PCOS affects a major part of a menstruating person’s life than many of them are aware of. The lack of information about the condition and the reluctance of people to talk about the matter makes it worse. As we kick off World PCOS Awareness Month, we try to understand the proper repercussions and the best ways to manage your periods. As science progresses each day, many women have taken the initiative to further the research on PCOS and the reproductive health of women. We spoke to Dr Prarthana Shah, a doctor who specialised in preventative CVD medicine and an Integrative Health Coach to get a better understanding of the vital role nutrition plays in a woman’s reproductive cycle.

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder affecting millions of women worldwide. Characterized by irregular menstrual cycles, excess androgen production, and the presence of cysts on the ovaries, PCOS can lead to a range of health issues, including infertility, obesity, type 2 diabetes, cardiovascular disease, and endometrial cancer.

Role of Nutrition in PCOS Management

A balanced diet plays a crucial role in managing PCOS symptoms and reducing the risk of associated health complications. By focusing on nutrient-dense foods and avoiding certain triggers, women with PCOS can significantly improve their overall well-being.

According to Dr. Prarthana, “The first thing is B12. So, a common deficiency, even otherwise, which can affect a woman's hormonal balance, because it helps regulate your hair length, and so it's important to make sure that you're getting enough B12.” There are important nutrients that women must have for healthy menstrual cycles.

• Vitamin B12: Essential for hormonal balance, hair health, and regular menstruation.
• Vitamin D: Helps regulate hormones, supports ovarian function, and improves insulin sensitivity.
• Iron: Crucial for preventing anaemia, which is common during menstruation.
• Electrolytes: Help maintain fluid balance and prevent fatigue.
• Amino acids: Provide building blocks for proteins and support overall health.

Dietary Recommendations for PCOS

As Dr Prarthana mentioned, the key nutrients that women lack are the reason why their periods might be irregular and make it difficult for them to handle it. She suggested that it's essential to prioritize a nutrient-rich diet. Focus on consuming whole foods like fruits, vegetables, whole grains, lean proteins, and healthy fats.

Minimize your intake of processed foods, sugary drinks, processed meats, and refined carbohydrates, as these can contribute to inflammation and hormonal imbalances. Consider limiting or avoiding dairy products, as they may contain hormones that can disrupt your hormonal regulation.

She also emphasised the importance of seasonal fruits. While many people have expressed their reservations with cross-contamination and germs from fruits she says, “You have to eat seasonal fruits and vegetables. Greens and salad leaves, all of these things for vitamin B12. Now, of course, there will be some vendors that cut it up. So, don't buy it from there. one tip I personally suggest is that I use something called Veggie Wash where I wash my salad leaves in that at home. You can also wash it with salt or apple cider vinegar.”

When enjoying seasonal fruits and vegetables, be mindful of potential contamination from vendors who cut and sell them. Wash them thoroughly at home to ensure safety. Finally, stay hydrated by drinking plenty of water throughout the day to support overall health and prevent dehydration.

Lifestyle changes you should make for PCOS

According to Dr Prarthana, your lifestyle plays a really important role in PCOS, “So, I know most women, even though they regularly exercise, I mean the ones that do, also kind of skip it during the period and that is the wrong thing to do, ideally.”

She also expresses how much it actually helps with period pains and relief for women, “It's okay. You should go and do some sort of exercise. Go for a walk. It could be lighter if you're, you know, tired. But something in some form of movement, maybe yoga, stretching, whatever works for each person depending on how much pain they have. It really opens up the muscles and gives you relief.”

Other changes include,

• Manage stress: Practice stress-reduction techniques like meditation, yoga, or deep breathing.
• Prioritize sleep: Aim for 7-8 hours of quality sleep each night.
• Consider supplements: Consult with a healthcare professional about potential supplements, such as vitamin D and iron, to address specific deficiencies.

Depression affects millions of people worldwide, but not everyone responds equally well to treatment. Now, researchers at the University of Sydney have identified a new subtype called “circadian depression,” which is linked to the body’s internal clock and may help explain why conventional antidepressants work less well for some people.

The subtype was identified in nearly a quarter of participants with severe, recurrent or persistent depression in an Australian study. Researchers say recognizing its characteristics could help clinicians identify patients who may benefit from different treatment approaches.

“Our research has identified circadian depression as a new subtype, affecting around a quarter of people in our study into those with severe, recurrent or persistent depression,” said Dr. Emiliana Tonini from the Brain and Mind Centre at the University of Sydney.

