India finally on the path to good healthcare

When Covid-19 hit nearly two years back, it laid bare several lacunae of the healthcare system in India — poor hospital infrastructure, acute shortage of doctors, nursing staff and equipment, specialised treatment facilities particularly in primary healthcare centres in rural areas. While the newly launched digital health ID by Prime Minister Narendra Modi this week, is not a panacea, it aims to bridge the gap between healthcare and technology for one and all. 

On September 26, Modi launched the Ayushman Bharat Digital Mission (ABDM) — a nationwide digital health ID for all citizens. The initiative aims to serve as an online repository of health records, which will have unique identification and authentication. 

Under the scheme, a unique 14-digit digital health ID will be provided to all Indian citizens, which will carry their health records. This means, all personal health records of a person — lab reports, prescriptions and diagnosis from several hospitals in different regions of the country — can be stored digitally and shown to any healthcare provider across the country with the consent of the patient. 

The mission is akin to the Unified Payments Interface or UPI, as both aims to create interoperability. The UPI framework enables a person to transfer money from one entity to another irrespective of which bank the two entities have their accounts in. In the same manner a digital health ID will enable the movement of health information from one hospital/healthcare provider to another even if the two are connected to each other or not.

This will help doctors, hospitals and healthcare service providers, to make better and faster diagnoses as well as help enhance transparency in care delivery. People will get faster treatment at cheaper cost. 

The health ID will ensure that health records are not lost, re-tests at a different hospital/ facility are not needed. Further, it will also fasten the process of purchasing and processing insurance claims.  

So how to be part of the initiative? 

It is not mandatory for citizens to be part of it, but as Modi said it has the “potential of bringing a revolutionary change in India’s healthcare facilities”. 

One can obtain the 14-digit number after registering at the government ABDM portal. Citizens can also download the ABMD Health Records app on a phone.

The system will collect details including “demographic and location, family/relationship, and contact details” — all which can be updated easily. 

The health ID can be availed using the Aadhaar number. The mobile number linked with the Aadhaar number will get a One Time Password. If the Aadhaar is not linked to the phone number, then one will have to visit a participating health facility to get a biometric authentication done.

The official site claims that the health ID can be linked with an Aadhaar or mobile number, but media reports cite that Aadhaar is not mandatory and a phone number is enough to generate a unique health ID.

Once the ID is generated, citizens can go to any healthcare provider, who is linked to ABDM. To know who is linked, one can visit the Health Facility Registry — a comprehensive repository of all the health facilities of the country across different systems of medicine. 

Healthcare provider, linked to ABDM, will tag all the records created by that provider to your Health ID. If you want to share these records with another provider, share the Health ID. The second provider can access your records only if you grant approval, much like the UPI app (GPay, PhonePe, Paytm, etc). Here’s a link to create your Health ID — https://healthid.ndhm.gov.in/register 

How HealthSafe can help you in this good health journey

While the ABDM interface is being built and healthcare providers familiarise themselves with the platform, HealthSafe through its Keypr solutions is democratising this space and making it exceedingly simple for patients to manage their health records. Keypr, as the name suggests is a ‘Keep your prescriptions and medical records safe’ application that users can download from the playstore and the app store and use for managing their entire medical history and also connect with doctors, allied health specialists, diagnostic laboratories, and pharmacists (chemists) for their healthcare requirements. 

With a strong emphasis on the patient, the startup promises to provide highest levels of data safety and security and ease-of-use to patients, and also to caregivers who can remotely manage the health needs of their loved ones as well as benefit from community support in the Keypr discussion forum. HealthSafe also has tie-ups with several financing partners including medical insurance, crowdfunding and medical loan companies to provide resolution to the financial needs of patients thus completing the chain of events in a user’s healthcare journey. 

HealthSafe stands to complement ABDM so that users can avail several of the above mentioned services including digitisation of their medical records, accessing healthcare providers and participating in community discussions from one unified interface. The platform aims to make one’s healthcare journey easy and fuss free, while taking into account the fact that empowered users make the best healthcare decisions.

Check out www.healthsafetoday.com to download the HealthSafe app and progress on your safe, secure and worry free healthcare journey. 

