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.

When it comes to heatwave-like conditions, most people worry about the risk of dehydration and sunburn. But it turns out that the scorching heat could also take a toll on your skin—according to experts, extreme summer heat can increase the risk of skin infections. Heatwave-related skin infections can be triggered by high humidity, sweat, and bacteria trapped on the skin. Some of the other issues associated with heatwaves are folliculitis, heat rash, impetigo, and yeast infections.

What makes heatwaves conducive to increased skin infections?

Talking about it, Dr. Gitika Sanodia, Consultant Dermatologist at Dr. L H Hiranandani Hospital, Powai, answered some FAQs associated with heatwaves and consequent skin infections.

The expert said that when there is an increase in temperature, there is an increase in sweating, dehydration, and breakdown of the skin barrier, which creates an environment suitable for infection development, mainly in children, the elderly, diabetics, and obese individuals. Heatwaves also cause friction, which leads to skin infections. As a result, rashes can develop and cause a great deal of discomfort.

Can sweating too much increase the risk of infection?

During summer, because of the heat, one ends up sweating far more than normal, and if you are someone who often wears tight clothes, it can be even worse. Overproduction of sweat keeps the skin constantly wet. Such an environment provides perfect conditions for bacteria and fungi to multiply. Being trapped under breast tissue, between the thighs, and in folds around the neck and armpits causes conditions such as yeast infections or folliculitis.

What are the infections associated with heat?

During a heatwave, some skin infections are likely to develop silently. These include:

1. Fungal infections such as tinea and candidiasis
2. Bacterial infections such as folliculitis and boils
3. Heat rash resulting in miliaria

Who is at risk of skin infections during a heatwave?

At a time when temperatures are rising constantly, heatwave-related infections are likely to affect certain groups more than others. These high-risk groups are:

1. Children
2. The elderly
3. Overweight people
4. People with diabetes
5. People who wear tight or non-porous clothes during summer

How to prevent heatwave-related skin infections?

In order to prevent heatwave-related skin infections, you need not make major changes to your lifestyle or wardrobe. Rather, some simple, cost-free methods can also do the trick. Here are some expert-recommended tips to beat the heat:

1. Keep your skin dry, especially skin folds
2. Wear loose-fitting cotton clothes
3. Bathe after sweating
4. Do not share towels or undergarments with anyone
5. Use an antifungal dusting powder on susceptible areas
6. Keep yourself hydrated

With the increasing number of heatwaves, these problems have become more than just seasonal. However, with the right choices in terms of diet, lifestyle, and clothing, you may be able to avoid skin infections during a heatwave.

Persistent back pain in young adults is often dismissed as poor posture, long hours at a desk, or muscle strain. But doctors are warning that in some cases, it could be a sign of ankylosing spondylitis — a chronic inflammatory autoimmune disease that affects the spine and can silently progress for years before diagnosis.

In India, 16.5 lakh people suffer from the condition, with an average diagnostic gap of nearly seven years from the time symptoms first appear. During that window, the disease continues to silently progress, and the burden is far from small.

“Ankylosing Spondylitis is one of the most underdiagnosed conditions we encounter in clinical practice, and the consequences of that delay are real,” Dr. Arvind Mehra, Senior Director and HOD - Orthopaedics at Paras Health Gurugram, told HealthandMe.

Moreover, “It takes several years of pain and stiffness before people seek treatment, and by then, the diagnosis comes too late, and there has already been damage to the spine,” added Dr. Ashish Tomar, Director - Orthopaedics & Minimally Invasive Spine Surgery at Sarvodaya Hospital, Faridabad.

What Is Ankylosing Spondylitis?

Ankylosing spondylitis, also known as axial spondyloarthritis, is a type of arthritis that primarily targets the spine but can also affect other joints. The term “ankylosing” means stiff or rigid, “spondyl” refers to the spine, and “itis” indicates inflammation.

The inflammatory disease causes some of the bones in the spine to fuse over time. This fusing not only makes the spine less flexible but can also cause issues while breathing.

