Many of us may have taken ibuprofen, sometimes two pills at once, especially when we are struggling with menstrual cramps. Well, as good these pills may be in treating the pain, they are not recommended for your health, especially if you are someone who consumes it on a daily basis or frequently. Gastroenterologist Trisha Pasricha, MD, writes in The Washington Post about why should you avoid taking nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen, naproxen and aspirin.

What happens when you consume pain killers?

She writes that NSAIDs are great in treating short term pain. They comprise of a group of drugs that inhibit the production of prostaglandins, which serve as a variety of purposes in the body. Some of which also includes contracting the uterus during menses and regulating blood flow in our vessels.

While one to two doses every now and then is okay, following a regular dosage routine, which could range from several times a month, or twice in an hour or so could lead to health risk. NSAIDs are well known to increase intestinal permeability. This means, these painkillers could damage the lining of your gut.

A 2018 review by Ingvar Bjarnason et. al., also writes about how NSAIDs can reduce the blood flow in the tiny vessels that feeds our guts. It can also disrupt the intestinal cells forming a barrier between the outside world and your insides.

What can be done?

While people with conditions like migraines, chronic back pain or bad period cramps can find NSAIDs to be helpful. It is always advisable to have a chat with your physicians to explore NSAID alternatives.

Pasricha suggests acetaminophen.

However, if someone is in dire need of NSAID, her tip is to take the pill right at the start of your symptoms. She says that the drug can do a far better job at stopping things at the source than chasing after all prostaglandins.

Why is it a concern?

NSAIDs are available as over the counter drug, which means people do not need a prescription for it and can make medical decision about them without the guidance of a physician.

A 2018 study published in the Official Journal of the International Society for Pharmacoepidemiology by David W Kaufman, et.al., found that 15% of adult ibuprofen users in the US have exceeded the maximum recommended daily dose. The study also mentions that more than a third of ibuprofen users were taking other NSAIDs, like aspirin and naproxen, while consuming ibuprofen at the same time. Out of these, 61% did not realise that they were using NSAIDs.

Pasricha talks about how it ruptures the gut wall, as she herself has rushed to the hospital in the middle of the night "far more times than" she can count "to perform an emergency endoscopy on someone who was bleeding profusely from an ulcer caused by NSAID".

Another 2009 study published in the American Journal of Gastroenterology states that as many as 1 in 4 chronic NSAID users will get an ulcer and about 4% will bleed or rupture through the gut wall.

An older study from 2005 titled A quantitative analysis of NSAID-induced small bowel pathology by capsule enteroscopy, found that as 75 percent of people regularly using NSAIDs develop low-grade inflammation in their small bowels. NSAIDs can also lead to development of fatty liver disease. This happens because your gut lining becomes more permeable, more toxins and bacteria from the outside world enters your liver and leads to inflammation.

A 2011 study titled Haemoglobin decreases in NSAID users over time: an analysis of two large outcome trials, states that as many as 6% of people taking NSAIDs regularly have found their blood count dropping within a few months of starting the medicines, this suggests that this is due to the small, slow amount of bleeding in the gut overtime.

Most young men assume that if there is no pain, there is no serious problem. Unfortunately, many important testicular conditions, especially testicular cancer, often begin as a painless lump, swelling, or enlargement of one testicle. Because there is no pain, men tend to ignore it, thinking it is due to exercise, minor trauma, tight clothing, cycling, or temporary swelling. Embarrassment and reluctance to discuss genital symptoms also contribute to delay.

Dr. Chandan M. N, Consultant Urologist, Andrologist, Uro-Oncologist & Renal Transplant Surgeon, Apollo Hospitals, Sheshadripuram, Bangalore, spoke about the pain conundrum. The expert said that when it comes to testicular health, absence of pain must not be a reassuring factor.

Pain is usually seen as a warning signal, but in testicular disease, absence of pain should not reassure patients. Testicular cancer is one of the most common cancers in young men, particularly between 15 and 35 years of age, and it can progress quickly if diagnosis is delayed. However, when detected early, it is also one of the most curable cancers.

What are the common signs men may overlook in day-to-day life?

The most commonly overlooked sign is a painless lump or swelling in one testicle.