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Superfoods, Nahh! Just a simple healthy diet to deal with COVID19 infection & the Vaccination effects

While there is no replacement for proper medication,  grandma’s homely and nutritious recipes may also help in strengthening the body against infections. People who eat a balanced diet tend to be healthier with stronger immune systems and lower risk of chronic illnesses and infectious diseases. Let’s find out what these simple diet changes are that can help us better combat the Coronavirus infection and support us in coping with the side effects of COVID-19 vaccination that might be hard for some of us to deal with. 

What to eat when vaccinated for Covid-19

To ensure that your Covid-19 vaccination experience is safe and smooth, it is imperative to take care of your diet too. So, here is a curated list of what you should and should not eat or drink prior to or after getting the vaccination.

Illustration by Sarah Chai, Pexel
  1. Drink water
    Keeping yourself hydrated is extremely important, especially when you are getting vaccinated against Covid-19. Proper water consumption throughout the day helps to re-energize your immune system, which in turn minimizes the risk of developing severe side effects. 8 to 10 glasses of water should do the trick!
  1. Eat whole grain and fibre rich foods
    When you decide to take the Covid-19 vaccine shot, make sure to consume healthy whole grain foods that are rich in fibre, rather than processed foods that are oftentimes high in saturated fats and calories. It is especially important that you try to avoid eating too many sugary foods. Experts believe foods rich in fibre are crucial for a relaxed body and a strong immune system.
  1. Consume a balanced diet
    A properly varied and balanced diet is key to good health, especially before and after getting the Covid-19 vaccine. Many reports have listed fainting and weakness as a stress-induced side effect of the Covid-19 vaccine. These can be minimized by eating healthy, wholesome foods. According to the Centre for Disease Control and Prevention, apart from getting some reassurance about the process, staying hydrated and eating a healthy balanced diet or a snack can prevent fainting associated with anxiety.


DO NOT:

  • Drink alcohol
    Various studies have shown that alcohol consumption results in weakened immunity. At a time like this, staying well hydrated is the key to good health. Hence, you must try to avoid drinking alcohol as much as possible as it can lead to dehydration, which in turn may intensify post-vaccination side-effects, including fever, fatigue and body ache.
  • Take any over-the-counter medications
    The use of non-essential medications  is advised against before your vaccination. Unless you require these medicines regularly, you should avoid drugs like ibuprofen, aspirin or acetaminophen as they may affect vaccine-related side effects. Similarly, antihistamines should not be used prior to vaccination to limit the chances of developing an allergic reaction against the vaccination.

Photo by Sarah Chai from Pexels

What if you contract a viral infection?

If you do end up contracting a viral infection such as Covid-19 or are currently recovering from it, there are certain dietary tips that you may want to follow in order to facilitate recovery. To battle the most common symptoms, we have tailored dietary tips for each of them. Be sure to follow these recommendations in combination with the healthy diet previously described by our nutritional specialists in our previous article. This will surely  minimise the long-term impact of Covid-19 on your health, accelerate your recovery, and quickly bring down any of the symptoms you may be experiencing.

  • Shortness of breath
    – Spread out your meals over the day; so consume little, but often.
    – Soft or moist foods may be easier to consume.
    – Drink fluids in-between meals, rather than during your meals/with your meals.
  • Dry mouth
    – Use sauces for dry foods.
    – Drink regular sips of water throughout the day.
    – Suck or chew on sugar-free sweets/gum to increase saliva production.
    – Your chemist may be able to provide you with medication if you have a sore mouth, 
      consult your doctor if unsure.
  • Tiredness
    – Do not rush your meals, try to consume your food slowly.
    – Soft or moist foods may be easier to consume.
    – Ready meals may be easier to eat if you feel too tired to cook.
  • Changes in taste or smell
    – Sustaining a varied and healthy diet is essential, even if the flavours may no longer   
      appeal to you. Keep retrying foods as well as your taste preference may change.
    – Keep your mouth clean throughout the day. Try to avoid alcohol based mouthwashes.
    – Good protein intake is essential for your recovery, but may have a metallic taste. If so,  you may want to marinate your foods with sweet/sour marinades.
    – If you find your food tastes metallic, switch to non-metallic cutlery and cookware.
    – Adding herbs and sauces may help improve taste.
    – Salty or bitter tastes may be improved by opting for foods low in salt or adding sweet
      flavours, including sweetener, honey, or sugar. Try not to use more than 6 tablespoons
      of sugar a day, but if more, be sure not to exceed 12 tablespoons.
  • Constipation
    – Stay well hydrated and drink 8-10 glasses of water a day.
    – Consume foods high in fibre, including fruits, vegetables and legumes.
    – Your chemist may be able to provide you with a laxative.

