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.

In today’s fast-paced, wellness-driven world, looking fit does not always translate to being reproductively healthy. Currently, even fit and active individuals are facing fertility challenges due to hidden hormonal and metabolic imbalances. Hence, it is necessary to focus on reproductive health. Dr. Meenu Handa, Director of Fertility & Head Academic of Reproductive Medicine, Motherhood Hospitals, Gurgaon, decoded the link and listed some of the common fertility issues that most people overlook.

Now, a large number of people are opting for various activities such as yoga, Zumba, Pilates, the gym, and kickboxing to stay fit. Those who are health-conscious are also maintaining an optimum weight with a proper diet. These habits, in turn, can help to ensure good fertility. Shockingly, many people who are perfectly fit and fine on the outside may also struggle with fertility problems. Yes, that is right! This is also a common occurrence nowadays. Couples are panicking as they seem to adhere to a well-balanced lifestyle but still fail to conceive. So, this can be referred to as “invisible fertility issues," where underlying hormonal or metabolic imbalances silently affect reproductive health.

Decoding invisible fertility issues

Dr Handa said that many men and women who exercise regularly may suffer from issues such as hormone imbalance, fluctuating insulin levels, poor thyroid function, and compromised reproductive organ health. Conditions like polycystic ovary syndrome (PCOS), thyroid disorders, insulin resistance, and even chronic stress can exist without obvious physical signs and can take a toll on fertility. The expert also shared some of the common hidden infertility issues.

Even couples who are physically fit today often deal with high mental stress due to demanding jobs and poor work-life balance. This ongoing stress can quietly disturb hormonal balance in the body. Increased cortisol levels may affect ovulation in women and sperm production in men and, over time, can impact egg and sperm quality—making natural conception more difficult. That is why managing stress is just as important as staying physically fit when planning a pregnancy.

Women may have issues like poor ovulation, compromised egg quality, or hormonal imbalance, even if their menses tend to be regular. In some cases, even subtle symptoms like fatigue, acne, hair fall, or mood swings may be overlooked but can signal deeper hormonal concerns. Men can struggle with low sperm count, which can affect their fertility. Even insufficient sleep, excessive exercise, or extreme dieting can increase the chances of hormonal imbalance and fertility issues. It is necessary to consult an expert and seek timely help. Pollution and lifestyle stress also contribute to the trend.

Couples should not just plan a pregnancy because they are fit and exercise daily. Pregnancy should not rely only on outward fitness as a sign of reproductive health. Regular health check-ups, including hormone tests and fertility assessments, can help identify hidden issues early.

Follow these tips

1. Couples should eat a well-balanced diet, exercise daily, stay stress-free by practicing yoga and meditation, and get enough rest.
2. It is also imperative to maintain blood pressure and blood sugar levels within the recommended range, include healthy fats and proteins in the diet, avoid overtraining, and manage stress through relaxation techniques like yoga or meditation, which can support hormonal balance.
3. If a couple is unable to conceive even after 6–12 months of trying (depending on age), a detailed fertility evaluation is recommended.
4. Seeking timely medical advice is equally important if conception is delayed.
5. Couples who find it challenging to conceive may be advised to use ARTs, such as in vitro fertilisation (IVF).

So, awareness, balanced lifestyle choices, and timely medical support can make a huge difference in improving fertility outcomes.

A heatwave is getting worse with each passing day, and with it come dehydration, stomach flu, and sometimes even mood swings. But little do people realise that the risks associated with a heatwave could be much worse - it turns out that exposure to extreme heat could also give you a stroke. Dr Deep Das, Consultant - Neurology, CK Birla Hospitals, CMRI, in an interview with Health and Me, decoded the link between heatwaves and the risk of stroke.

How does a heatwave affect stroke risk?

Dr Das said that in very high temperatures, the body does not always cope in predictable ways. The brain is particularly sensitive to these shifts. One of the concerns is stroke. In the heat, people tend to lose fluids without realising how much. Blood volume drops, and circulation is affected. In some cases, the blood becomes more prone to clotting. At the same time, blood pressure can fluctuate. This combination increases the chances of a disruption in blood flow to the brain.

Can extreme heat give you a seizure?

Seizures are another risk, especially in those who already have epilepsy. Even when the condition has been stable, heat can unsettle things. Dehydration and changes in electrolyte balance make the brain more reactive than usual. A person who has been well-controlled for months may still have an episode during a prolonged heatwave. What makes this difficult is that these changes are not always gradual. Symptoms can appear suddenly.

What are the symptoms of a stroke?