Sometimes the change is subtle; a testicle may simply feel slightly harder, heavier, larger, or firmer than before. Many men also ignore a dragging sensation, heaviness in the scrotum, or a dull ache in the groin or lower abdomen because these symptoms are mild and not severe enough to disrupt daily life.

Other signs that should not be ignored include sudden fluid collection in the scrotum, change in the shape or size of one testicle, unevenness between the two testicles, persistent discomfort, or a feeling that something is different. Some men may also notice back pain, breast tenderness, or unexplained swelling if the disease has spread. Importantly, not every testicular lump is cancer. Conditions such as hydrocele, varicocele, spermatocele, orchitis, or hernia can also present with swelling or heaviness. But the only safe approach is to get examined rather than assume it is harmless.

How to do a simple self-examination at home?

Young men should know what is normal for their own body. A simple self-examination once a month, ideally after a warm shower when the scrotal skin is relaxed, can help detect early changes.

Men should gently feel each testicle for lumps, swelling, hardness, change in size, or heaviness. Familiarity with one’s normal anatomy makes it easier to notice when something changes. Any new lump, swelling, change in shape, or persistent discomfort should be evaluated promptly by a doctor. Usually, a physical examination and scrotal ultrasound are enough to identify the cause. Early medical advice can differentiate a harmless condition from something serious and, in the case of testicular cancer, can make the difference between simple treatment and advanced disease.

Malaria is widely known as a mosquito-borne disease that causes fever, chills, and body aches. But what many people don’t realize is that in severe cases, it can also affect the heart.

Malaria is caused by parasites belonging to the Plasmodium genus. It may cause complications beyond the bloodstream. In some cases, this may happen in severe malaria, where either the diagnosis or treatment is late.

How Malaria Infection Affects The Heart

Speaking to HealthandMe, Dr. Ravi Prakash, Senior Consultant Cardiology, PSRI Hospital, Delhi, noted that malaria affects different parts of the body, depending on the severity and the patient's immunity.

"In severe malaria cases, the parasite that causes malaria infects the red blood cells, making them sticky. When these stick together, the cells block the flow of blood in smaller blood vessels, limiting oxygenation of important organs, including the heart," Dr Prakash explained.

The condition may then result in myocarditis, arrhythmias, or heart failure. Although these complications rarely affect the heart, they require prompt medical intervention.

Further, Dr. Rakesh Pandit, Senior Consultant & HOD, Internal Medicine, Aakash Healthcare, highlighted that malaria can put stress on the heart either directly or indirectly.

It can lead to inflammation of the heart and result in chest pains, fatigue, or arrhythmia.

"Patients suffering from severe malaria may develop tachycardia or, in worst-case scenarios, experience heart blockage," Dr. Pandit told HealthandMe.

The Role of Anemia

Furthermore, malaria infection may limit the blood flow to the heart by increasing the stickiness of the blood, thus blocking small blood vessels.

"Anemia associated with malaria can increase the load on the patient's heart," Dr Pandit said.

Fever, dehydration, and hypoxia further increase cardiac stress in malaria patients, who may end up having their pre-existing heart conditions unmasked.

Malaria: Early Signs Of Heart Damage?

Early detection is important. Besides classic malaria symptoms such as fever, sweats, shivers, headaches, and tiredness, any unusual symptoms such as chest pains, difficulty breathing, rapid heartbeats, or excessive weakness must be considered carefully.

"These could be signs of organ damage caused by the disease, which means early diagnosis and treatment are vital. Blood tests will be conducted to identify malaria parasites in your body," Dr. Prakash said.

Malaria And Heart: Who Is At More Risk

Some individuals are more susceptible to contracting malaria, which increases their chances of developing complications from the disease.

These include

• children,
• pregnant women,
• the elderly,
• immunocompromised patients.

"People who have underlying diseases may develop heart-related problems due to the malaria infection," Dr Prakash said.

Moreover, travelers to malaria-endemic areas without adequate protection from the disease are also likely to be affected.

How To Prevent?

The best method to avoid contracting malaria is to take preventive measures.

• Individuals must protect themselves from mosquito bites.
• Applying insect repellents, sleeping under mosquito nets, and covering your arms and legs when you go out are effective ways to shield yourself from being bitten.
• Proper hygiene and sanitation practices are necessary to prevent mosquitoes from reproducing.
• Having a good general health status is another preventive measure. Your immune system must be able to combat invading agents.