We hope you found these dietary insights helpful and learned something new. When it comes to diet, it is important that you are not too hard on yourself. Try to improve your diet step by step and you will soon reap the health benefits, feeling more energized and resilient, overall. If you would like to keep track of certain dietary habits like eating sugary foods or drinking enough glasses of water, be sure to check out the new activity tracker feature on the Health Safe app! 

Key Points

  • Consume a balanced diet, which especially includes a sufficient intake of fruits, vegetables and water. 
  • Vitamin C and D are especially advantageous in fortifying your immune system in defense against Covid-19.
  • Avoid drinking alcohol, carbonated drinks and concentrated juices.
  • Avoid a high intake of sugar, salt and saturated fats.
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Sleep Hygiene and its Impact on the Life of Teenagers

“Go to bed on time!”,  “Don’t stay up too late” are some common instructions yelled at teenagers and sometimes even adults every night. How many times have you felt so exhausted at work or school that you’ve just wanted to take a nap? Maintaining good sleep hygiene is a vital practice in our lives that is becoming harder to implement and is often ignored as we binge watch shows on Netflix or gossip with our friends. 

Sleep hygiene refers to maintaining a good sleep schedule in which one ensures that the total sleep requirement is met each day and the sleeping and waking routine is maintained. Our body’s internal clock, known as the circadian rhythm, ensures that we maintain good sleep hygiene. This is controlled by the hormone melatonin which is secreted in higher amounts when there is low light. This melatonin secretion is often suppressed due to long hours at night, increased stress, and the 24X7 entertainment industry, compromising sleep hygiene. 

How has the lifestyle of teenagers affected their sleep hygiene?

Research shows that the sleep requirement for a teenager is 8.25 to 9.2 hours for optimal alertness the next day. In a study involving 1215 undergraduate students in India, researchers found that the lifestyle habits of teenagers had impacted their sleep hygiene. Such habits included indulging in highly stressful activities before sleep like completing lengthy and challenging assignments and thinking about important matters at bedtime. These practices were also common in Australian, Chinese and American students. Furthermore, the study also concluded that students enrolled in more rigorous courses such as engineering found it harder to maintain proper sleep hygiene. 

How does sleep hygiene impact the academic performance of teenagers?

The teenage years are occupied with academic activities where maintaining sleep hygiene becomes more challenging because of the workload, late-night parties and other daily activities like scrolling on social media platforms for long periods of time at night. Currently, with online schooling, the exposure to artificial light has increased and the working hours have changed drastically. According to a survey conducted in Ahmedabad, approximately 70% of students have a delayed sleep time by 60-90 minutes due to increased screen time and a lack of physical activities, thereby impacting their sleep hygiene. Additionally, after school coaching classes increases the workload for Indian students, further affecting their sleep. A cross-sectional study conducted in a school in Delhi studied the sleep pattern of 501 adolescents and its impact on their academic performance and mood. This study found that the irregularity of the sleeping patterns on weekends and weekdays, and not meeting the total sleep requirement each day caused many students to suffer from sleep debt – daytime sleepiness, preference of activities in the evening, and moodiness. Around 80% of the students were sleep deprived which caused moodiness and often depression. This further impacts the attendance and attention of students at school or college. This study also found that low attendance correlated with poor academic performance

Can inadequate sleep hygiene affect the mental health of teenagers?

According to the WHO, 10%-20% of teenagers around the world suffer from mental health diseases such as depression, anxiety and hyperactivity. A cross-sectional study conducted in Shanghai studied the sleep hygiene and mental health of 4,823 adolescents from ages 11 to 20, found an inverse correlation between sleep hygiene and mental health problems. Teenagers with poor sleep hygiene were found to have more violent and disruptive behaviour, which increased as sleep became more unstable (varying sleeping patterns). 

How can one maintain good sleep hygiene?

