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.

Obstructive hypertrophic cardiomyopathy (oHCM) remains one of the most misunderstood cardiac conditions, despite being the most common inherited cardiomyopathy. Misconceptions around the disease often lead to fear, delayed diagnosis, and hesitation in seeking appropriate medical care.

While oHCM has historically been associated with sudden cardiac death, particularly in young athletes, advances in diagnosis and treatment have significantly transformed its management. Today, with early diagnosis and appropriate treatment, many patients can lead active and fulfilling lives.

Understanding the facts is essential, not only for patients living with the condition, but also for families, caregivers, and the wider community. Separating myths from medical evidence can help ensure timely diagnosis, informed treatment decisions, and better long-term outcomes.

Understanding oHCM

Obstructive hypertrophic cardiomyopathy (oHCM) is a form of hypertrophic cardiomyopathy (HCM)—an inherited heart muscle disorder caused by genetic mutations that affect heart muscle structure and function. These changes cause the heart muscle to become abnormally thick, most commonly affecting the wall (septum) between the two lower chambers of the heart.

In nearly two-thirds of patients with hypertrophic cardiomyopathy, the thickened heart muscle can block the flow of blood leaving the heart—a condition known as obstructive HCM (oHCM). As a result, the heart must work harder to pump blood throughout the body, often leading to symptoms such as breathlessness, chest pain, fatigue, dizziness, palpitations, or fainting during physical activity.

Myth: A diagnosis of oHCM inevitably leads to sudden death.

Fact: While oHCM was once primarily recognised for its association with sudden cardiac death, advances in medical science have significantly improved patient outcomes.

With timely diagnosis, appropriate medical care, and ongoing monitoring, many people with oHCM can lead active lives with a good quality of life and a near-normal life expectancy. Regular follow-up helps assess disease progression and guides individualized care over time.

Myth: People with oHCM need to avoid physical activities

Fact: Complete avoidance of physical activity is no longer recommended for most patients.

Although high-intensity competitive sports may not be suitable for everyone with oHCM, mild-to-moderate exercise is generally encouraged and offers important cardiovascular benefits. Exercise recommendations should always be individualised after a comprehensive assessment by a cardiologist, taking into account symptoms, severity of obstruction, and overall risk profile.

Myth: Diet and lifestyle are the primary causes of oHCM.

Fact: oHCM is a genetic condition. It is not a lifestyle disease.

Unlike heart conditions caused by high blood pressure, diabetes, or high cholesterol, oHCM develops because of inherited genetic mutations affecting heart muscle proteins. Healthy lifestyle choices remain important for overall cardiovascular health, but they do not cause or prevent the condition itself. Because the disease often runs in families, screening of close relatives may also be recommended.

Myth: Every patient with oHCM will require surgical treatment.

Fact: Surgery is only one of several available treatment options. Care is individualized, and the most appropriate approach depends on each patient's symptoms and clinical condition.

Myth: oHCM cannot go unnoticed.

Fact: The condition can remain silent for years. Some individuals carrying the genetic mutation never develop symptoms, while others experience mild or intermittent symptoms that may be attributed to more common conditions. Typical symptoms include:

• Shortness of breath
• Chest pain
• Fatigue
• Palpitations
• Dizziness or light-headedness
• Fainting, particularly during or after exercise

Given this variability, individuals with persistent symptoms or a family history of cardiomyopathy or sudden cardiac death should undergo appropriate cardiac evaluation.

Myth: Medication can cure the disease

Fact: Advances in treatment have significantly improved disease management, helping many patients lead healthier and more active lives. While current therapies focus on controlling symptoms and reducing complications, ongoing research continues to expand treatment possibilities.

Treatment aims to reduce symptoms, improve blood flow, minimize obstruction, and lower the risk of complications such as abnormal heart rhythms and heart failure. Long-term follow-up remains an important part of care, allowing treatment to be adjusted as the condition evolves.

Myth: There's no benefit to diagnosing oHCM early

Fact: Early diagnosis can make a significant difference. Because oHCM symptoms often resemble those of other conditions, timely testing is important—especially for those with a family history of the disease. Early detection can help patients access appropriate treatment, manage symptoms effectively, and reduce the risk of complications.

Why Awareness Matters

The understanding and management of obstructive hypertrophic cardiomyopathy have evolved considerably over the past decade. Although it remains a lifelong condition, it is no longer viewed through the lens of fear alone. Advances in medical therapies, improved diagnostic tools, and personalized treatment strategies have changed the outlook for many patients.

By challenging common myths and promoting awareness, more individuals can be diagnosed earlier, receive appropriate treatment, and live healthier, more active lives with confidence.