Malaria is usually understood as a fever illness, with symptoms such as chills, sweating, body ache, weakness, and in severe cases, anemia or organ complications. But for women, especially in malaria-prone regions, its impact can be more layered.

It can disturb the body’s hormonal rhythm, worsen fatigue, complicate menstrual symptoms, and create confusion between infection-related pain and period-related discomfort. That is why malaria should not be seen only as a seasonal mosquito-borne disease, but also as a health concern that can affect women’s reproductive and menstrual well-being.

India has made strong progress against malaria. According to the Government of India, reported malaria cases fell from 11.6 lakh in 2015 to 2.27 lakh in 2023, a reduction of roughly 80%. Malaria-related deaths also declined from 384 to 83 in the same period, a fall of about 78%. This shows that prevention, testing, surveillance, and treatment have improved significantly.

At the same time, malaria has not disappeared. The risk remains higher in endemic, tribal, forested, and hard-to-reach areas, where mosquito exposure, delayed testing, limited access to care, and anemia can make the illness more difficult to manage.

How Malaria Dents Menstrual Health

The connection begins with the body’s stress response. Malaria infection does not remain limited to the bloodstream. Research on hormones in malaria shows that the infection can affect host metabolism and create hormonal imbalances, with changes influenced by parasite type, disease severity, immune response, age, sex, nutrition, and stage of infection.

The research notes that malaria can dysregulate the hypothalamic-pituitary-adrenal, thyroid, and gonadal axes, which are central to stress, metabolism, and reproductive hormone regulation.

For menstrual health, this matters because periods are not controlled by the uterus alone. They depend on coordination between the brain, ovaries, and hormones such as estrogen and progesterone. When the body is fighting malaria, that rhythm can be disturbed.

Fever, inflammation, poor appetite, weakness, anemia, and high physical stress can make periods late, lighter, heavier, or more exhausting than usual. In some women, premenstrual symptoms such as body ache, fatigue, abdominal discomfort, and mood changes may also feel worse because malaria itself produces overlapping symptoms.

There is also a direct hormonal pathway to consider. Cortisol, often called the stress hormone, is reported to rise in both P. falciparum and P. vivax malaria. High cortisol can affect immune function and may also disturb the wider hormonal balance on which regular ovulation and menstruation depend.

The same research notes that lower estradiol has been reported in severe falciparum malaria, while progesterone levels have also been reported to be lower in patients with P. falciparum malaria.

These findings do not mean every woman with malaria will have menstrual changes, but they do show that malaria can interfere with the hormonal systems linked to reproductive health.

Link Between Malaria And Anemia in Women

Anemia is another important link. Malaria can destroy red blood cells and contribute to severe anemia. Menstruation, especially heavy bleeding, can also lower iron stores. When both happen together, the result can be extreme tiredness, dizziness, breathlessness, paleness, poor concentration, and slower recovery.

This is particularly relevant in India, where anemia among women is already a major public health concern. A woman recovering from malaria who also has heavy periods should not dismiss prolonged weakness as “normal period fatigue.”

Malaria: Delayed Symptoms In Women

One reason diagnosis can be delayed is that malaria symptoms are often nonspecific. WHO lists fever, headache, and chills as common early symptoms, and says early testing is important because symptoms may initially resemble many other fever illnesses. In women, body ache, fatigue, abdominal discomfort, and weakness may be mistaken for PMS, a painful period, viral fever, or early pregnancy unless malaria is actively considered.

The risk is even more serious during pregnancy, including early pregnancy when a woman may not yet know she is pregnant. WHO states that malaria during pregnancy can cause premature delivery or low birth weight, and it is also noted that pregnancy reduces immunity to malaria, increasing the risk of severe anemia and illness.

The practical message is simple: if fever with chills, severe body ache, vomiting, unusual weakness, dizziness, or headache appears around the time of a period, it should not automatically be treated as PMS or “period weakness,” especially after travel to or residence in a malaria-prone area.

A malaria test should be done promptly, and treatment should be taken only under medical supervision.

Malaria can affect menstrual health by placing stress on the body’s blood, hormones, immunity, and energy reserves. For women, recognizing this connection can help prevent delayed diagnosis and support faster recovery.