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!

From childhood, many girls are taught to be agreeable, responsible and perfect in everything they do. They are praised for being obedient, hardworking and emotionally controlled. Over time, this expectation can shape behavior in ways that may quietly harm mental and physical health.

This pattern is often referred to as “Good Girl Syndrome”. While it is not a formal medical diagnosis, doctors say the effects of constantly trying to live up to expectations can be very real. The pressure to appear composed and capable all the time can lead to emotional suppression, chronic stress and eventually hormonal disturbances.

To understand how this pressure affects the body, NDTV Health spoke with Dr. Y. D. Meherprasad, Senior Consultant in Endocrinology and Preventive Healthcare at MGM Malar Hospital, Chennai, who says he has observed this pattern among many young women in his clinical practice.

The Hidden Stress Behind Perfection

Good Girl Syndrome describes a behavioral pattern where individuals, often women, feel compelled to meet expectations without showing weakness or stress. This can translate into people pleasing behaviour, fear of conflict and difficulty setting boundaries.

Dr. Meherprasad explains that constantly trying to maintain this image can create a persistent stress response in the body.

“Hormonal imbalances are being noticed in young Indian women associated with the Good Girl Syndrome, where women are always trying to meet expectations and are continuously successful, all without showing any signs of stress,” he told NDTV Health.

According to him, the problem arises when emotions are suppressed for long periods. “When women suppress emotions for long periods, the body remains in a state of constant stress response,” he said.

Emerging research in the field of psychoneuroendocrinology suggests that emotional stress can directly influence hormonal regulation in the body.

The Cortisol Connection

At the centre of this process is cortisol, the body’s main stress hormone. Normally, cortisol rises briefly during stressful situations and then returns to normal levels once the threat passes.

However, when stress becomes constant, cortisol levels can remain elevated for long periods.

Studies have shown that chronic high cortisol can disrupt reproductive hormones. One effect described in research is sometimes called “progesterone steal,” where the body prioritizes producing stress hormones instead of reproductive hormones.

Low progesterone levels can contribute to irregular menstrual cycles, acne and other hormonal symptoms that many young women experience.

Stress, Insulin Resistance And PCOS

Dr. Meherprasad says chronic stress may also contribute to metabolic changes. In some cases, it can mimic or worsen conditions such as Polycystic Ovary Syndrome (PCOS).

When cortisol levels remain high, the body releases more glucose into the bloodstream to provide energy for a perceived threat. If that energy is not used through physical activity, insulin levels rise to regulate blood sugar.

Over time, this can lead to insulin resistance, which is a key factor associated with PCOS. Women may experience abdominal weight gain, irregular ovulation and difficulty managing their weight.

Warning Signs The Body May Be Struggling

The effects of prolonged stress do not appear overnight. They often show up gradually through subtle changes in the body.

Dr. Meherprasad says menstrual irregularities are one of the early warning signs. Some women may experience delayed cycles or even a temporary halt in ovulation.

Sleep disturbances are also common. Many women report difficulty falling asleep because their minds remain constantly active, leading to fatigue the next day.

Other symptoms may include mood swings, persistent anxiety, brain fog and difficulty losing weight despite maintaining a careful diet.

Restoring Balance

Dr. Meherprasad says addressing these hormonal issues requires both medical evaluation and lifestyle changes.

Regular hormone screenings can help detect issues related to thyroid function, insulin levels and reproductive hormones such as LH and FSH. Early treatment is important if conditions such as PCOS or thyroid dysfunction are present.

Equally important is addressing the emotional component of chronic stress.

“Hormonal imbalance is not only physical but also closely linked to emotional health,” said the doctor.

He recommends prioritizing adequate sleep, regular physical activity and practices such as yoga that help calm the body’s stress response. Creating space for emotional expression through journaling or therapy can also help reduce long term stress.

In a culture that often rewards perfection, doctors say it may be time to rethink the idea of the “perfect girl”. Sometimes, protecting one’s health begins with allowing space for imperfection.

Cancer deaths in the United Kingdom have dropped to their lowest recorded levels, according to new data from the charity Cancer Research UK. The figures show that cancer death rates have fallen by 11 per cent in the past decade, reflecting progress in early detection, screening, treatment and prevention.

Researchers estimate that around 247 people in every 100,000 in the UK now die from cancer each year. This is a significant decline from the peak recorded in 1989, when about 355 people per 100,000 died annually from the disease. Overall, that represents a 29 per cent reduction over the past few decades.

Experts say this steady improvement is the result of sustained scientific progress, improved healthcare systems and public health measures that target risk factors such as smoking.

Major Declines In Several Common Cancers

The new data highlights falling death rates across several major cancers. Ovarian cancer deaths have dropped by 19 per cent over the past ten years, up to 2024. Lung cancer deaths have fallen by 22 per cent during the same period, reflecting the long-term impact of reduced smoking rates and better treatment options.

