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!

Psoriasis is a long-term inflammatory skin disorder that impacts the immune system. It can cause itchy and unsightly areas of thick, flaky skin that can impact your confidence, relationships and everyday activities.

Symptoms can be erratic. Differ among individuals. Although a cure does not exist there are treatments that're effective. It is non-infectious.

What Happens In Psoriasis?

There is overactivity in the system causing an overproduction of skin cells. This causes a build-up of scaly patches known as plaques. The common form of psoriasis is plaque psoriasis. This type of psoriasis often appears on the scalp. It also often appears on the elbows. It also often appears on the knees. It also often appears on the back. This can cause itching, pain, breaking and bleeding. Nails can become pitted, with holes and can become thickened and lifted off the nail bed. Other forms can cause spots, shiny patches in areas of skin fold and pustules.

Depending on your skin colour, you may see /red patches on lighter skin or dark patches with less pink tones on darker skin. Sometimes your skin colour can become temporarily different when the inflammation has subsided.

Causes of Psoriasis

Whilst we do not fully understand the cause of psoriasis, it is caused by a combination of immune and environmental factors. If you have a family history, then you are more likely to develop psoriasis. Common triggers can vary between individuals, but infection, trauma, stress, smoking, excessive alcohol intake and certain medications can cause psoriasis or make symptoms worse.

Strep throat infections are commonly linked to guttate psoriasis (spot-like patches). Knowing your triggers can help; however, there may not always be a trigger.

Can We Reduce Flare-ups?

Unfortunately, there is no way to prevent psoriasis; however, keeping skin clean, taking medication and knowing your triggers can help reduce symptoms.

Have a shower using a cleanser and warm water. Apply a fragrance-free moisturiser to damp skin. Try not to scratch or rub your plaques. Try to avoid causing trauma to your skin and sunburn.

Keeping active, maintaining a weight if needed, quitting smoking and reducing alcohol can all improve your general health. Some people find keeping stress to a minimum helps; however, this cannot replace treatment. If your symptoms get worse when starting medication, let your doctor know. Do not stop taking your medication.

Treatments

This will depend on the type of psoriasis where it's how bad it is and how it is affecting your daily life. Your dermatologist will also take into consideration any medical conditions and if you have any joint symptoms.

Mild psoriasis can often be treated using various treatments. These can include steroids, vitamin D analogues and other medications. Steroids should be used at the correct strength and for the correct length of time depending on the area. Long-term steroids should be monitored.

Phototherapy uses specialist UV light, narrow-band UVB. This may be suggested if you have widespread psoriasis or topical treatments have not worked well enough. This should be monitored. Monitored. More severe or hard-to-treat psoriasis may need medication or biologicals. This can include Methotrexate, Ciclosporin, acitretin, or Apremilast. Biologicals work by targeting inflammatory pathways such as TNF, IL-17 and IL-23. This should be discussed individually with monitoring.

Talk to your doctor about any concerns you have regarding your treatment. This can include side effects, cost and difficulty sticking to a regimen. This will allow your doctor to put together a treatment plan.

Further Considerations

Some people with psoriasis can develop arthritis. If you have any pain, swelling, stiffness when waking up or heel pain, this should be assessed quickly. If left untreated, the inflammation can cause damage to your joints.

Psoriasis can put you at increased risk of developing disease, diabetes and other metabolic issues. This does not mean everyone with psoriasis will develop these conditions, but your doctor can advise what checks you need to do and how to keep your health in check. If your psoriasis is affecting your sleep, confidence, relationships or mood, let your doctor know. Counselling and other mental health support can be an addition to your treatment.

When To See A Doctor

If you have scaling changes to your nails or symptoms that are affecting your daily life, you should see a dermatologist. This will usually be diagnosed by looking at your skin and nails. Occasionally a skin biopsy may be needed.

If you have inflammation, scaling, pustules and are unwell or have a fever, you should seek urgent medical attention. This can indicate psoriasis and needs treating quickly. Whilst psoriasis can be unpredictable, there are treatments available. You deserve a treatment plan to help your symptoms.

The menstrual cycle is more than a monthly reproductive event. It is a complex physiological process involving fluctuations in hormones such as oestrogen and progesterone, which can influence appetite, energy balance, mood and digestion, raising the question: does a woman need to eat differently during different phases of her menstrual cycle?

Current research suggests that nutritional needs do not dramatically change from one week of the cycle to another for most healthy women. However, appetite, food intake and certain symptoms can change across the cycle. Understanding these changes can help women make practical dietary choices without turning nutrition into a complicated four-phase diet.

