A report by Swachh Bharat Mission says that 74.5 per cent of public places are equipped with toilets. Another report by the Ministry of Jal Shakti states that there are 2.23 lakh Community Sanitary Complexes built across all States and UTs under the Swachh Bharat Mission (SBM) since October 2014. Over 92 lakh toilets have been constructed since the launch of SBM Gramin (SBM (G)) in April 2020.

While toilets are there, are they accessible? This is the question one should ask. The National Family Health Survey (NFHS) focuses on 131 health indicators, but not until the NFHS 5 survey did they include the question of accessibility of toilets in the survey. This happened after the inputs from the Department of Drinking Water and Sanitation (DDWS) and the Ministry of Health & Family Welfare questioned the accessibility.

One might ask, why is the question of accessibility so important? The answer is quite simple. Access to water, sanitation and hygiene is the most basic human need and is also included under the Sustainable Development Goals by the UN.

Are These Numbers Real?

This thought crossed my mind because back in 2021, I went on a solo trip, on a bus to Udaipur from Delhi. There, the bus made two stoppages. This was done so people could get a quick dinner and freshen up, relieve themselves and be prepared for the rest of the journey. This was a nightmare. The bus only stopped for 10 minutes. While some men used the washroom, others went to the bushes.

For the women, there were three cubicles. One of them was broken, and the other one did not have a light bulb, which meant only one was usable. There was a long queue for that cubicle, and time was short. There was no point in trying to find an isolated corner, because it was past midnight, in an unknown area.

I waited anxiously. When finally, my turn came, I saw an overused, dirty washroom. The toilet seat is in a horrible condition. I wanted to touch nothing there. But I had to pee. So, I used my mask to cover my nose from the odour, folded my pants so they did not touch the floor and squatted. It was quite a task to balance.

On my way back to Delhi, I made sure to not drink any water for over a 13-hour bus journey. I dehydrated myself so I did not have to use the washroom. When I did reach, I was severely dehydrated and was sick for three days.

I shared my experience with my friends only to realise that many women have faced the same. There are no washrooms for women.

A friend of mine told me that it is because these roads and dhabas are mainly designed to serve men. They are the ones who travel at night or are on the roads most of the time. As a result, the few women who do travel or are on the road suffer.

Health Risks Women Are Prone To

Well, it is true, but partially. While holding your pee for too long can lead to health risks, peeing on a dirty toilet seat cannot lead to infections unless your urethra is in contact with the bacteria present on that toilet seat. However, nobody wants to sit on a dirty toilet seat, even if you do not get an infection. A safe and hygienic toilet is a basic need.

One of the regular saleswomen, Usha, who visits my house shared her experience with me. “Being on the road constantly means I must use the dirty public washrooms. But I do not want to use them. So, sometimes I ask my regular customers to let me use their washrooms. Some say yes, and some say no. I understand they are also concerned about their safety and privacy,” she says. As a result, Usha spends most of her day not drinking enough water and holding her pee when she is at work. Due to this, she also suffered from a Urinary Tract Infection (UTI).

Her friend, Halima too faced similar problems and due to increased levels of uric acid in her body, she suffered from Hyperuricemia.

Other health risks are kidney stones and other kidney problems, headaches, dull skin, xerostomia or dry mouth, fatigue, and urinary incontinence, which means losing control over your pelvic floor muscles leading to uncontrolled leakage of urine, seizures and weakness.

What Can You Do?

Wear comfortable clothes and capris. Capri pants are comfortable and are short in length, which means this won’t touch the toilet floor when you squat or sit.

Carry Essentials

Even though you cannot get a UTI alone from sitting on a toilet seat, it is always safe to carry a toilet seat sanitiser. If nothing, it can help you get rid of the bad odour so you can use your stand and pee device inside the toilet. You can also use disposable toilet seat covers if your knees are weak, and you cannot squat. Always flush with your seat down.

Always keep disposable gloves, a portable bidet (fill it with water before use), a pocket liquid handwash, wet wipes, tissues and sanitiser handy. Do not forget to keep extra sanitary pads. It might sound a lot, but I promise that it all fits in one pouch. Use this travel-friendly pouch every time you are on the road, or using a public washroom.