Deaths from stomach cancer have seen one of the most dramatic improvements, dropping by 34 per cent in the past decade. Bowel cancer deaths have decreased by six per cent, while breast cancer deaths have fallen by 14 per cent.

Other cancers have also seen notable declines. Cervical and prostate cancer deaths have both dropped by 11 per cent. Deaths from leukemia are down by nine per cent, while esophageal cancer deaths have fallen by 12 per cent.

Experts say improved diagnosis, new therapies and better awareness are playing a key role in these trends.

Screening And Vaccination Making A Difference

One of the biggest public health successes has been the decline in cervical cancer deaths. Since the 1970s, deaths from cervical cancer have fallen by around 75 per cent in the UK. Health experts attribute much of this progress to the national cervical screening programme run by the NHS.

Screening helps detect abnormal cells early, allowing treatment before cancer develops or spreads.

Another major contributor is the human papillomavirus vaccine, commonly known as the HPV vaccine. The vaccine protects against the virus responsible for most cervical cancer cases. It is routinely offered to schoolchildren in the UK, and since its introduction in 2008, at least 6.5 million young people have received it.

Public health experts believe the vaccine will continue to reduce cervical cancer rates in the coming decades.

Some Cancer Death Rates Still Rising

Despite the overall progress, the data also shows worrying increases in deaths from certain cancers. Gallbladder cancer deaths have risen by 29 per cent, while deaths from eye cancer have increased by 26 per cent.

Liver cancer deaths are up by 14 per cent, and kidney cancer deaths have risen by five per cent. Meanwhile, death rates for thyroid cancer, pancreatic cancer and melanoma have remained largely unchanged.

Another important trend is that the total number of people dying from cancer continues to rise. This is largely due to population growth and an ageing population, as cancer risk increases with age.

Calls For More Research And Clinical Trials

Experts say the long-term decline in cancer deaths reflects decades of medical research and innovation. However, they stress that continued investment is necessary to sustain progress.

Cancer Research UK researcher Dr Sam Godfrey said the figures show the impact of scientific breakthroughs over many years. He has called on the government to support more clinical trials and ensure that NHS staff have enough time and resources to take part in life saving research.

Public health policies such as smoking bans, along with screening programmes and vaccines, are also credited with helping drive down cancer deaths across the country.

Are you in the habit of catching up on social media or news updates while sitting on the pot? A new study shows you may be "unintentionally" spending extra time and increasing your risk of developing painful hemorrhoids by 46 percent.

The study, published in the open-access journal PLOS One, explained that getting distracted by news or social media can increase pressure on sensitive anal tissues, which leads to hemorrhoids.

Hemorrhoids, also called piles, are swollen and inflamed veins around your anus or in your lower rectum.

"Using a smartphone while on the toilet was linked to a 46 percent increased chance of having hemorrhoids. We're still uncovering the many ways smartphones and our modern way of life impact our health,” Trisha Pasricha, from the Beth Israel Deaconess Medical Center in the US.

“It's possible that how and where we use them -- such as while in the bathroom -- can have unintended consequences," she added.

For the study, the researchers examined data from colonoscopies of 125 adults in America, and conducted an online survey to understand their lifestyle habits and behavior while using the toilet.

Two-thirds of the participants reported using their smartphones while on

the toilet. Compared with those who did not, endoscopists found that they had a 46 percent higher risk of hemorrhoids.

Longer Toilet Time And Mobile Scrolling

More than a third of bathroom smartphone users reported spending more than five minutes there during a single visit -- reading news (54.3 percent), or browsing social media (44.4 percent).

In comparison, just 7.1 percent of non-users reported staying that long.

"Smartphone use may unintentionally extend the time people spend sitting on the toilet. Sitting for longer periods could increase pressure on tissues in the anal region, which may contribute to the development of hemorrhoids,” the researchers said.

Pasricha suggested individuals leave smartphones outside the bathroom to understand the actual time it takes for a bowel movement.

"If it's taking longer, ask yourself why. Was it because having a bowel movement was really so difficult, or was it because my focus was elsewhere?" she said, calling for more studies.

Hemorrhoids: The Symptoms, Risk Factors

Studies estimate that hemorrhoidal disease affects 40% of people all over the world, and it is one of the most common diseases in the anorectal region.

The two types of hemorrhoids are:

• external hemorrhoids -- under the skin around the anus
• internal hemorrhoids -- in the lining of the anus and lower rectum

• bright red rectal bleeding during bowel movements,
• anal itching or irritation, pain or discomfort (especially while sitting),
• swelling or hard, tender lumps around the anus

• straining during bowel movements
• sitting on the toilet for too long
• chronic constipation or diarrhea
• eating low fiber foods
• older age >50
• pregnancy
• lifting heavy objects

• consume 25-35g of fiber daily,
• drink 6-8 glasses of water,
• avoid straining,
• limit toilet time to under five minutes
• do not delay bowel movements,
• maintain hygiene.