A woman's health is intricately linked to her menstrual cycle, which is an important sign of her overall well-being. Throughout puberty and menopause, hormonal changes affect not only fertility but also mood, energy, and long-term health. A normal cycle usually indicates balance, whereas abnormalities may suggest problems such as PCOS, endometriosis, or thyroid disease.

Our bodies do not always work in a perfect clockwork operation and unexpected vaginal bleeding can often confused us. Is it a mere spotting? A normal period? A symptom of something more concerning? Differences between spotting, menstrual bleeding, and intermenstrual bleeding should be understood is crucial for maintaining reproduction health.

Here is a short guide to help you differentiate while you are confused.

Spotting

Spotting is vaginal bleeding that doesn't happen as part of your regular menstrual period. It commonly manifests as fine droplets or smears of blood on clothing or toilet tissue. The intensity of the blood ranges from deep red (recent blood) to pink (having cervical mucus mixed in it) or brown (older, oxidized blood). Spotting is not very much and can't be seen in a way that needs either a tampon or a pad to absorb.

Common Causes of Spotting

Spotting is caused by numerous factors, and in the majority of instances, it is nothing to worry about. Some frequent causes are:

Hormonal Birth Control Transitions: New birth control technique, for instance, birth control pills, IUDs containing hormones, or implants, results in temporary spotting as the body adapts.

Ovulation Bleeding: A few individuals get spotting light around the time of ovulation as a result of hormonal changes. It normally happens in the mid-cycle and could be followed by slight cramping.

Cervical Ectropion: A harmless condition when cells from the inside of the cervical canal migrate to the outer cervix, causing the outer cervix to become more sensitive and prone to faint bleeding on coitus or physical activity.

Early Pregnancy (Implantation Bleeding): 15–25% of pregnant women experience light spotting around 10–14 days post-conception, which is confused with an early period.

When to See a Doctor

Spotting is usually harmless, but it's best to consult a doctor if:

• It continues after a few months of initiating new birth control
• Is accompanied by pelvic pain or abnormal discharge
• Occurs after frequent intercourse
• Occurs during pregnancy and is not verified as implantation bleeding

Menstrual Bleeding

There is a time, also known as a period or menstruation, when the uterine lining sheds due to changing hormone levels. It would last for approximately 2-7 days and is heavier initially. The hue and texture of period blood shift during the menstrual cycle:

Red: New active bleeding at the start of a period

Brown or dark red: Older, slower blood in leaving the uterus

Clots: It's normal to have small clots, but bigger clots may be a sign of heavy menstrual bleeding (HMB)

Why You Have a Period Essentially?

Menstruation is a part of the reproductive cycle, and it happens around every 21–35 days. When there's no pregnancy after ovulation, hormone levels fall, causing the uterine lining to be shed.

Signs Your Period May Be Abnormal

Though periods differ in different people, there are some signs that point towards probable underlying conditions:

• Prolonged bleeding (longer than 7 days)
• Heavy flow necessitating pad/tampon changes every 1–2 hours
• Severe cramps that disrupt daily life
• Irregular periods or absent periods

If you have any of these, conditions such as polycystic ovary syndrome (PCOS), endometriosis, or thyroid disease may be involved, and a medical visit is in order.

Intermenstrual Bleeding

Unlike spotting, intermenstrual bleeding is heavier and unexpected between regular periods. It may be from bright red to dark brown and can contain blood clots.

Possible Causes of Bleeding Between Periods

Sexually Transmitted Infections (STIs): Chlamydia and gonorrhea can lead to inflammation and abnormal bleeding.

Pelvic Inflammatory Disease (PID): A bacterial infection of the reproductive organs and can lead to abnormal bleeding.

Uterine Fibroids or Polyps: Benign growths in the uterus that may cause unexpected bleeding.

Endometrial Hyperplasia or Cancer: In some instances, abnormal bleeding may be a sign of abnormal cell growth in the lining of the uterus.

When to See a Doctor

See a doctor if intermenstrual bleeding is:

• Frequent or persistent
• Associated with pelvic pain or discomfort
• Associated with abnormal discharge, fever or painful sex

Recognizing your body's rhythms can assist you in identifying normal versus abnormal bleeding. Monitoring your menstrual cycle through an app or calendar may flag changes that should be checked with a doctor. If you have any questions regarding abnormal bleeding, visiting your health care provider is the way to go.

