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.

Changing lifestyles, career priorities, financial planning, and personal choices are leading many couples to marry later than before. While late marriages are becoming increasingly common, fertility specialists are observing a parallel rise in delayed pregnancy planning and age-related fertility complications. Many couples now begin trying to conceive only after the age of 35, when fertility in both men and women naturally starts declining.

Currently, there is a growing trend of late marriages due to career priorities, financial stability goals, higher education, and changing lifestyle choices. Many couples are choosing to settle professionally and personally before planning a family. However, this delay can also lead to postponed pregnancy planning, often at a stage when fertility naturally starts declining. Increasing stress, underlying medical conditions, and lack of fertility awareness are further contributing to challenges in conception among couples in their mid to late thirties.

What are the complications that can occur in a pregnancy after turning 35?

“The increasing trend of late marriages (30–35+) is directly leading to delayed pregnancy planning. Most couples start trying to conceive after 35, when fertility has already begun to decline significantly. By the time many patients seek medical help between 36 and 39 years, several are diagnosed with low ovarian reserve (low AMH) or conditions such as oligoasthenoteratozoospermia (OAT) and azoospermia.

Lack of early fertility awareness often causes women to miss the window for timely intervention or fertility preservation options like egg freezing. Advanced maternal age pregnancies (40+) are steadily rising and are often associated with complex complications and lower treatment success rates. Currently, nearly 75% of fertility patients are above 35 years of age, while 25% are above 40. Only around 20% of patients are in their late 20s,” said Dr. Jyotshana Palgamkar, Fertility Specialist, Nova IVF Fertility, Virar.

Dr Jyotshna further added, “One of the biggest concerns linked to late pregnancy planning is reduced ovarian reserve in women. By the time many women seek medical help between the ages of 36 and 39, their anti-Müllerian hormone (AMH) levels, which indicate egg reserve, may already be low. This reduces the chances of natural conception and can also affect the success rates of fertility treatments. Male fertility is also being affected. A large number of men are diagnosed with oligoasthenoteratozoospermia (OAT), a condition in which sperm count, motility, and morphology are affected.

Consequences of delayed fertility evaluation

Delayed fertility evaluation often means that couples lose valuable time before beginning treatment or considering assisted reproductive options. Another major challenge is the lack of awareness about fertility preservation. Many women remain unaware that egg freezing at a younger age may help preserve fertility for the future. By the time they start exploring fertility options in their late thirties or forties, treatment becomes more complex and emotionally stressful. Advanced maternal age pregnancies, especially above 40, are also increasing. These pregnancies are often associated with lower conception rates, higher miscarriage risk, pregnancy complications, and reduced IVF success rates,” Dr Jyotshna explained.

Male fertility treatment options depend on the underlying cause of infertility and may include lifestyle changes, medications, hormonal therapy, or surgical procedures. “Conditions such as low sperm count, poor sperm motility, abnormal morphology, raised DNA fragmentation index (DFI) affecting sperm quality, varicocele, or azoospermia can often be managed with timely medical intervention. Assisted reproductive techniques like IUI, IVF, and ICSI are also commonly used to improve the chances of conception. Early diagnosis and proper fertility evaluation play an important role in selecting the most effective treatment option for men,” said Dr Palgamkar.

Understanding fertility timelines, seeking timely evaluation, and discussing preservation options early can help couples make informed decisions and improve their chances of successful parenthood in the future.

Back pain is generally considered a problem seen in old age, but of late, we are increasingly seeing younger adults suffering from back pain. Prolonged sitting hours, inadequate physical activity, smoking, and an unhealthy lifestyle have made back pain a common complaint even in people under 30 years of age.

What is a slipped disc?

In an interview with Health and Me, Dr Pramod Sudarshan, Spine Surgeon (ortho), Apollo Hospitals, Bangalore, said, “Most commonly, we attribute this pain to a slipped disc or other disc-related conditions. However, they are just one among many reasons causing back pain. A thorough understanding of the other conditions that can lead to back pain, and knowing the ‘red flags’ to help identify them, will assist in seeking early treatment and preventing further complications.”

Muscle strain is considered to be one of the most common reasons for developing back pain in younger individuals. Daily activities like travelling for long hours, lifting heavy weights without proper technique, and carrying heavy backpacks can lead to muscle strain. Often, the pain due to muscle strain comes down with the help of medications such as muscle relaxants and rest.

Poor posture and back pain

Working professionals and students spend many hours a day studying, gaming, and working on computers without maintaining proper posture, leading to excess strain on the back muscles and, in turn, prolonged back pain. Having a properly ergonomically designed workstation/study table setup can prevent back discomfort and stiffness.

What are the causes of back pain?

Lack of physical activity and associated conditions such as obesity weaken our core muscles, which are considered the main pillars supporting our spine. Weakened core muscles will not be able to perform the functions expected of them, leading to back pain. Regular exercise, weight management, a healthy diet, and guided weight training will help strengthen our core muscles and reduce the risk of back pain.