“Depression is not a uniform illness and understanding the characteristics of different subtypes mean that we can give people earlier access to treatments that will be most effective for them,” she added.

Circadian Depression: What Are The Key Symptoms?

Also read: Burning Skin, Panic Attack & Depression: ‘Godzilla’ Weight Loss Drug Retatrutide Linked To 129 Symptoms

Circadian depression is linked to the body’s 24-hour internal clock, which regulates the sleep-wake cycle. Researchers identified several symptoms and characteristics associated with this subtype, including:

• A seasonal pattern of illness

• Sleeping longer during depressive episodes

• Waking up feeling very tired

• Being a night owl

To investigate the subtype, researchers analyzed clinical and genetic data from more than 10,000 people with depression who participated in the nationwide Australian Genetics of Depression Study.

Of these, 2,604 participants, or nearly 25%, were identified as having circadian depression.

The researchers also found that people with this subtype were more likely to experience depression earlier in life and had more severe symptoms, including mania and higher levels of suicidal thoughts.

In addition, these participants had a higher genetic risk for inflammatory and cardiovascular health problems, as well as major neurodevelopmental disorders, including attention-deficit/hyperactivity disorder (ADHD).

The findings, published in the British Journal of Psychiatry, offer insights into the genetic mechanisms associated with circadian depression and may help explain why conventional treatments, such as selective serotonin reuptake inhibitors (SSRIs), work less well for some people with this subtype.

How Does Circadian Depression Differ In Treatment Response?

Antidepressants such as SSRIs and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly used to treat depression. However, the researchers reported that these medications were less effective and associated with more side effects in people with the circadian subtype.

Because circadian depression is linked to the body’s internal clock, treatments targeting circadian rhythms may be relevant for some patients. These include light therapy, melatonin and melatonin-targeted antidepressants.

“Because circadian depression is linked to people’s internal body clock, treatments targeting the circadian rhythm, such as light therapy and melatonin, may be much more relevant, and clinicians should reach for these much earlier in people with this presentation,” said Dr. Jacob Crouse, co-senior author of the study, from the Brain and Mind Centre.

“For those who find that antidepressants are not working for them, it is important to speak to your clinician for advice about your individual circumstances,” he added.

Professor Ian Hickie, co-director of the Brain and Mind Centre and a clinical psychiatrist, emphasized that failing to recognize circadian depression in young people could contribute to early treatment failures and more side effects.

“We really want young people to receive the most appropriate treatment early in their course of illness.

“Most young people will be offered SSRIs first up, but for at least a quarter there are better circadian-focused medical and behavioural options to help treat and manage their condition.”

The findings suggest that identifying circadian depression could help clinicians consider more tailored treatment approaches. However, the study does not establish that body-clock disruption causes depression or that every person identified with this subtype will respond better to circadian-focused treatments. Patients should consult their clinicians before making any changes to prescribed medication, the experts said.

In India, breast cancer is the most diagnosed cancer among women and the leading cause of cancer-related deaths in women. According to the International Agency for Research on Cancer’s GLOBOCAN 2024 estimates, the country recorded approximately 237,231 new cases and 96,100 deaths. Across both sexes, it is the second leading cause of cancer death.

The median age of diagnosis among Indian women is 51, nearly a decade younger than in most developed countries. One hospital-based study estimates that 25% of cases occur in women under 40, underscoring the importance of breast awareness, timely symptom evaluation, clinical examination and individual risk assessment. The Breast Imaging Society of India recommends mammography screening from age 40, considering individual risk and available resources.

Breast cancer risk does not suddenly begin at a particular birthday, and two women of the same age may have very different risk profiles. Women should be encouraged to become familiar with the usual appearance and feel of their breasts and to seek prompt clinical evaluation for unexplained breast changes. In India, where breast cancer often presents at a comparatively younger age and access to high-quality imaging is uneven, discussions about early detection should extend beyond age alone. Family history, inherited susceptibility, previous breast findings and other recognized risk factors can help determine whether a woman may benefit from earlier assessment, specialist referral or additional imaging.

Why individual risk matters

A risk-informed approach should consider several factors:

• Family history: Breast or ovarian cancer in close relatives, particularly diagnoses at younger ages, cancer affecting both breasts, male breast cancer, or multiple affected relatives may indicate inherited susceptibility. This may warrant earlier risk assessment before age 40.

• Genetic factors: Women with BRCA1 or BRCA2 gene variants may also require earlier than average-risk screening, starting as early as age 25.