(Dr. Daljeet Kaur, Cardiac Electrophysiologist at AIG Hospital, Hyderabad)

It is a common belief that metabolic dysfunction-associated steatotic liver disease (MASLD)—formerly known as non-alcoholic fatty liver disease (NAFLD)—is primarily associated with diet, sedentary lifestyles, and obesity. However, there are other factors as well that affect this aspect. Post-menopausal women experience a significantly higher incidence and faster progression of fatty liver disease, even when maintaining a stable body weight.

In Pre-menopausal women, estrogen plays a central role in metabolism by promoting healthy fat accumulation in subcutaneous tissue (below the skin) rather than around internal organs; it also increases insulin sensitivity and suppresses liver inflammation.

After menopause, when estrogen levels drop, this protective function is lost; there is redistribution of fat leading to more fat accumulation around internal organs, including the liver, thus leading to increased chances of NAFLD and also increasing insulin resistance. Needless to say, with age, our metabolic rate also goes down, which also plays a role in this.

The important part lies not only in understanding the above but in going further in early detection and prevention of menopause associated NAFLD. As we know, fatty liver is a silent disease and often does not cause any signs and symptoms till a very advanced stage.

First and foremost is to change lifestyle with advancing age, changing both the dietary habits and physical activity. Regular screening and monitoring are warranted with blood tests, routine metabolic panels, keeping a tab on weight, sugar, and cholesterol levels, and a basic ultrasound of the abdomen. For someone already diagnosed with second or third stage fatty liver, a simple non-invasive FibroScan can help monitor and assess the response to treatment.

Coming to the treatment part of NAFLD in post-menopausal women, being primarily a lifestyle disease, the core of management also lies in managing lifestyle. Medicines are available for treating and controlling NAFLD in conjunction with lifestyle management. Hormone replacement therapy (HRT), when initiated early in post-menopausal women for symptomatic relief, may offer secondary benefits by maintaining metabolic health. However, HRT should always be initiated after proper evaluation and expert guidance.

NAFLD is a silent epidemic and primarily a lifestyle disease; knowing about it and knowing the triggering and precipitating factors helps with understanding and prevention better. Menopause, being a natural biological phenomenon in every female’s life, makes it essential for us to know how it affects our liver health and overall health as well.

Eating healthy is often associated with loading your plate with salads, fruits, whole grains, legumes, smoothies and sugar-free products. However, a diet that is considered healthy for one person may trigger digestive discomfort in another. Bloating, excessive gas, abdominal cramps, constipation or loose stools after eating “healthy” foods may indicate that your gut is struggling with the quantity or type of foods you are consuming.

One common reason is a sudden increase in dietary fibre. Fibre is essential for bowel health and can support regular bowel movements, but increasing it too quickly can cause fermentation in the large intestine, resulting in gas and bloating. Adults generally need around 22–34 grams of fibre daily, depending on age and sex, but it is better to increase intake gradually rather than making a sudden dietary shift.

Certain nutritious foods can also contain FODMAPs—short-chain carbohydrates that are poorly absorbed in the small intestine. Foods such as onions, garlic, beans, lentils, cauliflower, certain fruits and some dairy products can trigger bloating, abdominal discomfort, diarrhoea or constipation in susceptible individuals, particularly those with irritable bowel syndrome (IBS). A low-FODMAP diet may help selected IBS patients, but it should ideally be undertaken with medical or dietetic guidance and followed by gradual reintroduction of foods.

“Sugar-free” does not necessarily mean gut-friendly either. Sugar alcohols such as sorbitol, mannitol, xylitol and maltitol can be incompletely absorbed and may cause gas, bloating or diarrhoea in some people. Similarly, large quantities of fruit, fruit juices or certain whole grains may aggravate symptoms in people with specific carbohydrate intolerances.

Another overlooked factor is how we eat. Eating very quickly, consuming large meals, drinking fizzy beverages, chewing gum or using straws can increase swallowed air and contribute to belching and bloating. Smaller meals, slower eating and adequate hydration can often make a meaningful difference.

The solution is not to abandon healthy foods, but to personalise your diet. Maintain a food-and-symptom diary, introduce fibre gradually, identify individual triggers and avoid unnecessarily restrictive diets. Persistent symptoms should not simply be attributed to “food intolerance.” Recurrent abdominal pain, unexplained weight loss, anaemia, blood in the stool or black stools require medical evaluation because these may indicate an underlying gastrointestinal condition rather than simple dietary sensitivity.

A healthy diet should nourish your body without consistently making your gut uncomfortable. The goal is not to follow every trending diet, but to understand what works for your individual digestive system.