Several studies have indicated that caffeine, nicotine and alcohol administration, especially close to bedtime, disrupts sleep and often causes long-term sleep problems. Additionally, regular exercise and management of stress improve one’s sleeping patterns. Various psychological studies have proved that different stress management techniques have been shown to reduce pre-sleep stress and hence improve sleep. Maintaining a regular sleep schedule helps reduce the variable sleeping patterns and a constantly changing circadian rhythm thereby preventing sleep problems and the other consequences of improper sleep hygiene. 

How to estimate sleep quality?

Activity trackers, which measure your active and inactive states can be a great option to have a general idea of sleep quality. 

Dr Alan Schwartz, M.D., director of the Sleep Disorders Center at Johns Hopkins Bayview Medical Center says,

“If you have any concerns about the quality of your sleep, it’s a good idea to talk to a doctor. If you’re an otherwise healthy person who just wants to gain some insight into your sleep routine , tracking devices might be a good option. The tracker will give you something to reflect on – often with user-friendly graphs or reports that make it easy to spot trends”.

Many digital health platforms can integrate with these activity trackers and assimilate rough data regarding the quality of one’s sleep. This data can then be used to make lifestyle changes in order to improve sleep quality. Furthermore, depression and neuropsychiatric disorders are also associated with a disturbed sleep pattern. Hints from data collected through activity trackers can also help dig out deeper problems associated with poor sleep. It’s always good to identify such problems and their root causes and gain medical advice and treatment before they are exacerbated.

Key Points

  • Sleep hygiene refers to a regular sleep schedule that allows the body to rejuvenate. Teenagers and adults are failing to fulfill this basic requirement of the body
  • A good night’s sleep can help mitigate mental health problems in young adults
  • Tracking one’s sleeping routine can estimate the sleep quality and help people make changes in their lifestyle to achieve better sleep hygiene.
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Can digital health platforms increase access to healthcare within the LGBTQ+ community?

When you last saw a patient-intake form or a medical insurance claim did you notice that gender is listed as a default binary? Imagine the plight of a non-cis person who does not identify with either of the genders in this scenario. While cis people would go about their business hardly bothering to notice the hospital receptionist after submitting the form, non-cis people would have to laboriously explain their gender to the receptioninst and ask to be included. They will then carry this process on right till the time they meet the doctor. Not forgetting that they are visiting the hospital because they are sick, and while they are explaining their identity to different people they are anticipating that they may be laughed at.  

What is sexual and gender identity? How does it matter in the healthcare scenario

Sexual orientation and gender identity are interrelated aspects of a person’s identity. While gender is a deep sense of identification with a male, female, or an alternative gender, a person’s sexual orientation defines their attraction to another person and guides their social behaviour. 

Dr. Ketki Ranade, from the Tata Institute of Social Studies, on a presentation of health inequities in the healthcare community says that,

“The assumption of heterosxualism and the gender binary of male and female that leads to the false categorisation of people as ‘normal’ and ‘abnormal’ is a fundamental problem ubiquitous in healthcare institutions, services, curricula and training.”

Non-inclusive hospitals impede growth within the healthcare sector

 While our law boldly claims, “Recognition of one’s gender identity lies at the heart of the fundamental right to dignity. Gender, as already indicated, constitutes the core of one’s sense of being as well as an integral part of a person’s identity. Legal recognition of gender identity is, therefore, part of the right to dignity and freedom guaranteed under our Constitution” (NALSA Judgement of 2014, section Article 21 and Transgenders, clause 68), there is very little affirmative action with regard to application of such statements in real life. Homophobia or culturally produced fear of or prejudice against homosexuals that sometimes manifests itself in legal restrictions or, in extreme cases, bullying or even violence against homosexuals is very commonly observed in all sections of society, with this chasm between members of the LGBTQ+ community and others clearly visible in healthcare too.

As stated before, it starts right with the administrative process of most hospitals being discriminatory providing no option to people identifying with diverse genders. This  lack of awareness perpetuates through the system, leading to many more grave problems. A revolting evidence for this comes from the pitiful condition of Anirban Kundu. Anirban, who identifies as a transgender woman, met with an accident and was rushed to the hospital with a bleeding nose and a head injury. While she was under severe distress, two hospitals refused her admission in the dead of the night as they could not decide whether she could be placed in a female ward.  