• Breast density: Dense breast tissue can lower the sensitivity of mammography and is independently associated with breast cancer risk. Supplemental imaging such as MRI may be considered in selected women, based on the overall risk, the quality of available imaging and the potential for false-positive results and unnecessary biopsies.

• Previous breast findings: A previous high-risk breast lesion, atypical biopsy result or suspicious imaging finding may change the recommended screening frequency or method. Women with such findings should follow an individualized plan developed with their physician.

Also read: Breast Cancer: Are Women in India Being Diagnosed Too Late?

Persistent inequalities in access

Access to breast assessment, imaging and specialist interpretation remains highly unequal across India. The lifetime prevalence of breast cancer examination is only 8.8 per 1,000 women, with uptake varying by education, economic status and geography. High uptake among educated, affluent, and urban women, especially in southern India, highlights how social determinants and health system barriers shape access to breast cancer screening. India also faces shortages and maldistribution of imaging specialists, with approximately one radiologist per 100,000 people, compared with one per 10,000 in the US. Specialists are disproportionately concentrated in urban areas.

Addressing these inequalities requires more than awareness campaigns. Priorities include strengthening clinical breast examination and referral pathways, training frontline health workers, expanding access to diagnostic imaging and pathology, ensuring timely follow-up after abnormal findings, and monitoring outcomes across socioeconomic and geographic groups.

Also read: World Breast Cancer Day 2026: Life After Breast Cancer, The Fear No One Sees

Where artificial intelligence could support early detection

Artificial intelligence (AI) is being evaluated as a potential support for breast cancer detection in settings where imaging capacity and specialist availability are limited. Depending on the technology and clinical context, AI may assist with triage, image interpretation, workflow prioritization or risk estimation. Its clinical value depends on appropriate validation, reliable referral pathways, diagnostic confirmation, quality assurance and ongoing monitoring for unequal performance across population groups.

Integrating community health workers, portable AI technology and digital referral pathways within primary health care could potentially help reach women who face geographic, financial or health-system barriers. The most important feature is not the algorithm alone, but the complete pathway linking awareness, initial assessment, referral, diagnostic confirmation and treatment. AI output is not a diagnosis. It must be interpreted alongside the patient’s clinical history, risk factors, examination findings and appropriate diagnostic imaging.

Translating personal risk into informed screening decisions

For women, a more personalized approach does not mean performing more tests in every case. It means identifying those who may benefit from earlier, more frequent or different forms of assessment while avoiding unnecessary imaging and procedures among women unlikely to benefit.

As part of a shared decision-making conversation, women may wish to ask their physician:

• Based on my age and personal risk factors, when should breast cancer screening begin?
• Does my family history suggest that I need a formal risk assessment?
• Would referral for genetic counselling be appropriate for me?
• If I have dense breasts, how does that affect the interpretation of my mammogram and my overall risk?
• Do previous breast symptoms, imaging findings or biopsy results change my follow-up plan?
• Which screening or diagnostic services are available locally, and what follow-up will be provided if an abnormality is found?
• Would a formal breast cancer risk-assessment help guide my screening plan?

Breast Cancer Awareness Month is an opportunity to advocate for equitable care pathways, from risk assessment and early detection to diagnosis and timely treatment. In India, a key challenge is ensuring every woman with a concerning symptom or abnormal finding receives appropriate assessment, diagnostic confirmation and treatment without avoidable delays.

Preparing future physicians for evolving healthcare needs is central to medical and public health education at St. George’s University School of Medicine. Through a diverse, international learning environment and clinical exposure, students develop the medical knowledge, clinical skills and professional competencies needed to care for diverse patient populations.

By Dr. Tonia Frame, Assistant Professor and Director of the Global Health Unit in the Department of Public Health and Preventive Medicine at St. George’s University

After Dussehra festivities, Delhi woke up to an alarming AQI of 300, maybe even more in some parts of the city. On October 21, pollution curbs under GRAP-1 were implemented, which are brought in force when AQI ranges between 201 and 300.

As Delhi's air pollution increases, some people may experience uncommon symptoms like feeling unusually tired, sluggish or unable to concentrate. This is not just a coincidence. Even people without asthma or breathing difficulties can feel fatigue, especially during periods of high air pollution.

Fine particulate matter (PM2.5) can penetrate deep into the lungs and trigger inflammation and physiological stress. Its effects may extend beyond the respiratory system, affecting blood vessels health, cardiovascular function as well as sleep.