What Can We Learn From Others?

However, in case we do not get these technologically advanced toilets here, you can always pack a travel-friendly toilet kit!

More women in the US and UK are seeking testosterone to manage menopause symptoms, with some turning to online pharmacies without a prescription, according to media reports.

There are no US Food and Drug Administration (FDA)-approved testosterone products specifically indicated for women. Australia has approved a low-dose testosterone product for postmenopausal women, while the UK and New Zealand permit some female-dosed formulations, although availability varies.

What’s Happening In The US?

Reuters reported that off-label testosterone use is rising in the US, mainly to treat persistently low sexual desire associated with menopause. Some clinicians are also prescribing testosterone for symptoms such as fatigue and loss of muscle strength, despite a lack of medical guidance supporting these uses.

Prescriptions for low sexual desire reportedly rose 146% between January 2023 and July 2026. However, many pharmacies and health insurers continue to deny these prescriptions.

Also read: US Congress To Hold First-ever Menopause Hearing: Why It Matters For Women

Why Are UK Women Turning To Testosterone?

The BBC reported that some women in Wales are posing as men to buy testosterone from online pharmacies because of difficulties accessing NHS prescriptions.

There has also been a “very sharp increase” in testosterone referrals to the NHS for postmenopausal women.

Menopause specialist Dr Michelle Olver said she had seen women with testosterone levels up to 12 times the safe level after buying the hormone online, putting them at risk of permanent side effects.

Why Is Testosterone Gaining Attention?

Also read: ‘I Was Vocal About Cancer But Silent About Menopause Out Of Shame’, Says Actress Lisa Ray

Although testosterone is often called a male hormone, women also produce it, primarily through the ovaries and adrenal glands. Levels generally decline with age.

Some women are prescribed testosterone for distressing loss of sexual desire. Others are seeking it for fatigue, impaired thinking, low mood and loss of muscle strength.

The FDA is set to hold a public workshop on September 17 to examine testosterone use in menopausal women. The agency says off-label use is growing, while questions remain about its effects on sexual function, mood, cognition, muscle and bone health, as well as long-term cardiovascular and breast cancer safety.

What Does The Evidence Say?

Menopause does not automatically mean a woman has a “testosterone deficiency.”

Notably, there is no established testosterone level below which an otherwise healthy woman is diagnosed as testosterone deficient. A blood test alone also cannot determine whether low testosterone is responsible for symptoms such as fatigue, low mood or loss of sexual desire.

However, the Menopause Society and other medical organizations support testosterone use in menopausal women with hypoactive sexual desire disorder.

“We do not have any evidence in women that it will improve muscle mass or bone density or mood or well-being or really any other metric,” said Dr Stephanie Faubion, director of Mayo Clinic's Center for Women's Health and medical director of The Menopause Society.

“What testosterone is being touted for in the lay public and on social media is not really what we have data for,” she said.

Are There Any Side Effects?

According to Cleveland Clinic, testosterone treatment generally isn’t recommended for women with cardiovascular disease, liver disease or hormone-sensitive cancers such as breast or uterine cancer.

Excess testosterone can cause acne, increased facial or body hair and scalp hair loss. Higher doses may also lead to voice deepening and clitoral enlargement, some of which can be irreversible.

Testosterone should therefore not be used in higher doses as a way to boost energy, muscle strength or libido.

You've probably seen gallon jugs with stuff like "BORG o'clock somewhere" scrawled on them in Sharpies, often showing up at parties. Well, there's actual research on them now, and it's not great.

The study by Rutgers University, published in the Journal of Studies on Alcohol and Drugs, surveyed over 100 college students about their BORG habits. The study finds significant health risks.

What Is BORG?

BORG stands for "Blackout Rage Gallon," and it's basically a personal-sized jug loaded with liquor, water, and whatever flavoring you're into. It started gaining traction around 2020 and hasn't slowed down since the hashtag #borg has racked up millions in views on TikTok alone.

Here's the number that stands out, though. A full BORG can pack up to a fifth of liquor. That's about 17 standard drinks. In one jug. And it is meant for one person.

