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.

From bone smashing to black market peptides, the modern push to “optimize” the male body increasingly runs through human endocrinology, often without a doctor anywhere in the loop.

A Trend That Outgrew Its Origins

Looksmaxxing began on incel forums that blamed romantic failure on fixed facial geometry. That ideology has since spread to TikTok and Instagram, stripped of some of its uglier language but keeping its core premise: a man’s body can and should be engineered, whatever the cost. What started as a fringe belief system now functions as mainstream influencer content with millions of followers.

Clinicians split the practice into softmaxing (sleep, skincare, fitness, mostly harmless) and hardmaxxing, which branches into two wings: mechanical (bone smashing, jaw implants, leg lengthening) and pharmaceutical (unsupervised testosterone, anabolic steroids, SARMs, and peptides marketed as growth hormone substitutes). The pharmaceutical wing is growing fastest, and it sits squarely in endocrinology’s territory.

What These Drugs Actually Do

The body regulates testosterone through a feedback loop running from the hypothalamus to the pituitary to the testes. Flood that system with outside testosterone or anabolic steroids, and it shuts down its own production, taking fertility down with it. SARMs were built to act on muscle and bone while sparing the prostate, but none are approved for human use, and the versions sold online are unregulated and inconsistently dosed. Peptides like ibutamoren (MK-677) stimulate the body’s own growth hormone release. The mechanism sounds gentler, but few have completed real clinical trials for the uses they are marketed for.

The Documented Harms

Anabolic steroids:

● Testicular atrophy and infertility from HPG axis suppression

● Gynecomastia, from testosterone converting to estrogen

● Hepatotoxicity, especially with oral forms

● Psychiatric effects at high doses, including mood instability

SARMs:

● Liver injury, including cholestatic jaundice in black market cases

● Dose-dependent suppression of natural testosterone production

● Elevated liver enzymes, reduced HDL cholesterol

Across the board:

● Elevated hematocrit, raising clotting risk if unmonitored

● Adrenal suppression and disruption of corticosteroid and DHEAS production: exogenous androgens interfere with the hypothalamic-pituitary-adrenal axis, blunting the adrenal gland’s output of cortisol and dehydroepiandrosterone sulphate (DHEAS). The result is impaired stress response, fatigue, and hormonal dysregulation that persists well after the substance is stopped.

● Elevated blood pressure and increased cardiac sympathetic drive: anabolic agents raise systolic pressure and heighten sympathetic nervous system activity in the heart, accelerating resting heart rate and increasing myocardial oxygen demand. Over time, this contributes to left ventricular hypertrophy and raises the risk of arrhythmia.

● Unreliable contents: labels rarely match what is actually in the product, and contamination or substitution is common enough that toxicology reports periodically turn up drugs users never intended to take.

The Mechanical Risks

Bone smashing has no basis in orthopedic science. Bone remodels under sustained load, not blunt trauma, which produces fractures, hematomas, and sometimes permanent damage. Cosmetic jaw implants and leg lengthening are legitimate procedures in the right clinical context, but carry the same surgical risks, infection, nerve damage, long recovery, without the medical justification that normally accompanies them.

The pharmaceutical track carries its own structural toll: supraphysiological androgen levels accelerate calcification in tendons and menisci, reducing their elasticity and load-bearing capacity. Meniscal and tendon calcinosis increases the risk of tears and joint instability, often in the absence of any acute injury. Athletes who stop using these compounds may find the damage is already done.

A related danger runs alongside both tracks. Some men adopt extreme dieting, dehydration, or fasting protocols purely to sharpen jaw and cheekbone definition before photos. The behavior carries the same physical risks as any restrictive eating disorder, yet it rarely gets recognized or treated as one, since it is framed online as discipline rather than disorder.

Why Now

Gallup polling found that roughly a quarter of young American men report frequent loneliness, a notably higher rate than young women. Online communities built around appearance fill that gap with something that looks like belonging, even though the content itself runs on comparison and self-criticism.

TikTok’s own data illustrate how fast the trend has moved: searches for bone smashing and related terms ran in the hundreds of thousands per day in early 2026 and climbed into the millions within a month, before the platform restricted the content. Marketing has kept pace too: one UK survey found nearly a third of 16 to 25-year-olds see SARM ads on social media weekly.

What Legitimate Treatment Looks Like

TRT for confirmed hypogonadism, diagnosed through repeat morning bloodwork and monitored over time, is genuinely effective medicine. That is a different undertaking entirely from a eugonadal man sourcing hormones or peptides online to chase a feeling, with no diagnosis and no monitoring. The same distinction applies to surgery: a qualified surgeon’s evaluation is not the same as a procedure booked off a forum recommendation.

The Bottom Line

None of this is an argument against fitness or grooming, and most softmaxxing is harmless. The danger lies in a narrower set of behaviors: fracturing healthy bone, importing unregulated hormones, chasing a standard that keeps moving regardless of what is achieved.