Other than muscles, the spine also contains small joints known as facet joints, irritation or inflammation of which can lead to back pain. A structure known as the pars interarticularis acts as a clamp in the spine, holding two adjacent vertebral bodies, and any defect, such as a congenital defect or fracture due to repetitive microtrauma, as seen in gymnasts, can lead to the slipping of one bone over the other, causing back pain.

Though mechanical back pain is most common, there are other conditions such as inflammatory arthropathy, tumours, and infections. Conditions such as ankylosing spondylitis, rheumatoid arthritis, and hyperuricemia/gout are some examples of inflammatory conditions in which an individual experiences early morning back pain associated with stiffness and may also present with pain in other joints.

Can tuberculosis lead to back pain?

Tuberculosis affecting the spine is considered the most common infection of the spine. Severe back pain, weight loss, loss of appetite, fever, and night sweats are some of the common symptoms. Other bacterial and fungal infections are also seen affecting the spine, most commonly in immunocompromised individuals.

Tumours, though rare in young individuals, warrant further investigation when symptoms such as severe weight loss, night pain, and prolonged back pain are present to rule out the possibility of tumours.

Other conditions such as scoliosis (congenital/adolescent idiopathic scoliosis), which is a three-dimensional deformity of the spine, can cause back pain. It requires further assessment in the form of radiological investigations to assess the degree of deformity and to plan any surgical intervention, if required, based on the severity of the curve.

What are the symptoms?

Identifying some of the red-flag signs, such as weakness in the legs, numbness around the groin, bladder or bowel dysfunction, fever, unexplained significant weight loss, or severe pain following major trauma, is essential. These symptoms may indicate serious underlying pathology requiring medical care.

Fortunately, back pain in young people is largely preventable. Basic lifestyle modifications such as regular exercise, maintaining proper posture, avoiding prolonged sitting, maintaining a healthy body weight, undertaking monitored weight-training programmes, following a healthy diet, and getting adequate sleep will help prevent as well as overcome existing back problems. Invest in your spinal health at the earliest opportunity to reap the benefits in the second half of life.

Researchers from the University of Oxford and pharmaceutical firm Moderna have developed a vaccine that may prevent bowel and ovarian cancer. The first trial is to be this summer, and it will try to see if the vaccine can train the immune system to recognize and eliminate pre-cancerous cells in people with Lynch syndrome before cancer develops.

In the United Kingdom, one in 300 people has Lynch syndrome, an inherited health condition that massively increases the chance of contracting cancers like bowel and ovarian cancer.

What Is Colorectal Cancer?

Colorectal cancer is the umbrella term for both colon and rectal cancer. As the name also suggests, colon cancers happen only in the colon, but if it is left untreated, it can spread to different organs in your body. Colorectal cancer begins inside the rectal tissues or the colon walls. It presents itself in the earliest stages as small masses, known as polyps. If a polyp becomes cancerous, it can spread cancer from the inner part of the colon to the lymph nodes or bloodstream. If this happens, cancer can then quickly move throughout the system.

Early Symptoms Of Colorectal Cancer

• Persistent changes in bowel habits, especially if they last more than a few days, must be taken seriously. Narrow or ribbon-shaped stools may indicate a tumor partially blocking the colon.
• Blood in the stool is one of the most common and concerning signs. While it might be due to hemorrhoids or fissures, it’s important not to assume. A proper evaluation is critical.
• Unexplained weight loss: Especially when unintentional.
• Abdominal cramps or bloating: Misinterpreted as common digestive issues.

What Is Ovarian Cancer?

Ovarian cancer is one of the deadliest gynecological cancers and is often referred to as the “silent killer” because its early symptoms are vague and easily mistaken for common digestive or urinary issues.

It develops when abnormal cells in the ovaries grow uncontrollably and may spread to other parts of the body. Survival rates are significantly higher when detected early—around 93 per cent of women diagnosed at stage one survive at least five years, compared to just 13 per cent at stage four, according to the American Cancer Society.

Unfortunately, many cases are diagnosed at advanced stages, when treatment options are limited, and outcomes are poorer.

• Early Symptoms Often Overlooked

“Ovarian cancer is commonly called a ‘silent disease’ because its early signs are vague and often resemble routine gastric issues,” Dr. Tejinder Kataria, Chairperson – Radiation Oncology, Medanta Hospital, Gurugram, told HealthandMe.

Common symptoms include:

• Persistent bloating
• Feeling full quickly or reduced appetite
• Pelvic or abdominal discomfort
• Unexplained constipation or diarrhea
• Ongoing indigestion
• Excessive gas
• Abdominal heaviness

Dr. Parminder Kaur, Consultant Gynaecologic Oncologist at CK Birla Hospital, Delhi, told HealthandMe that the key concern is when symptoms become frequent, persistent, and unusual for an individual’s normal health pattern.