Imagine an alternative scenario, the hospital invests funds in sensitising their staff towards the LGBTQ+ community and in creating dedicated infrastructure so that they can receive good treatment with minimum anxiety with respect to their identity.  Overall, this would lead to a better and more inclusive healthcare system, satisfying the needs of people of all communities and  reducing the GDP loss from poor health outcomes, which in India has been recorded to be anywhere between 0.1% -1.7% due to homophobia related transgressions.

Not including gender/sexual identity in the healthcare system also leads to poor data collection, which is catastrophic for population-based research on diseases. Infact, Indian contribution to research and implementation of health for the LGBTQ has been abysmal. There have been delays in COVID19 vaccination for the LGBTQ community due to the misconception that hormone replacement therapy may cause blood clots due to the vaccination.

Maithilee Sagara of Nazariya, a queer feminist resource group says,

“Such people should ideally consult their endocrinologist before going for the vaccine, instead of being hesitant. The media, too, should highlight the stories of trans-rights activists who have shared their experiences of taking the vaccine. This will encourage more individuals to opt for vaccines”. 

It may be difficult for  members of the LGBTQ community to find a doctor

A survey by Center for American Progress (CAP) in 2015 showed that doctors refused to diagnose 8% of LGBQ respondents and 29% of trans respondents. Almost 9% of LGBQ and 21% of trans respondents were verbally abused by  doctors while 7% of LGBQ and 29% of trans participants were sexually abused. 

Another  report highlights the maltreatment of the transgender community by healthcare workers in India, which may be further brought to light by a systematic and quantitative analysis of of gender and sexual orientation based healthcare related issues and possible interventions.

Digital health can democratize the healthcare system increasing access to all

  • Digital health platforms can serve as secure locations to store medical records: While we may want to live in a utopia where there is no discrimination against different gender identities and sexual orientations we have to accept the fact that many people belonging to the LGBTQ+ spectrum do face social stigma. Due to this they may want to restrict access to their personal health records. Digitizing medical reports and prescriptions provides a safe and hassle free option which would relieve them of the anxiety of managing health records on paper.
  • Digital health platforms can be a great way to locate ally/friendly healthcare providers: With the evolution of the healthcare industry, new ways to engage and include members of the LGBTQ+ community are also increasing. Names of healthcare providers who are sensitised towards the LGBTQ+ cause and therapists and psychiatrists who specialise in dealing with mental health issues of the people of the LGBTQ+ community can be compiled in a directory which can be accessed online.
  • Teleconsults and Video consults can improve access to healthcare: While there may be a need to visit a doctor for getting a diagnosis in certain cases, preliminary diagnosis and followup opinions can be managed through tele- or video consults. In this way, people can contact doctors/specialists in different geographical locations. This would not only boost the confidence of the LGBTQ+ community in the Indian health system and also reduce the anxiety associated with finding the correct doctor for people belonging to the spectrum.

Key Points

  1. The healthcare sector in India is not completely inclusive.
  2. There is lack of research on the accessibility of healthcare for the LGBTQ+ community in India, while there is preliminary proof that they may suffer from discrimination from the healthcare community
  3. Digital health platforms can increase access to healthcare for the LGBTQ+ community by providing access to teleconsults and also listing out ally specialists. 
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Personal health record: Know how to manage your medical data

Imagine that you visited the hospital for an inflamed eye. However, the first people you meet, that is, the nurses and general physicians would rarely look into your eye. They would begin with your vital measurements such as blood pressure, pulse rate, oxygen saturation, weight, and height and send your blood sample for a general blood test. These basic measurements would become the first few elements of your personal health records (PHRs). 

“PHR is an electronic record of health-related information on an individual that conforms to nationally recognised interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual”.

Healthcare Information and Management Systems Society (HIMSS), a US-based non-profit.

The PHR is a system, where a person’s health records are collated in a secure location, and is easily accessible potentially at any time of the day from any location. The data is recorded, tracked and stored manually by the patient, and in other cases by the hospitals or health insurance providers. 

PHR provides a sneak peek into the patient’s medical history, thus fast-forwarding the current diagnosis. It may include common information such as contact details of the patient and his or her family members, past medical diagnoses, medications, list of allergies, immunisation history, test results, personal experiences and medical history of the family. 