HeathandMe spoke to Dr Puneet Khanna, Chairman, Respiratory Medicine and Pulmonology, Manipal Hospital Dwarka, New Delhi, Dr. Puneet Gupta, HOD - Pulmonology, Intervention Pulmonology & Sleep Medicine, Yatharth Super Speciality Hospital, Noida Extension, and Dr Mrinal Sircar, Director, Respiratory and Sleep Medicine, Medanta, Noida, who explained why rising AQI can leave some people feeling exhausted, what can help and when chronic fatigue needs medical attention.

High AQI May Make You Feel Tired Even Without Breathing Problems

Poor air quality does not affect just the lungs. Dr Sircar explains that air pollution can cause symptoms even in people without a pre-existing respiratory condition.

According to Dr Khanna, exposure to PM2.5 can trigger inflammation and oxidative stress, increase the body's workload and affect sleep quality. These changes may contribute to tiredness, headaches, low energy and reduced concentration, even in people with otherwise healthy lungs.

“Exposure to polluted air may also affect sleep quality and increase the body's overall stress response, contributing to symptoms such as tiredness, reduced energy and difficulty concentrating,” he says.

Dr. Gupta delves deeper into the process of PM2.5's attack and how the body responds to it.

He explained, "Your immune system treats fine particles (PM2.5) as intruders and mounts a constant low-grade defence, which burns energy much like a mild infection. At the same time, irritated airways and gases like carbon monoxide can make oxygen delivery slightly less efficient. The most underrated cause is sleep: a dry throat, blocked nose, and mild night-time cough fragment your sleep, so you wake up unrefreshed without knowing why. Fatigue here doesn’t mean your lungs are weak. It means your body is working overtime quietly."

Also read: Sky Turns Orange In Indonesia: How Toxic Smog From Wildfires Can Impact Health

Can PM2.5 Affect The Heart And Blood Vessels Too?

PM2.5 particles are small enough to penetrate deep into the lungs. Some of its components can even enter the bloodstream. Exposure can trigger inflammatory and oxidative stress responses beyond the respiratory system.

Dr Khanna says, “These changes may reduce physical endurance, increase feelings of fatigue, and contribute to symptoms such as brain fog, lethargy, and reduced exercise tolerance, particularly during periods of severe air pollution.”

Dr. Gupta explained PM2.5 can create the same response from body as a common flu does. But the extent of these effects depends on pollution levels, duration of exposure and individual risk.

He said, "PM2.5 is small enough that it, or the inflammatory chemicals it triggers, can enter the bloodstream. Signalling molecules such as IL-6 and CRP then travel through the whole body and produce the same “wiped out” feeling you get with the flu."

He also said that particles also create oxidative stress, which damages mitochondria, the power plants of your cells. Blood vessels become stiffer, blood pressure can rise slightly, and the nervous system’s control of heart rhythm can be disturbed, which may feel like heaviness or palpitations. Inflammation can also reach the brain, causing fog and poor focus.

Also read: Delhi Smog: Can You Really Tackle Pollution Season With An N95 Mask And Air Purifier?

What Can Help?

According to the doctors, the key is to reduce exposure to polluted air. Practical steps include:

• Limit exertion: Avoid strenuous outdoor activity when pollution levels are high, especially during periods of severe pollution.
• Wear a well-fitting N95 respirator: It can reduce exposure to fine particles when outdoors.
• Improve indoor air quality: Keep windows closed when outdoor air quality is poor and use a suitably sized air purifier with a HEPA filter where feasible.
• Maintain basic health routines: Get adequate sleep, stay hydrated and eat regular meals.
• Check AQI levels: Use local air quality updates to plan outdoor activities.

Dr Khanna emphasises that these steps can help reduce exposure but cannot eliminate the effects of ongoing pollution. He also said that severe breathlessness, chest pain, fainting or sudden weakness requires urgent medical attention.

Does Pollution-Induced Fatigue Go Away When AQI Improves?

For many otherwise healthy people, symptoms can improve once air quality improves. Dr Khanna says recovery may occur within a few hours to several days, depending on pollution severity, exposure duration and individual health.

However, there is no fixed recovery timeline. People with underlying respiratory or cardiovascular conditions may take longer to recover, while persistent tiredness may point to another health problem.

Dr Sircar advises seeking medical advice if fatigue continues after air quality improves.

The doctors also advise that if fatigue is chronic, recurrent, worsening or interferes with daily activities, medical evaluation should be sought rather than simply attributing it to air pollution.

Dr Sircar also says that that a doctor may need to investigate other possible causes, including anaemia, thyroid disorders, sleep problems and cardiovascular conditions. Fatigue accompanied by a chronic cough, wheezing, breathlessness, chest problems or reduced exercise tolerance also needs intervention.