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!

Many in their late 30s and early 40s find themselves Googling weird stuff, including 'why am I having a tingling feelin in my arm?' 'why do I feel like something is brushing across my arm?', and more. This is what many call a phantom feeling arm, which means there is nothing actually tickling, but you feel it anyway. Medically, it is known as paresthesia, a tingling feeling or numb sensation, usually what people refer to as the pins and needles sensation. This is caused by temporary pressure on a nerve or any underlying nerve damage issue.

If you look up anything like that, many women claimed, it instantly shows: perimenopause.

Despite an increased awareness around it, perimenopause and menopause still remain a taboo. In a survey, it was found that 54 per cent of women were concerned about the uncertainty they are about to face in their perimenopause and menopause period.

Menopause is not just hot flashes, it is much more than that. Dr Mahima Gulati, an endocrinologist at UConn Health points out symptoms like gaining weight despite "doing everything right", brain fog, aching joints, sleepless nights, exhausting days, and depleted energy. She says "These symptoms are real. This is not something women are imagining, and it is not just aging. There are real biological changes happening, and women deserve evidence based care and support as they move through them."

What Can Help Women Dealing With Menopause and Perimenopause?

Before going into the solution, let us first understand what these term really mean.

Perimenopause: It is the period when a menstruator transitions to menopause, or when the period stops permanently. This phase is characterized by fluctuating hormone levels, irregular periods, which could be shorter, longer, heavier, or lighter, hot flashes, sleep problems and mood changes.

Menopause: This is the natural, permanent end of menstruation defined as 12 consecutive months without a period. This typically occurs between ages 45 to 55.

What Can Help In Menopause And Perimenopause?

Form Connections

“For women to sit in a room and realize they are not alone is incredibly therapeutic. Connection itself reduces the burden of chronic conditions,” points out Dr Gulati.

The doctor points out that women often learn from each others’ experience and this is why social connections are extremely important in this time.

Pay Attention On Sleep

Sleep problems are one of the most common and exhausting symptoms of perimenopause and menopause. Hormonal changes can disrupt deep sleep, causing women to wake up in the early hours, deal with night sweats, and struggle to fall back asleep. When this happens regularly, it leads to severe energy drain, not just tiredness.

To improve sleep, Gulati focuses on simple, practical habits. These include keeping a regular sleep schedule, avoiding caffeine and alcohol in the evening, reducing screen time after 7 p.m., keeping phones out of the bedroom, and practicing calming activities like yoga or meditation. Drinking enough water during the day can also help regulate body temperature at night and reduce hot flashes.

Managing Stress Differently

Instead of trying to eliminate stress, which is often unrealistic, Gulati encourages women to change how they respond to it. Stress is treated as a signal to reassess priorities, set boundaries, and ask for support when needed. This shift helps build resilience and prevents burnout.

Movement Beyond Exercise

Physical activity becomes especially important in midlife, but it’s not just about workouts. Strength training helps protect muscles and bones, while regular movement throughout the day, balance exercises, and flexibility work support long-term health. Reducing long sitting hours is just as important as planned exercise.

Reducing Harmful Habits

Gulati also advises cutting back on alcohol and avoiding tobacco. After menopause, alcohol can worsen sleep, increase belly fat, and raise the risk of conditions like breast cancer and osteoporosis. Limiting late-night screen use can further improve sleep quality.

Eating to Support the Body

Nutrition is another key focus. Rather than aiming for perfection, Gulati encourages small, steady improvements like eating more vegetables and protein, staying hydrated, and choosing foods that may ease menopausal symptoms. The goal is better energy, sleep, and overall health, not just weight loss.

Glaucoma is an umbrella term for a group of eye diseases that create pressure inside your eyeball, which can damage delicate, critical parts at the back of your eye, including the optic nerve.

While most of the diseases are progressive, meaning they gradually get worse and eventually cause permanent vision loss and blindness. In fact, glaucoma is the second-leading cause of blindness worldwide and is the leading cause of blindness for people over 60 years old.

Dr Niteen Dedhia, Medical Director, Ojas Maxivision Eye Hospital tells Business Standard: "Glaucoma slowly and quietly causes damage to the optic nerve. Changes in eye pressure, blood flow and nerve fibres occur over time, while the brain often compensates for the loss.

"As a result, symptoms go unnoticed, and by the time vision loss becomes apparent, the damage is usually permanent."

Many forms of glaucoma have no warning signs and the effect is extremely gradual, to the point that you may not notice a change in vision until the condition is in its late stages.

Here are some symptoms that mid-age people need to keep an eye out for:

1. Gradual loss of circumferential vision

One of the earliest symptoms of glaucoma is damage and subsequent loss of peripheral vision. Dr Dedhia noted: “Glaucoma starts by damaging the peripheral vision but doesn’t affect the centre (front) vision."

If you seem to struggle with spotting objects approaching from the side or bump into things more often, you may be experiencing early stages of the disease and not merely experiencing normal ageing.

2. Difficulty seeing or reading in the dark or low light settings

3. Frequent changes in eye power

Dr Neeraj Sanduja, Ophthalmologist, Eye Surgeon at Viaan Eye Centre, Gurgaon told the publication: "Needing frequent prescription changes or feeling that glasses 'never feel quite right' may reflect subtle visual field changes caused by glaucoma rather than simple refractive error progression."

