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!

A uterine growth diagnosis can be very alarming. That said, it is vital to note that such growths are often simple, run-of-the-mill fibroids. They are non-cancerous, very common, and completely harmless. At the same time, it is important to realise what uterine sarcoma is, and why fibroids are often confused with uterine sarcoma. It comes down to anatomy. The uterus consists mainly of smooth muscle tissue. A fibroid is just an overgrowth of this smooth muscle that expands over time. Uterine sarcoma is a rare cancer that originates within that very same muscle wall. Since both develop in the same spot, they tend to trigger identical symptoms—like unexpected bleeding, pelvic aching, or pressure.

Why Accurate Diagnosis Matters Before Surgery

Before starting treatment, it is important to fully understand what the diagnosis is, as that is the first step to safety.

Surgeons often treat routine fibroids with minimally invasive techniques. These methods break or chop the tissue into smaller fragments so it can be pulled through tiny incisions. If a growth, however, turns out to be an unsuspected sarcoma, breaking it apart inside the pelvis can spread malignant cells. A thorough diagnostic workup beforehand makes sure nothing gets disrupted accidentally, so that the surgical team builds the safest possible treatment plan.

What You Need to Know About Fibroids

Here is some genuine peace of mind: benign fibroids don't suddenly turn into cancer. Medical research shows that malignant transformation inside an existing fibroid is exceptionally rare. Because fibroids and sarcomas are biologically different conditions from the start, monitoring a standard fibroid does not put you at risk of it turning into a tumor down the line.

Most fibroids stay completely harmless throughout life. It is, however, important to watch out for a few specific red flags:

Post-menopause changes: Fibroids shrink on their own once hormone levels drop after menopause. Any new growth or spotting at this stage demands a closer look.

Growths that keep expanding on medication: If a mass gets bigger while one is on prescriptions designed to shrink it, the patient must seek out a secondary review.

Ambiguous scans: When a routine ultrasound shows atypical tissue structure, stepping up to advanced imaging helps clear up the picture.

Next Steps and Second Opinions

Following an ultrasound, it is recommended to opt for a dedicated pelvic MRI for a much sharper view of the uterine muscle wall to confirm whether a mass is truly benign.

Getting a second opinion from a specialist is a normal, proactive move. It is especially critical if:

• A mass grows rapidly after menopause.

• A patient develops new pelvic symptoms or bleeding years after your period has stopped.
• The scans are flagged as atypical or difficult to read.

The good news is that uterine sarcomas are remarkably rare, making up just 2% to 5% of all uterine cancers. A patient needs to be cognizant by paying attention to changes in the body and asking questions about the scans.

Dr Bindhu KS - Sr. Consultant Obstetrics, Gynaecology & Robotic Surgery, Apollo Hospitals Navi Mumbai

For many women, polycystic ovary syndrome (PCOS) begins with a familiar story—irregular periods, acne, unwanted hair growth or difficulty conceiving. But PCOS is far more than a reproductive disorder. At its core, it is often a complex interplay between metabolism, hormones and reproductive health.

One of the most important, yet frequently overlooked, pieces of this puzzle is insulin resistance. When the body becomes less responsive to insulin, the pancreas compensates by producing more.

Elevated insulin levels can, in turn, contribute to increased androgen production by the ovaries and disrupt the delicate hormonal signals required for regular ovulation. The result may be irregular cycles, fewer ovulations and, for some women, difficulty becoming pregnant.

PCOS And Insulin Resistance Can Affect Women Of Any Weight

Importantly, PCOS and insulin resistance are not synonymous with obesity. Women with a healthy body weight can also have significant metabolic abnormalities. This is why judging metabolic health by appearance alone can be misleading.

The 2023 International Evidence-based PCOS Guideline recognises insulin resistance as an important underlying feature and recommends attention to metabolic risk across the weight spectrum.

Also read: Decoding The Fertility Markers

The Metabolic Risks Go Beyond Fertility

The metabolic implications extend well beyond fertility. Women with PCOS have a higher risk of impaired glucose tolerance and type 2 diabetes, making long-term metabolic surveillance an important part of care.

The guideline recommends appropriate glycaemic assessment, particularly when pregnancy is being planned or fertility treatment is being considered.

Also read: Can Regular Consumption of Junk and Processed Food Affect Fertility?

Building A Healthier Foundation For Pregnancy

Yet there is an equally important message of hope: PCOS does not mean infertility, nor does it have to define a woman’s health journey. Lifestyle interventions—including regular physical activity, nutritious eating, adequate sleep and sustainable weight management where appropriate—form the foundation of care and can improve metabolic health.

For a woman planning pregnancy, the goal should not simply be to “get pregnant.” It should be to enter pregnancy metabolically and emotionally healthier, with blood sugar, blood pressure, nutrition, lifestyle and other risk factors appropriately addressed.

Take-home message: PCOS is not merely about irregular periods or cysts on the ovaries. It is a lifelong condition in which metabolic health and reproductive health are deeply connected. Recognising insulin resistance early, looking beyond weight, and providing personalised care can help women protect both their fertility today and their health for years to come.

The view generally is that the occurrence of knee issues is usually associated with age, injury or overexertion. However, there is another reason people ignore: lack of movement. If a person leads an inactive lifestyle, spending long hours sitting at a desk, working from the couch, watching TV or doing nothing physical, the eventual consequences for the knees might arise.

Knees are created for motion, and motion is essential for keeping the flexibility of a joint. Their effective functioning depends on the health of the muscles surrounding your knee. The less active various leg muscles are, including quadriceps and other counterparts, the weaker they will be. The muscles help stabilize the knee and can relieve it from some of the burdens during daily activities performed by the knees.

Remaining seated for an extended time can also lead to stiffness. When you sit for a while, you may feel uncomfortable or stiff in your knees when you finally stand up. While the occasional instance of stiffness may go away with movement, constant stiffness can impact mobility and cause people to wish to move even less.

Another issue is gaining weight. Living a sedentary lifestyle causes individuals to become heavier, and excess weight puts more stress on the knees. In time, this added pressure will lead to increased wear of the joints and the development of knee pain and other problems in the musculoskeletal system.

The positive aspect with respect to your knees is that you don’t have to put in hours at the gym to keep them safe. Small, steady efforts can easily do the trick. You can choose to walk for five minutes after being seated for a long time, stretch regularly, take stairs if you are physically able and do some simple workouts for the legs and thighs to increase strength. Low-impact sports such as swimming, cycling and walking can help you maintain muscle power and flexible joints while avoiding the stress on your knees resulting from extensive workouts.

Persistent pain in the knee, however, cannot be treated as a usual symptom of ageing. Knee swelling or prolonged stiffness, difficulties climbing stairs, instability, or pain that has an impact on routine activities should be addressed by health professionals.

Movement is necessary for knees to be strong and flexible. Therefore, if you want your knees to be strong, you need to use them consistently and perform all activities without remaining still for long.

(By Dr Sujoy Bhattacharjee, Chairman & Chief, Max Institute of Robotic Joint Replacement, Max Super Speciality Hospital, Saket)