Endocrinologists studying this are not against masculinity or ambition about one’s appearance. They are arguing that hormonal systems deserve the same evidence-based caution as any other organ system, and that distinction matters more now that these behaviors are still treated as cultural curiosities rather than the clinical concerns they actually are. A blood test and a doctor’s judgment remain better tools than a forum thread and a vial of unknown origin.

The United Kingdom is facing constant heatwaves. So far, the nation has witnessed two heatwaves, while the natural temperature increases usually during late July and August, thus creating fear and the possibility of more and more temperature rises. As the country has been going through a weather roller-coaster since May, there was a huge area of high pressure, commonly explained as a 'heat dome'. This resulted in dry, very warm, and sunny weather in the island nation.

Notably, the temperature soared up to 35.1 °C in London during the month of May. The temperature in the UK has been on a rising trend over the past few years, and the first time it touches 40C in July 2022. And according to the experts at the Met Office, if global warming continues at its current pace, temperatures in the mid-forties could be a serious possibility for the UK by 2050.

The World Health Organization advises people to drink plenty of water, avoid going outdoors during the hottest hours of the day, wear loose and light-coloured clothing, and keep homes as cool as possible as temperatures continue to spike across many parts of the world.

Indians are used to living with intense summer heat, and over the years, people have developed simple yet effective ways to cope with it. Many prefer to finish outdoor work during the cooler hours of the morning or after sunset. Drinking plenty of water and traditional cooling beverages, seeking shade whenever possible, and keeping a close eye on elderly family members, young children, and people with existing health problems are all common practices during extended spells of extreme heat.

Also Read: Why Thousands Of Black Men In The UK Are Now Being Invited For Prostate Cancer Screening?

Hospitals Under Pressure Throughout Western Europe And Strict Restrictions

The worsening conditions have disrupted healthcare services, with media reports saying hospitals have had to postpone critical imaging scans after sensitive equipment overheated. Cities have also opened emergency cooling centers to protect vulnerable residents.

In Paris, authorities have announced temporary bans on public alcohol consumption and takeaway alcohol sales to ease pressure on hospitals. Public drinking will be prohibited from noon to 7 a.m. over the weekend, while takeaway alcohol sales will be banned between 6 p.m. and 7 a.m.

The extreme temperatures have also reached the sporting world. Formula 1's governing body, the FIA, has declared another "heat hazard" ahead of the Austrian Grand Prix weekend at Spielberg's Red Bull Ring, triggering additional measures to protect drivers, teams, and spectators.

The June 2026 heatwave has triggered red alerts across France, Spain, Italy, and the United Kingdom, and killed dozens of people.

How Does Heat Impact Health?

Health experts warn that prolonged exposure to extreme heat can have serious and sometimes fatal consequences, particularly for older adults and people with underlying medical conditions.

According to the WHO, extreme heat can overwhelm the body's ability to regulate temperature, increasing the risk of heat exhaustion and heatstroke. As the body works harder to cool itself, it places added strain on the heart and kidneys, potentially worsening chronic conditions such as cardiovascular, respiratory, mental health, and diabetes-related illnesses, and increasing the risk of acute kidney injury.

Although monsoon rains provide relief from the unbearable summer heat, they also increase the risk of infections, dehydration, and diseases that are transmitted through water and that can affect the functioning of your kidneys. Since kidneys play a crucial role in eliminating toxins from your body and maintaining fluid balance, kidney care during the monsoon season becomes necessary.

Stay Hydrated

Though it is cooler during monsoon rains, your body needs enough water to help the kidneys filter the toxins efficiently. Try drinking 2-3 liters of clean water daily, or according to the requirement advised by your doctor. Avoid drinking contaminated water, as it increases the risk of infections in the kidneys.

Eat Healthy and Fresh Food

Eat fresh and cooked food at home instead of junk food that might get contaminated during the monsoon rains. Include seasonal fruits, vegetables, whole grains, and healthy protein sources in your diet. Restrict the intake of excess salt, canned products, and sugar drinks.

Prevent Infections

The monsoon season is prone to UTIs that may eventually reach the kidneys if not treated on time. Keep your body clean, wear dry clothes, and never keep urine in your bladder for a prolonged period. In case you have burning sensations while passing urine, fever, or pain in your lower abdomen, do see a doctor.

Control Health Problems

Individuals suffering from diabetes, hypertension, or pre-existing kidney problems should take special care of themselves throughout the monsoon. They should be taking their medications, measuring their sugar and blood pressure levels, and undergoing regular medical examinations to avoid kidney diseases.

No Self-medication

Analgesics and other OTC medications can cause damage to the kidneys when consumed frequently and without consulting a doctor.

Conclusion

It does not take much effort to maintain the health of your kidneys during the monsoon season. Simple things such as staying well-hydrated, consuming hygienic food, preventing any infection, keeping control of existing illnesses, and taking no medicines unnecessarily will ensure that your kidneys continue to perform at their best. In case of any swelling, change in urine output, fever, or back pain, you must see a doctor right away. The importance of the kidneys is undeniable for your well-being.

(By Dr. Bhanu Mishra, a Consultant- Nephrologist at Fortis Hospital, Shalimar Bagh)