Understanding the Menstrual Cycle

The menstrual cycle can broadly be divided into the menstrual, follicular, ovulatory and luteal phases.

During menstruation, oestrogen and progesterone levels are relatively low, and the uterine lining is shed. The follicular phase begins with menstruation and continues until ovulation. Oestrogen generally rises during this period and reaches a peak around ovulation.

After ovulation, the body enters the luteal phase. Progesterone rises, along with another increase in oestrogen, before both hormones decline if pregnancy does not occur. These hormonal changes can influence appetite and food preferences.

Research has found that energy intake tends to be somewhat higher during the luteal phase than during the follicular phase.

Some studies suggest that resting metabolic rate may increase slightly during the luteal phase, although the estimated change is relatively small and varies between individuals and studies.

This is important because it means that feeling hungrier before a period is not necessarily a failure of willpower. It may partly reflect normal biological changes.

Why Nutrition Matters Across the Cycle

The goal should not be to follow a completely different diet every week. Instead, nutrition should provide the body with adequate energy, protein, fibre, vitamins, minerals and fluids throughout the entire cycle.

For women who experience premenstrual syndrome (PMS), dietary habits may be particularly relevant. PMS can include bloating, breast tenderness, headaches, fatigue, appetite changes, food cravings and mood changes.

Calcium is one nutrient that has attracted considerable attention. The American College of Obstetricians and Gynecologists recommends including calcium-rich foods such as yoghurt and leafy green vegetables as part of dietary strategies for PMS.

Iron is another important consideration, particularly for women with heavy menstrual bleeding. The recommended dietary allowance for iron is 18 mg per day for women aged 19–50 years. Good sources include lentils, beans, spinach, meat, poultry, seafood, fortified cereals and nuts. Vitamin C-rich foods can improve absorption of plant-based non-haem iron.

Dietary Recommendations

1. During menstruation: focus on iron, protein and hydration

If menstrual bleeding is moderate to heavy, prioritising iron-containing foods is sensible.

Include:

· Lentils, rajma, chickpeas and soy

· Green leafy vegetables

· Eggs, poultry or lean meat

· Sesame and pumpkin seeds

· Iron-fortified cereals

· Vitamin C-rich fruits such as oranges, guava, amla and kiwi

Pairing plant-based iron sources with vitamin C can improve iron absorption.

Adequate fluid intake can help maintain hydration, particularly if you experience symptoms such as bloating or headaches.

2. During the follicular phase: maintain a balanced eating pattern

There is no need for a special “follicular-phase diet”. This can be a good time to establish consistent meals containing whole grains, vegetables, fruits, pulses, dairy or alternatives, nuts and seeds.

Protein should be distributed throughout the day rather than concentrated in one meal.

For example, breakfast could include eggs or paneer with whole-grain toast; lunch could contain dal, vegetables and roti; and dinner could include tofu, paneer, fish or another protein source.

3. Around ovulation: focus on overall dietary quality

Focus on a diet rich in colourful vegetables and fruits, whole grains, legumes, nuts, seeds and adequate protein. These foods provide fibre and a broad range of micronutrients and plant compounds.

4. During the luteal phase: plan for appetite and cravings

This is perhaps where nutrition can be adapted most practically.

Since appetite may increase during the luteal phase, trying to rigidly maintain the same food intake every day may backfire for some women. A better approach is to choose satisfying foods.

Combine protein + fibre + healthy fats in meals and snacks. For example:

• Yoghurt with fruit and nuts
• Roasted chana with fruit
• Apple with peanut butter
• Oats with milk, seeds and fruit
• Whole-grain roti with dal and vegetables

ACOG also recommends complex carbohydrate-rich foods and reducing excessive intake of salt, sugar and high-fat foods when managing PMS symptoms.

Practical Tips

Keep a symptom and food diary. Tracking your cycle for two or three months can help identify personal patterns in appetite, cravings, bloating, bowel habits, headaches and mood.

Do not compensate for increased appetite through extreme dietary restriction. A modest increase in hunger during the luteal phase can be a normal physiological response.

Build meals around protein and fibre. These can improve satiety and help make meals more filling.

Stay consistent with calcium-rich foods. Milk, yoghurt, paneer, ragi, sesame and calcium-fortified alternatives can contribute to calcium intake.

Be cautious with supplements. More is not necessarily better. Evidence for nutrients such as magnesium and vitamin B6 in PMS is mixed, and supplementation should be individualised. High-dose vitamin B6 taken for prolonged periods can cause neurological problems.

Common Myths and Facts

Myth: Every woman needs a different diet for each menstrual phase.