A stroke refers to a potentially fatal medical emergency. It can be sudden or gradual, and it is characterised by a blockage in blood circulation to the brain. It can result in rapidly dying brain cells and requires immediate medical attention. The symptoms of stroke can be identified as FAST:

1. Face: Face drooping on either side
2. Arms: Weakness in the arms or inability to move the arms
3. Speech: Slurred speech
4. Time: Time is an important factor; immediate action can be life-saving for stroke patients

Apart from this, other symptoms of a stroke are:

1. Severe, unusual headaches
2. Confusion
3. Loss of consciousness
4. Dizziness
5. Loss of balance
6. Inability to see clearly from one or both eyes

How to dodge a heatwave-related stroke?

In this weather, small precautions matter more than they seem. Some of the best ways to dodge a stroke amid a heatwave are:

1. Drinking water regularly helps, even before you feel thirsty
2. Staying indoors during peak afternoon hours reduces strain on the body
3. Living spaces need some form of airflow, even if it is basic ventilation

It also helps to keep an eye on people who may not notice these changes early—older adults, those living alone, or anyone with an existing medical condition.

Should you be worried?

Some people are more prone to stroke risk than others. Therefore, it is important to be aware of the risk factors, especially during a heatwave. If you are dealing with any of the following comorbidities, think twice before stepping out amid a worsening heatwave:

1. Hypertension
2. Diabetes
3. Irregular heartbeat
4. Sleep apnoea
5. High cholesterol

Furthermore, people who are 65 years and above must avoid stepping out from 12 noon to 4pm. Even people who have a family history of stroke must not step out during these hours.

Breast cancer remains one of the most common and fatal cancers among women worldwide, and early detection is proven to play a crucial role in improving outcomes. While mammography remains the most effective screening tool, knowing when to start and how often to get screened can be confusing.

The changing medical guidelines, as with the new screening guidelines from the American College of Physicians (ACP), can also leave women confused about when to start mammograms and how often to repeat them. HealthandMe spoke to experts to understand the correct timing.

So, What Do The ACP Guidelines Say?

The new guidance statement developed by ACP's Clinical Guidelines Committee urged mammography screening once every two years in asymptomatic, average-risk adult females, instead of the annual recommendation.

The ACP guidelines further state that all average-risk females ages 50 to 74 must undergo biennial mammography. It added that women aged 75 years or older with asymptomatic and average-risk can also discuss stopping routine screening with their doctor.

In sharp contrast, the United States Preventive Services Task Force (USPSTF) urges starting annual screening at age 40 to save lives.

What You Should Follow

“Some cancer societies like the American Cancer Society say biennial, while NCCN says annually. We prefer annually starting at age 40 till the woman is in good health, as biennial screening may delay early diagnosis in some cases,” Dr. Ashwani Kumar Sharma, Vice Chairman - Manipal Comprehensive Cancer Centre and Onco Robotic Surgeries, Manipal Hospitals, Gurugram, told HealthandMe.

NCCN, or the National Comprehensive Cancer Network, is an alliance of 34 cancer centers in the US.

Dr. Sharma added that a practical and balanced approach would be to do biennial mammography from 40 to 50 years of age and annual mammography after 50 years of age for maximum benefit.

What Are Mammograms?

A mammogram is a low-dose X-ray that captures detailed images of breast tissue, capable of identifying cancers before any physical symptoms appear.

In women with a BRCA1 or BRCA2 gene mutation who are referred to as "high risk" or with a history of radiation to the chest between ages 10 and 30, screening may start as early as age 30 and include annual breast MRIs alongside mammograms.

Mammograms: What Do India’s Guidelines Say?

Breast cancer in India is usually diagnosed at an advanced stage due to poor health awareness. But of late, there has been an increase in awareness, and more and more women are reporting in their earlier stages with a breast lump.

“Sometimes even this is too late. Breast cancer screening would help us diagnose this disease at an even earlier stage to help increase the chances of a cure from this deadly but treatable disease with the help of simple tests,” Dr Abhijit Kotabagi, Senior Consultant, Department of Surgical Oncology, Yatharth Hospital, Noida, told HealthandMe.

“I would endorse screening and women’s health awareness in our Indian population for women above 40 years after discussion of the pros and cons of screening with a clinician,” he added.

The Indian Council of Medical Research (ICMR) and other health organizations recommend the following guidelines:

1. Women Aged 30-40 Years

• Clinical Breast Examination (CBE) every 1-3 years by a doctor.
• Self-Breast Examination (SBE) every month to check for lumps or changes.

2. Women Aged 40-50 Years

• Annual Clinical Breast Examination (CBE).
• Mammogram (X-ray of the breast) every 2 years if advised by a doctor.

3. Women Above 50 Years

• Mammogram every 2 years (or as recommended by a doctor).
• Continue monthly self-exams and yearly clinical exams.