PHRs can be paper-based as well as web-enabled using devices, such as computers, smartphones and tablets. Following are the types of PHRs: 

Types of PHR

  • Standalone Personal Health Records: 

In this, medical information is recorded, tracked and stored by the patient. This type of PHR gives patients more control over the data as they decide who should have access to the data.  

This system is best to keep a check on lifestyle behaviours like exercise and diet, monitor blood pressure and glucose at home, list of immunisations, medications.

“Paper-based PHRs are likely to fade away with time, prone to error and updating them can be a tedious and time-consuming task. On the other hand, web-enabled PHR systems can easily collate, track, store and update. But, they are prone to cyber risks.”

Source: Pixabay.com

  • Tethered Personal Health Records: 

A tethered PHR is medical data typically recorded by a healthcare organisation. While the data is electronically stored, it is also made accessible to patients. 

It can be updated easily and also has features like reminders, schedules, easy viewing of lab results. 

However, this type of PHR consists of information from only one health care provider, it may not be accessible if one visits multiple doctors. This can also be at risk of cyberattacks.  

Is PHR a bane or boon?

A PHR can be  a blessing, particularly in emergency cases. It aids physicians with an individuals’  existing medical conditions, allergies, medications, blood type and emergency contacts.  Easy access to such pertinent health information helps avoid duplication of tests and procedures, while accelerating early diagnosis and treatment. 

Efficient management of PHR that can be shared digitally can also contribute and accelerate research especially to build personalized precision medicine based treatment plans. A wonderful example of this is the use of patients’ electronic health records during the current COVID19 pandemic to assess the risk of COVID infection in patients with comorbid conditions. 

The obvious next step in this research would be to predict health outcomes based on medical history, as As Christopher M. Petrilli, MD, assistant professor, Department of Medicine at NYU Langone Health, explains

“While we continue to study outcomes in patients who tested positive for COVID-19 to create reliable real-time tools, the next phase of investigation will be development of predictive risk models to build into provider workflows, analyzing differences in outcomes across different hospitals to identify best clinical practices, and, finally, looking at non-COVID patients who may have delayed medical care from being fearful to come to the hospital”. 

Besides clinical processes, PHR also plays an important role at the administrative level as it can greatly help improve hospital management systems providing insights into department-wise patient visits and thus help estimate the associated requirements.  

Patients also benefit through PHRs with regard to insurance processing. Their documents can be shared seamlessly and easily, in their authentic format, with the insurance company, for hassle-free pay-outs. 

The use of blockchain technology-driven health records is the future as it holds great potential to boost privacy, security, and interoperability of health data across different healthcare platforms and transform healthcare.

Advanced digital health platforms have been built by deep-data scientists with years of research, to provide specialized services of easy data management, analytics and sharing & integration with any healthcare service that you use, come check out Health Safe Today!!!

Key points:

  • A PHR system can boost health management for a lifetime
  • It is helpful system both for patients and their physicians
  • Easy access to PHR can aid speedy diagnosis and treatment and also in document sharing for insurance payouts
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Let’s ‘Man Up’ & Care for Men’s Mental Health

It is a common misconception that men are less likely to experience psychological challenges than women. Rather, most men seem to be wearing a mask when it comes to expressing their feelings and emotions, struggling with their mental health issues behind closed doors.

Young boys are told “boys are strong, they don’t cry”, “boys don’t feel hurt”, “real men don’t talk, they act”. Stigma around men’s mental health has been stopping them from seeking mental health support. This is especially dangerous now during a global pandemic abounding in unforeseen setbacks, loneliness and mental health challenges. Therefore, we are taking a moment to acknowledge men’s mental health issues and consider the many ways in which we may go about creating a healthier mindspace.

“Did you know that men are three times as likely to die by suicide than women? And that men are two to three times more likely to misuse drugs? And that men report lower general life satisfaction than women? (2-3)”

Toxic Masculinity – Is there a better way?

Although mental health has been stigmatized for both men and women, conventional ideas of masculinity have further exacerbated men’s willingness to seek help for their psychological problems. Traditionally, men have perceived talking about their emotions and feelings as a sign of weakness and therefore as ‘unmanly’. Yet 1 in 8 male adults are diagnosed with a serious mental health problem each year across the globe (1). 