Ankylosing spondylitis leads to inflammation in the spine and large joints, causing stiffness and pain. It can also impact the joint between the spine and the hipbone, potentially resulting in additional symptoms such as digestive issues, rashes, and weight loss.

Not Your Typical Back Pain

What makes ankylosing spondylitis difficult to spot is that it often feels like ordinary back pain — but there are warning signs that set it apart.

According to experts, ankylosing spondylitis-related pain typically:

• Causes maximum stiffness early in the morning
• Gets worse after long periods of rest
• Improves with physical activity or exercise
• Persists for months rather than days or weeks
• Often begins in young adults, especially in their 20s and 30s

This pattern is very different from mechanical back pain, which usually worsens with movement and improves with rest.

Pain Beyond The Spine

Dr. Tomar told HealthandMe that ankylosing spondylitis is not simply a musculoskeletal problem — it is an autoimmune disease, where the body’s immune system mistakenly attacks healthy tissues, particularly around the spine and joints.

“Ankylosing spondylitis is not just another musculoskeletal disease. It requires the attention given to autoimmune disorders because it may affect the chest, hips, shoulders, and even the eyes, while also causing severe posture problems in advanced stages,” he said.

Beyond the spine, the disease may affect:

• Chest joints
• Hip joints
• Shoulders
• Eyes
• Posture, causing severe problems in the advanced stages

Who Is At Most Risk? How To Treat?

Young adults, typically in their twenties, are more likely to experience this condition because people often overlook its existence or mistakenly identify it as something else.

The combination of early diagnosis, structured physiotherapy, and suitable medications allows for effective disease progression control.

“When a young adult presents with inflammatory back pain, especially in the gluteal area, that persists beyond three months, the reflex should not be to prescribe a painkiller and wait. It should be investigated further. That shift in approach can make an extraordinary difference to someone’s long-term quality of life,” Dr. Tomar said.

Common treatments for ankylosing spondylitis include:

• Regular physical activity can reduce stiffness and prevent worsening of ankylosing spondylitis
• Over-the-counter painkillers for pain and inflammation
• Biologic DMARDs to reduce inflammation and pain, potentially halting disease progression.
• Corticosteroids are prescription anti-inflammatory medications
• Surgery is rarely suggested for severe symptoms unresponsive to other treatments.

When women are in their 40s, their bodies start to change a lot because of the hormones. This is mainly because the estrogen and progesterone levels in the body start to go down. This time is called Perimenopause.

It is when women start to move towards menopause. It can bring a lot of emotional changes. Some of these changes are normal.

Why Do Hormonal Changes Happen After 40?

After 40, women's bodies start to produce estrogen. This means they can have an imbalance.

Women's bodies need hormones like estrogen and progesterone to have periods, strong bones, a good mood, and to stay at a healthy weight. When these hormone levels change, it affects parts of the body. This change can take a year before it stops at menopause.

Common hormonal changes women experience

• Irregular periods

• Hot flashes and night sweats

• Mood swings and anxiety

• Weight gain and slower metabolism

• Sleep disturbances

• Skin and hair changes

Symptoms That Should NOT Be Ignored

While some changes are normal, some symptoms need a doctor's help:

• Heavy or prolonged bleeding

• Persistent fatigue

• Severe mood changes

• Sudden weight gain

• Bone pain or weakness

When women are over 40 and their hormones change, they are more likely to have:

• Heart disease
• Osteoporosis
• Thyroid disorders
• Metabolic issues

Estrogen helps keep the heart and bones healthy, so when its levels go down, women are more likely to have these health problems."

How Can Women Manage These Changes?

• Eat a balanced diet

• Exercise regularly

• Manage stress

• Have regular health check-ups

• Sleep well

Women should talk about these changes openly. If they know what is happening and see a doctor early, they can make this time easier.

Hormonal changes after 40 are a part of getting older, but women should not ignore them. Especially if the symptoms are very bad or happen all the time.

If women understand what is happening in their bodies and see a doctor when they need to, they can be healthier and more confident. If women take care of themselves now, they can have a life in the years to come.