The World Health Organization (WHO), notes that 36% of world's rabies deaths come from India, and a 2024 Lancet study notes that the country accounts for over one-third of global rabies deaths. When we spoke to Dr Aniket Mule, Consultant Internal Medicine at KIMS Hospital, Thane, he said that it is not just dog bites that lead to rabies, but it could happen from any rabies-susceptible animal. The first line of defense after you clear your wound immediately is to get the rabies vaccine. "Rabies vaccination is required for bites or scratches from any rabies-susceptible animal, including cats, monkeys, bats, foxes, and other wild mammals," he pointed out. As the country's apex court ruled and issued directives on stray dogs, focusing on public safety by ordering their removal, global health organizations, including WHO point out that this is not the right way to deal with rabies issue. Comprehensive methods including evidence=based strategies that center on mass dog vaccination is the key to the problem.

However, before this could be implemented, here's what you should know about dog bites and rabies.

What To Do After A Dog Bites Or Scratches You?

Dr Mule points out that even when there are minor scratches, without bleeding, you must get a rabies shot. "Rabies can be contracted through broken skin. Such exposures still require medical evaluation and, in most cases, rabies vaccination."

Read: In An 'Exceptionally Rare' Case, Man Dies Of Rabies After Kidney Transplant

What Should One Do Immediately After Being Bitten Or Scratched?

• Wash the wound immediately for at least 15 minutes with soap and running water
• Apply an antiseptic such as povidone-iodine
• Do not apply home remedies like turmeric, chili or oil
• Seek medical care promptly for rabies vaccination and possible immunoglobin

Dr Mule points out that the rabies vaccine should be started as soon as possible. "Ideally within 24 hours of a bite or scratch. However, even if there is a delay of days or weeks, vaccination should still be started immediately as rabies has a variable incubation period," he says.

After the bite, the immediate medical attention involves rabies post-exposure prophylaxis or PEP, and with a tetanus booster. Some rabies vaccines also use saline water as the diluent to reconstitute the freeze-dried powder before injection.

Read: Australia Issues Advisory Warning Travelers Of Counterfeit Rabies Vaccines Found In India

The temperature of the vaccine matters. "Rabies vaccines are temperature-sensitive and must be stored between 2°C and 8°C. Exposure to heat or freezing can reduce vaccine potency. Poor cold-chain maintenance is a known reason for vaccine failure in rare cases," points out the doctor.

Cases Of Rabies Coming Back After Vaccination Course Has Been Done

Dr Mule points out that in order to avoid such things happening, one must ensure immediate wound washing, timely vaccination, and correct use of Rabies Immunoglobulin or RIG. Rabies can come back if these following things occur:

• Delay in starting vaccination
• Failure to administer Rabies Immunoglobulin (RIG) in severe (Category III) exposures
• Improper wound cleaning
• Incorrect injection site (gluteal region)
• Poor vaccine storage (cold-chain failure)

Dr Mule points out that the vaccine should be given intramuscularly in the deltoid or upper arms for adults, as gluteal or buttock injections could lead to inadequate absorption and reduce effectiveness.

How Many Doses Should One Get?

• For someone not previously vaccinated, the current standard is 4 doses on days 0, 3, 7, and 14 (intramuscular schedule).
• In some government programs or intradermal schedules, 3–4 doses may be advised.
• Previously vaccinated individuals require only 2 booster doses (days 0 and 3).

The exact schedule depends on vaccination history and the protocol followed.

Winter in India is often associated with sardio ke laddoo, but also with increasingly sedentary lifestyle, worsening air pollution, all of which leads to more time spending home than to going out, taking a stroll, working out and more. This is why as winter sets in, India also sees a quiet but consistent rise in non communicable diseases, or NCDs, conditions that now account for nearly two thirds of all deaths in the country. Heart disease, diabetes, thyroid disorders, fatty liver disease and arthritis continue to rise across age groups, driven by sedentary lifestyles, dietary excess and delayed diagnosis.

Winter can further aggravate these risks. Physical activity drops, calorie dense foods become routine, sunlight exposure reduces and metabolism changes. Studies and hospital data in India have repeatedly shown that heart attacks and strokes tend to spike during colder months. Blood vessels constrict, blood viscosity increases and cholesterol levels often rise. Blood sugar control also becomes more challenging, while joint pain and stiffness worsen for many.

Dr. Mayanka Lodha Seth, Chief Pathologist at Redcliffe Labs, says the problem is not seasonal food but seasonal neglect. “Traditional winter foods are not harmful on their own. The real risk comes from consuming them without understanding what is happening inside the body,” she explains. “Winter tends to mask symptoms while quietly worsening internal imbalances.”