ALSO READ: Alcohol-Linked Cancer Deaths Doubled In US: Colorectal Leads In Men, Breast Leads In Women

The study pointed out that drinking games have always been part of college culture. But BORG drinks might be worse than most, mainly because of how they're made. Mixing hard liquor with sweet flavors can make people drink more without realizing how much alcohol they're actually consuming, and the fact that people often share sips of each other's jugs only adds to the risk.

"Excessive drinking in young adults has been fueled by drinking games for many decades. But the mixing of hard liquor and additive flavorings in BORGs may be particularly harmful given the sweetness of the beverage and the lure of sharing one's BORG and tasting others' concoctions," said lead researcher Andrea King, a professor of psychiatry and behavioral neuroscience at the University of Chicago, US.

When Can BORG Drinks Go Wrong?

The actual numbers from the study are rough. Almost a third of students said they'd blacked out from a BORG at some point, not just "drunk," actually blacked out, meaning their brain stopped saving memories from that stretch of time.

Nearly 20 percent of students said they threw up, and nearly 6 in 10 admitted to saying or doing something embarrassing. And this is just the students who actually admitted to having done this. The actual count could be much higher. Some cases were serious enough to end in injuries or trips to the emergency room.

According to the World Health Organization, there is no safe level or risk-free amount of alcohol consumption that does not affect health.

READ MORE: Exclusive: From IPL To Olympics — How Sport Became A Marketing Tool For Junk Food And Sugary Drinks

BORGs: The ‘Safe Drinking’ Myth

What's even more interesting, however, is how this trend began in the first place. BORGs were initially promoted on social media as the more responsible choice when it came to drinking. The idea was for everyone to bring their own jug instead of sharing cups, so as to avoid the spread of germs during the pandemic.

Some recipes online even threw in electrolytes or caffeine, supposedly to dodge hangovers or keep people from getting too drunk. Students still shared their BORGs constantly, and the added ingredients did nothing to stop the harmful effects of drinking so much alcohol at once.

Even knowing all this, however, a lot of students said they're not planning to stop. That's part of why this study seems to emphasize the fact that awareness matters so much, both for students and for their parents.

As King put it, "There are choice points along the way, ranging from whether to attend a BORG event, and if one does attend, whether to bring a BORG beverage and how much (if any) alcohol to put in the beverage. It doesn't have to be all-or-none, as being aware and mindful to minimize risks can be key."

Alzheimer’s disease is normally seen as a disease of old age, something that starts when memory starts to fail in the 70s or 80s. But science has a totally different narrative. Alzheimer’s is not something you ‘catch’ suddenly in old age. It’s a sluggish, degenerative disorder that develops slowly over decades. When a person begins to forget names, ask the same questions, or have trouble with everyday chores, there may have been damage to the brain for years.

This is why neuroprotection should start much earlier, ideally in our 30s and 40s.

Today, most patients only see the neurologist when the symptoms are obvious. Unfortunately, at this stage the disease process has already progressed and therapy options are limited. Doctors and health professionals need to be more open about prevention, to teach younger folks that brain health is established well before retirement age.

Our modern lifestyle is a silent neurological risk. A busy life is making chronic stress, poor sleep, physical inactivity, bad diets and extended hours of sitting normal. But these common activities may be quietly contributing to inflammation that’s damaging blood arteries and brain cells over time. Studies increasingly connect mid-life problems like obesity, diabetes, hypertension and sleep difficulties to a greater risk of dementia in later life.

Sleep is particularly important for removing such toxic substances from the brain. Constant stress boosts cortisol levels, which may interfere with memory areas. A sedentary lifestyle lowers the blood supply to the brain and undermines cognitive resiliency. Something that seems inconsequential today may be important decades from now.

The good news is that prevention is effective. Regular exercise, good sleep, management of stress, social activity, mental stimulation and regular health checks can all help protect the brain. Neuroprotection is not about fear; it’s about awareness and action.

What we decide to do in our 30s and 40s is not just about our careers or lifestyles; it’s about the health of our brains in our 70s and 80s. We need to change the conversation around Alzheimer’s from late-stage therapy to early-life prevention.

By Dr. Neha Pandita, Senior Consultant Neurology, Fortis Noida