Illustration by Hivelife

Consequently, these conventional ideas of masculinity have created an extremely toxic environment for men who suppress their mental health issues – and it is quite literally killing them. Suicide is the 7th leading cause of death among men, with men being three to four  times more likely to die by suicide than women. Especially young LGBTQ+ men, men aged 40-49, and men aged over 85 have shown to be at the greatest risk of suicide (2). Additionally, studies in the UK have shown that compared to women, men experience lower life satisfaction, are more likely to experience chronic sleeping problems and are nearly three times as likely to become alcohol dependent or use drugs frequently (3). In India this problem is worsened due to the undue social and professional responsibility that falls upon men as a result of the cultural preference for a boy child (13). Indians want a boy child and they expect the world out of him!

As neuroscientists have unveiled the chemical imbalances that underlie mental health issues, we have come to understand that mental health is not merely a psychological issue, but more importantly a neurological one (4-6). This shows that a male may not simply ‘man up’ to deal with mental health issues, but requires professional help and treatment, just like anyone else. Luckily, psychological and psychiatric treatment options have increasingly proven to be effective in helping men tackle their mental health challenges. Illustration by Hivelife

Men’s Mental Health
While male’s mental health challenges are biologically similar to that of women, various symptoms tend to be more commonly experienced in men than women. Here we highlight the major mental health problems that affect men and how you may be able to recognise them. 

  1. Depression
    Depression in men often goes undiagnosed. Contrary to most women, men are more likely to show irritability, sudden anger, increased loss of control, risk-taking behaviour and aggression. Moreover, they are more likely to seek out alcohol and drugs as coping behaviour (2, 8). And what makes the situation worse is that these dysfunctional or pathological behaviours are accepted as normal in men, resulting in a diagnosis never being even attempted (11).
  2. Anxiety
    Anxiety is the leading mental health disorder among men (7). It often presents itself in the form of a panic disorder or phobia. In India, it is estimated that about 2.7% of men experience anxiety disorders (13) . Although highly treatable, men are less likely to seek out treatment for anxiety than women.
  3. Bipolar Disorder
    This disorder is recognisable by its extreme mood swings, where the person experiences periods of extremely high energy and irritability, alternated with depressive episodes of a lasting empty and sad mood. This disorder is equally prevalent among men and women, and is likely to develop between 16-25 years old (2, 8).
  4. Psychosis and Schizophrenia
    This is one of the leading causes of disability. Remarkably, a study in the US showed that about 90% of patients diagnosed with Schizophrenia by age 30 are men (2).
  5. Eating Disorders
    Although less common, males experience eating disorders similar to women. Binge-eating disorder seems to be especially common among men. Additionally, in the US, a study showed that about 10% of anorexia and bulimia patients are men (2).
  1. Substance abuse

Contrary to women, men are more likely to use and abuse all types of illicit drugs and alcohol. Men have shown to be more susceptible to fellow male peer pressure and as a result have an increased likelihood of becoming addicted; 11.5% of men are estimated to suffer from a substance abuse disorder, compared to 6.4% of women (9).


The Future

Being a man in the 21st century has taken on a different meaning. As a man in this day of age, it has become our responsibility to face our mental health problems head-on and take concrete steps in order to solve them. In order to do so, we should all try to look after our physical health, be cautious with drug intake, and talk openly about our feelings and emotions with one another (10). Both men and women will have to come together in order to create a safe environment, where we may feel comfortable to discuss our mental health challenges, regardless of our gender. 

If you’re looking to get in contact with mental healthcare professionals or chat about possible treatment with them first, we highly recommend you to check out the ‘Allied Specialists’ functionality on the Health Safe app to find a good psychologist and schedule a (digital) consultation.

Key Points

  • Men’s mental health is neurologically similar to women’s. 
  • Conventional ideas of masculinity suppress men to seek the help that they need for their mental health issues.
  • Both men and women should aim to create a healthier mindspace for men to be open about their feelings and emotions.