With India already home to over 100 million people living with diabetes and a similar number estimated to be prediabetic, preventive testing becomes crucial. Doctors recommend five key tests that can offer a clearer picture of health before winter indulgence begins.

Blood Sugar Levels

Diabetes is one of the fastest growing NCDs in India, and a large proportion of cases remain undiagnosed. Winter diets high in sugar and fat can trigger frequent glucose spikes. Testing fasting blood sugar and HbA1c helps identify early risk and prevents long term complications affecting nerves, kidneys and the heart.

Lipid Profile

High cholesterol is a major contributor to cardiovascular disease, which remains India’s leading cause of death. Reduced activity in winter often pushes lipid levels higher. A lipid profile helps assess heart risk and guides dietary and lifestyle moderation before damage sets in.

Liver Function Test

Non alcoholic fatty liver disease is increasingly common in India, even among younger adults. Excess sugar and fat intake during winter can worsen liver fat accumulation. Early liver testing can flag reversible changes before they progress to chronic liver disease.

Thyroid Function Test

Thyroid disorders affect millions in India, especially women, and often go unnoticed. Symptoms like weight gain, fatigue and cold intolerance are frequently brushed off as winter sluggishness. A simple thyroid test helps distinguish seasonal lethargy from hormonal imbalance.

Vitamin D and Vitamin B12 Levels

Vitamin D deficiency is widespread due to limited sun exposure in winter, while Vitamin B12 deficiency remains common because of dietary patterns. Both deficiencies are linked to low immunity, muscle pain, bone weakness and worsening joint discomfort.

Dr. Seth adds, “Preventive diagnostic testing allows people to make informed choices. It helps them enjoy winter foods in moderation without unknowingly worsening an underlying condition.”

As NCD related healthcare costs continue to rise in India, early testing offers both health and financial protection. Winter comfort does not have to come at the cost of long term health. Staying informed may be the most effective preventive step this season.

Flu season is hitting hard this year, and the symptoms could feel relentless. People are suffering from rising fever, hacking cough, blocked and stuffy nose and sore throat. While many people get relief from Tamiflu, which is a prescribed antiviral medication that is used to treat or even to prevent illness, there are other alternatives available too.

Dr Ari Brown, a Texas based pediatrician and the author of Baby411 book series told CNN health that one of the most common complaints that she gets to hear from Tamiflu is vomiting. A 2023 study published in the Pediatric Infectious Disease Journal notes that 18% of people experienced vomiting with Tamiflu, as compared to 5% with Xofluza, an alternative.

“I’ve also had a few pediatric patients experience moodiness with Tamiflu, which is reported in the literature,” she said.

Read: Adenovirus Cases Rise In UK, Health Authorities On Alert

Tamiflu is usually gives to treat flu in people ages 2 weeks and older and to reduce the chance of getting the flu in people 1 year and older. The medicine could be administered in both form, liquid and capsules and usually taken twice daily for five days straight. This is prescribed for when flu is to be treated. However, when used for prevention, it is typically taken once for 10 days.

What Are The Other Alternatives Available For Flu Treatment?

Xofluza: It is administered as a single dose tablet and is approved for ages 5 and older. This medicine can also be used to treat or to prevent the flu. While it costs nearly $200 for those without insurance, eligible patients can use coupons to lessen costs. Dr Brown points out that this medicine could have side effects like diarrhea and vomiting. However, the study aforementioned notes that for this, only 5% patients had vomiting symptoms, when compared with Tamiflu.

Dr Brown also said that Xofluza can stop viral shedding in one day, while Tamiflu could take up to three days. "Both antivirals will help reduce the duration of misery by couple of days," she pointed out.

Dr Brown also pointed out that overall, "Xofluza is rising in popularity over Tamiflu." “One dose. Fewer side effects. More insurances are covering the cost of it now and manufacturer coupon makes it less expensive than in previous years," she said.

Rapivab: This is another prescribed medication that is approved to treat flu. This could be administered for people ages 6 months and older. It has to be given by a health care provider, as it is given once as an intravenous infusion. It could cost up to $1,000 without insurance and most common reaction in adults is diarrhea.

Relenza: This flu medication is inhaled in powder form. It is administered through an inhaler device, which is to be used twice a day for five days straight. The prescribed drug is approved to treat flu in ages 7 and older and for preventative use, in ages 5 and older. It could cost about $90 without insurance.

It may have side effects like dizziness, allergic reaction, or irritation of the nose. It is not recommended for people who have breathing issues or have asthma.