4. Eye pressure or unusual discomfort

Open-angle glaucoma, the most common form of the condition that causes patchy blind spots in your side vision, is often painless or limited to a mild sense of pressure or heaviness in the eyes.

Those suffering from open-angle glaucoma may notice a dull ache after prolonged screen time or reading that improves with rest. Frequently mistaken as regular eye strain, it is often ignored, however, may indicate subtle increases in eye pressure that require professional evaluation.

5. Frequent headaches with eye strain

Frequent headaches, especially when accompanied by eye strain or blurred vision, should not be ignored as migraine pain as it may signal rising eye pressure or early glaucoma changes, Dr Dedhia warns.

Who Is at Risk for Glaucoma?

Certain groups of people have a higher than normal risk of getting glaucoma which includes those who:

• have high eye pressure
• are farsighted or nearsighted
• have had an eye injury
• use long-term steroid medications
• have corneas that are thin in the center
• have thinning of the optic nerve
• have diabetes, migraines, high blood pressure, poor blood circulation or other health problems affecting the whole body
• are over age 40
• have family members with glaucoma
• are of African, Hispanic, or Asian heritage

Abnormal sleeping patterns, whether excessive or brief, can significantly increase your risk of developing chronic liver disease, an EMJ study suggests.

Sleep duration has previously been linked to worsening your chances of Type 2 diabetes; obesity; cardiovascular diseases including hypertension, stroke, heart attack; mental disorders such as depression, anxiety; weakened immune system and potentially contributing to neurological conditions such as dementia.

However, researchers have now also found that sleep disruption may intensify existing stress on the liver which can worsen metabolism and pave the way for disease progression.

The authors noted that poor sleeping habits may influence liver health for multiple reasons including by altering glucose metabolism, increasing inflammation and disrupt circadian rhythms that regulate liver function.

"Participants who reported consistently short sleep duration were more likely to have elevated liver enzymes and higher fibrosis risk scores compared with those reporting moderate sleep duration. Long sleep duration was also associated with adverse liver markers, though the relationship was weaker than that observed for short sleep," the study noted.

Despite discovering links, the involved researchers noted that the study only highlighted sleep as a potential factor that could worsen liver function along with other lifestyle reasons and did not act as a clear cause.

Why Is Chronic Liver Disease A Concern?

Once a rare condition, non-alcoholic fatty liver disease (NAFLD) now affects one in three Indians. A JAMA study has now found that about 40 percent of the global population is now suffering from NAFLD, with abdominal obesity identified as its single biggest risk factor.

Researchers found that nearly 70 percent of people with Type 2 diabetes and about 80 percent of those with obesity are affected by NAFLD. They also discovered that NAFLD prevalence is higher in men than in women, with rates of 15,731 per 100,000 population in men compared with 14,310 in women.

READ MORE: This Deadly Liver Disease Is Affecting People In Their 20s And This One Symptom Is The Red Flag

Between 2010 and 2021, India recorded a 13.2 percent increase in age-standardized prevalence, ranking just behind China at 16.9 percent and Sudan at 13.3 percent. Additionally, the disease peaks earlier in men, between 45 and 49 years of age, while women show the highest prevalence between 50 and 54 years.

NAFLD, now called as metabolic dysfunction-associated steatotic liver disease (MASLD), is when excess fat builds up in the liver, unrelated to heavy alcohol use, due to obesity, Type 2 diabetes, high blood pressure and cholesterol.

It ranges from simple fat accumulation to inflammation and damage, which can progress to fibrosis, cirrhosis or liver cancer, The disease often has no symptoms and is managed with lifestyle changes such as diet and weight loss.

Why Is NAFLD on the rise?

Poor diets (high carbs/sugar), sedentary habits and rising obesity are some of the key reasons why an uptick in NAFLD cases has been seen pan-India. Increased intake of refined carbs, sugary drinks, processed foods and unhealthy fats can increase the risk of obesity, diabetes, hypertension and high cholesterol which can pave the way for this liver disease.

Experts also note that working long hours at desks without any proper physical activity can lead to weight gain and fat accumulation in the liver.

According to the Union Health Ministry, the prevalence of the condition could be in the range of 9-53 percent. Multiple other health studies also suggest nearly 40 percent of urban Indians may have some form of fatty liver disease

Hepatologist Dr Cyriac Abby Philips, popularly known as LiverDoc on social media, noted on X that many patients do not realize that timely lifestyle changes can completely reverse the condition. “All it takes is being in charge of your body and health. No shortcuts—go slow and steady,” he wrote.

If left untreated, NAFLD can progress to Non-Alcoholic Steatohepatitis (NASH), where liver inflammation begins. Over time, this inflammation can lead to scarring of the liver, known as fibrosis. Advanced fibrosis results in cirrhosis, which severely affects liver function.

NAFLD can also increase the risk of chronic liver disease, liver failure and hepatocellular carcinoma. Many patients diagnosed with liver cancer have a history of untreated fatty liver.