of insulin in the body. People may need to adjust their food intake or insulin doses to reduce the risk of hypoglycaemia.

5. Regular Medical Follow-ups

Routine assessments help monitor glucose control and identify complications affecting the eyes, kidneys, nerves and cardiovascular system.

Type 1 diabetes diagnosis does not mean a person has to give up their career, travel, exercise or other ambitions. But living with this condition involves planning and attention to blood glucose levels, food, medication and physical activity.

Jonas has spoken about the importance of not allowing the condition to define his life. In an earlier interview with NIH's MedlinePlus Magazine, he shared a message for others living with type 1 diabetes, “Know that you can still do anything you want to do with your life.”

There is no cure for type 1 diabetes currently but advances in insulin delivery, glucose monitoring and research into therapies that preserve or replace insulin-producing cells are expanding treatment possibilities.

Pregnancy is often something women prepare for months in advance. They discuss nutrition, exercise, supplements, medical check-ups and what to expect as their bodies change. Menopause, however, rarely receives the same attention. It is often treated as a stage that women will simply reach one day and somehow manage along the way.

But menopause is also a major transition in a woman’s life, and being prepared for it can help make the experience easier to understand and manage.

Menopause itself is defined as the point when a woman has gone 12 consecutive months without a menstrual period. However, the transition usually begins earlier, during perimenopause, when changing hormone levels can lead to irregular periods, hot flashes, night sweats, sleep problems, mood changes and other symptoms. These changes can begin several years before menopause itself.

Preparation does not mean trying to prevent menopause or “balance” hormones before it happens. Most healthy women do not need supplements or hormones simply because menopause is approaching. Instead, preparation is about understanding what is happening and building a strong foundation for health.

What can women do before menopause?

Also read: At 58, She Mistook Memory Lapses For Menopause Brain Fog, But Tests Revealed Alzheimer’s Risk

Regular physical activity is one of the most useful habits to establish. Weight-bearing and resistance exercises can help maintain bone strength and muscle mass, which become increasingly important in midlife and beyond. Exercises that improve balance, coordination and proprioception, or the body’s awareness of its position and movement, can also support mobility and help reduce the risk of falls as women age.

Nutrition is equally important. A well-balanced diet should provide adequate protein along with essential vitamins and minerals. Calcium and vitamin D are particularly important for bone health, while a varied diet rich in vegetables, fruits, whole grains, pulses, nuts and other nutrient-dense foods can support overall health. Maintaining a healthy weight is also beneficial during this transition.

It is equally important to pay attention to cardiovascular and metabolic health. Regular checks of blood pressure, cholesterol and blood sugar can help identify common non-communicable diseases early. Avoiding smoking, staying physically active and maintaining healthy lifestyle habits can also support long-term health.

Preventive healthcare should not be overlooked either. As women enter midlife, keeping up with age-appropriate cancer screenings and routine health check-ups becomes an important part of looking after their health. The appropriate screening schedule can vary depending on age, family history, personal risk factors and local guidelines, so these should be discussed with a healthcare provider.

Just as importantly, women should become familiar with their own symptoms. Changes in periods, sleep, mood, body temperature, sexual health or concentration should not automatically be dismissed as “just ageing.” Keeping track of symptoms can help women recognise patterns and have more productive conversations with their healthcare provider.

Medical support is also an important part of preparation. Not every woman will experience menopause in the same way, and treatment is not automatically necessary. However, when symptoms begin to interfere with sleep, work, relationships or everyday life, hormonal and non-hormonal treatment options can be discussed with a doctor.

Perhaps the biggest change we need is in how we talk about menopause. It is not an illness, nor is it something women should simply suffer through in silence. It is a natural stage of life, but that does not mean its symptoms or its wider effects on health should be ignored.

Preparing for menopause is ultimately less about predicting exactly what will happen and more about entering this stage with knowledge, healthy habits and access to the right medical support. Women spend years preparing for major changes in their bodies. Menopause deserves that same attention.

By Dr Ponny M S, Consultant - Gynaecologist & Laparoscopic Surgeon, Apollo Adlux Hospital, Keralam