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.

The first national mental health survey carried out in India, 2015-2016, suggested that one in 10 Indians had a diagnosable psychiatric disorder.

Following the COVID-19 pandemic, there was a surge in common mental disorders (particularly anxiety and depression). Worldwide, the age of onset of substance use disorders is reducing, and there has been an increase in synthetic and pharmaceutical drug misuse.

Digital addiction is a growing problem, particularly among young people. Suicide is a major global concern, and in India, there were more than two lakh suicides in 2025. Rising suicides in urban areas and among students have been growing concerns.

Improving Mental Health Literacy

Just like people recognize physical disorders, it is important to improve mental health literacy so that people can recognize symptoms of a mental or psychiatric disorder in themselves or others. It is also important that they reach out for timely help, without a sense of feeling stigmatized.

Often, physical and mental disorders occur together and worsen each other, so addressing both is important to improve health outcomes.

How Government Is Tackling Mental Health Burden

The Government of India has initiated the Tele MANAS (14416) to provide telephonic mental health counselling and to link people up to other services. The National Mental Health Program of India seeks to provide decentralized mental health care at the District levels and below.

The Ayushman Arogya Mandirs also offer basic mental health support. NIMHANS, apart from providing quality institution-based services, has also been closely involved in developing community models of mental health care, working with non-governmental organizations and with community stakeholders. It has also been focusing on expanding human resources through its digital academy.

A second NIMHANS in northern India, strengthening some of the other institutions providing mental health care to expand infrastructure, human resources, and networking to develop a continuum of care from primary to tertiary care settings, is a recent step taken by the Union government.

Urological cancer cases are surging at an alarming rate in India. Yet, many patients continue to seek medical help only when the disease has reached an advanced stage. Doctors highlight that cancers affecting the urinary system are often silent during the initial stages and are ignored by people owing to a lack of awareness and hesitation in consulting an expert. It is important to remember that timely urology screening can help detect cancer early, reduce complications, and improve survival rates. Many people ignore symptoms and seek help only during the advanced stages, when the risk of complications also increases. Experts are urging people, especially those at higher risk, to seek early screening and intervention without delay.

What are urological cancers?

“People should prioritise their well-being and seek timely help,” said Dr Pradeep Rao, Head of Department – Urology Oncoscience, Gleneagles Hospital, Mumbai.

Diagnosis and treatment of urological cancers

Dr Pradeep Rao further explained how early-stage urological cancers are often treatable with less aggressive procedures, while advanced cancers require complex treatment and carry higher risks. Diagnosis is carried out through urine examination, ultrasound, and prostate-specific antigen (PSA) testing to detect cancer early. Timely screening and intervention can not only save lives but also preserve organ function. Advanced techniques such as robotic-assisted surgery are now widely used to provide relief to patients. Robotics has made diagnosis, treatment, and the healing journey much smoother for both patients and doctors.

What are the symptoms of urological cancers?

“Urological cancers such as prostate, bladder, and kidney cancer are rising across age groups, yet many patients seek medical help only when symptoms become severe. Each month, two to three patients in the age group of 30–65 consult me when symptoms worsen and the cancer progresses, which takes a toll on their overall well-being. Moreover, signs and symptoms such as blood in the urine, difficulty in urination, pelvic pain, or unexplained weight loss are often ignored, leading to advanced-stage disease that can cause anxiety and panic among patients. Delayed diagnosis can result in serious complications such as kidney damage, the spread of cancer, and reduced quality of life. Early screening and treatment are life-saving. Currently, a combination of robotic surgery, chemotherapy, radiation therapy, and targeted treatments offers better outcomes, but early diagnosis remains the most critical factor for successful recovery,” concluded Dr Anil Bradoo, Consultant Urologist, Zen Annexe, Zen Multispeciality Hospital, Chembur, Mumbai.

What are the benefits of robotic surgeries?

Dr Pradeep Rao also explained the benefits of robotic surgeries. Robotic-assisted prostatectomy for prostate cancer helps with the accurate removal of the prostate while protecting vital nerves, thereby reducing the risk of incontinence and erectile dysfunction. Robotic partial nephrectomy is performed for kidney cancer and helps remove diseased kidney tissue while preserving the kidney, with minimal blood loss and quicker healing. The advantages of robotic surgery include precise tumour removal with minimal blood loss, reduced pain and complications, shorter hospital stays, and faster recovery. Early-stage patients benefit the most from these modern treatments, which is why awareness and screening are so important.

Insulin resistance is a condition in which the body cannot effectively use insulin. Shockingly, this condition is now being linked to first-trimester miscarriages, especially in women with PCOS, with lab markers such as HbA1c and fasting insulin offering early clues. Therefore, it is essential for women to take charge of their health and maintain their blood sugar levels within the recommended range, as per Dr Sushruta Mokadam, Senior Consultant Obstetrician & Gynaecologist, Motherhood Hospital, Kharadi, Pune. The expert went on to talk about other aspects of the same, detailing just how first trimester miscarriages could be a consequence of ignoring high blood sugar or insulin resistance.

Why are miscarriages in the first trimester rising?

Currently, there is a surge in cases of miscarriages during the first trimester, which is raising concern among experts. This may be due to undiagnosed insulin resistance. Yes, that’s right—miscarriage is not only caused by infections, hormonal imbalance, or blood clotting disorders, but also by insulin resistance. Many women fail to pay attention to insulin resistance, which affects how the body processes sugar and plays a major role in causing hormonal imbalance. Women with Polycystic Ovary Syndrome (PCOS) are at a higher risk, as metabolic dysfunction can lead to miscarriage. Many women are experiencing repeated early pregnancy loss but are not screened for insulin resistance, leading to missed opportunities for early intervention.

How are miscarriages and insulin resistance linked?

Miscarriage and insulin resistance link: Insulin resistance occurs when the body’s cells do not respond properly to insulin, leading to higher blood sugar and insulin levels. This imbalance can impact ovulation and egg quality and interfere with the implantation of the embryo. In early pregnancy, it may affect placental development, increasing the risk of miscarriage in the first trimester. In women with PCOS, insulin resistance is commonly present, even in those who are not overweight.

The impact of insulin resistance on reproductive health

High insulin levels can lead to increased androgen (male hormone) production, further affecting reproductive health. This hormonal imbalance can make it difficult for a pregnancy to be sustained, especially in the early weeks, which may result in miscarriage. Lab tests such as HbA1c (which reflects average blood sugar levels over time) and fasting insulin levels can help identify at-risk women. Even subtle elevations in these markers, including those within the upper-normal range, can indicate underlying metabolic dysfunction that may increase the chances of miscarriage.

What to do?

Pregnant women should opt for regular screening, manage blood sugar levels, eat a balanced diet, and exercise daily before planning pregnancy. Even during pregnancy, they should stay in touch with an expert who can guide them throughout the process.