Fact: There is currently no strong evidence that healthy women require four completely different diets. A nutrient-dense dietary pattern should remain the foundation throughout the cycle.

Myth: Eating certain seeds during each phase can balance hormones.

Fact: Seeds such as flax, sesame, pumpkin and sunflower seeds are nutritious foods, but there is insufficient clinical evidence that consuming particular seeds at specific cycle phases “balances” reproductive hormones.

Myth: Weight gain before a period always means fat gain.

Fact: Changes in body weight around menstruation can reflect fluid retention, gastrointestinal changes and altered food intake. These changes should not automatically be interpreted as an increase in body fat.

Myth: Increased premenstrual hunger means a lack of self-control.

Fact: Research indicates that energy intake can increase during the luteal phase. Individual responses vary, but increased appetite can have a physiological component.

Myth: Supplements are necessary to manage PMS.

Fact: Some nutrients, particularly calcium, have evidence supporting a role in symptom management, but dietary supplements are not automatically necessary for everyone. ACOG recommends discussing PMS products and supplements with a healthcare professional because some products have limited evidence or may interact with medications.

Conclusion

So, does the body need different foods at different times of the menstrual cycle? Not in the way social media often suggests.

The evidence does indicate that hormonal fluctuations can influence appetite, energy intake and possibly energy expenditure. For some women, these changes are noticeable, particularly during the luteal phase. Nutritional priorities such as iron, calcium, protein, fibre, hydration and overall dietary quality remain important throughout the month.

The most useful approach is therefore not strict “cycle syncing”, but cycle-aware nutrition: understand your own symptoms, respond to changes in hunger, maintain adequate nutrient intake and avoid unnecessary dietary restrictions.

Nutrition should work with the menstrual cycle, not become another source of stress.

(By Neha Kanodia, Senior Executive Nutritionist, Cloudnine Hospital,Faridabad)

The biological age of ovaries may be influenced by the environment surrounding the organs, rather than being an entirely irreversible process. A new experiment done on mice found that older ovaries became biologically younger after being transplanted into younger animals, restoring and extending their ability to support pregnancy.

The research, led by scientists at Harvard Medical School, body's environment may influence how quickly the ovaries age. The findings could help researchers investigate treatments aimed at preserving ovarian function and fertility for longer in women.

Older Ovaries Produced Healthy Offspring In Younger Mice

The researchers transplanted ovaries from 13-month-old mice into younger mice that were four months old. The older donor mice had crossed their reproductive age.

Four to five months after transplantation, the younger recipients gave birth to healthy offspring, even though the transplanted ovaries were 17 to 18 months of age.

The same effect was not observed when older ovaries were transplanted into older recipients. This suggested that the recipient's biological environment, rather than the age of the ovaries alone, affected their reproductive function.

The team also performed the reverse experiment. When young ovaries were transplanted into older mice, the ovaries showed signs of accelerated ageing.

Also read: Heart Health In Women After Pregnancy: Why Pre-Eclampsia And Gestational Complications Matter Years Later

More About The Experiment

The researchers developed an ovarian ageing clock called OvaAge to observe the changes. The clock uses patterns of gene activity to ascertain an ovary's molecular age.

The results showed that the molecular age of older ovaries dropped when they were placed in younger animals. Conversely, young ovaries in older recipients aged faster.

The researchers also observed that older ovaries in younger hosts showed reduced inflammatory activity, while young ovaries in older hosts showed increased inflammation.

Also read: Children’s Mental Health In The Digital Age: Can Governments Protect Them Without Restricting Internet Access? | Interview

Effects Of Ovaries On Ageing Of Other Organs

The study also explored whether the ovaries affect ageing elsewhere in the body. When young ovaries were transplanted into older mice, researchers observed that the molecular ages of the brain, liver and uterus also dropped. The findings suggest that the ovaries may also influence other organs through hormones or other signals.

The researchers also identified changes in gene activity and cellular processes linked to inflammation, metabolism and tissue maintenance. Understanding these signals could help scientists investigate whether some effects of ovarian ageing can be targeted without an organ transplant.

Study's Scope In Women's Fertility

Ovarian ageing refers to a decline in both the number and quality of eggs. This reduces women's fertility as they grow older. The ovaries also produce hormones, including oestrogen, that affect overall health.

The new findings spark the possibility that the environment surrounding the ovaries could be a target for future treatments to preserve ovarian function.

If researchers can identify the signals that allowed older ovaries to function in younger mice, they may eventually be able to investigate ways to reproduce those effects without transplantation. But substantial research is still needed to move ahead.

The study was based mice, and ovarian biology, reproductive ageing and fertility outcomes differ significantly between mice and humans.