Mental Health Helpline 

KIRAN: Mental Health Rehabilitation Helpline

1800-599-0019

NIMHANS

080 46110007

Sangath COVID-19 Well-being Center

011-4198666

Vandrevala Foundation

1860-266-2345

9999 666 555

Parivarthan

080- 65333323

References

  1. https://www.counselling-directory.org.uk/men-and-mental-health-stats.html#menandmentalhealth
  2. https://www.mhanational.org/infographic-mental-health-men 
  3. https://www.mentalhealth.org.uk/a-to-z/m/men-and-mental-health
  4. https://jnnp.bmj.com/content/73/3/354.1 
  5. https://www.medicalnewstoday.com/articles/mens-mental-health-man-up-is-not-the-answer
  6. https://www.apa.org/monitor/2012/06/roots 
  7. https://adaa.org/understanding-anxiety/facts-statistics
  8. https://www.nimh.nih.gov/health/publications/men-and-depression/ 
  9. https://www.addictioncenter.com/addiction/differences-men-women/
  10. https://www.healthline.com/health-news/how-can-we-reduce-mens-mental-health-stigma
  11. https://www.sciencedirect.com/science/article/abs/pii/S0022103109002091
  12. https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30475-4/fulltext#tbl2
  13. https://www.jstor.org/stable/43189469
  14. Featured Image credit
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How Your Diet May Help You Combat COVID-19

Did you know that there are various foods you may eat in order to build up a better defense against Covid-19 and its vaccine? Get your plates ready for some delicious insights, because we spoke to various specialists in order to help you make the best dietary decisions. As Hippocrates said,

“ Let food be thy medicine and medicine be thy food.”

What to eat to build a strong immune system
While a healthy lifestyle of exercise, meditation and adequate sleep are prerequisites for good health, diet is probably the most crucial factor that contributes to a robust immune system. Especially in these times of the COVID-19 pandemic, a strong immune system offers tremendous protection from the infection and the opportunity for faster recovery. We interviewed Health Coach Ritu Khaneja, Nutritionist Saman Zaman, and Doctor Kuldeep Astha to explore the impact of diet on Covid-19.

Our specialists emphasize that a well-balanced diet and proper hydration are essential factors known to help build a stronger immune system,  and also lower the risks of both chronic illnesses and infectious diseases. Various dietary ingredients support the beneficial gut microbes which in turn shapes the immune responses in the body (1, 2, 3). Vitamins A, B12, B6, C, D and E and minerals, such as zinc and iron, are essential for the maintenance of a healthy immune system. Among these Vitamin C and Vitamin D have received special attention during the pandemic (4).  Vitamin C, which is present in most fruits and vegetables, especially appears to contribute strongly to a healthy immune system (5).  The deficiency of Vitamin D, an important component of our diet, is known to increase the severity of experienced Covid-19 symptoms (6). Vitamin D, which we mostly obtain through sun exposure or from foods like salmon, sardines, red meats and egg yolk, plays an important role in supporting our immune system as it increases the creation of new immune cells. Therefore, although vitamin D may not cure a Covid-19 infection, it will give your immune system the help it needs to fight off the infection.

Photo by Jane D. from Pexels


To receive a daily dose of  these nutrients, our dietary specialists recommend eating a variety of fresh and unprocessed foods, pulses & legumes, nuts  and whole grains every day. Also keep track of your fluid intake. It is recommended to drink about 8-10 glasses of water a day. If you do eat meat, the recommendation is to consume eggs daily, eat red meat no more than once or twice per week and poultry 2-3 times per week. 

What Dietary habits to avoid

Certain dietary habits should be avoided to sustain a healthy immune system. For instance, it is recommended not to overcook vegetables, avoid foods high in saturated fats (e.g. found in butter, fatty meat, coconut and palm oils, cheese, ghee, and cream) or refrain from snacking irregularly. Instead, try to opt for raw or vegetables and foods with unsaturated fats (e.g. found in avocado, nuts, olive oil, fish, soy, canola, sunflower and corn oils). If you crave that snack every now and then, go for the healthy makhana or fox nuts, roasted semolina with veggies (sooji upma), bajra/millet baked crisps, our old friend, the humble an apple and definitely, avoid foods high in sugar, salt or fat. Moreover, be sure to avoid carbonated drinks, concentrated juices, or other drinks high in sugar.

Photo by cottonbro from Pexels

Although these suggestions apply to almost everyone, including children, men and women, Doctor Kuldeep Astha does share some additional individualised advice for some of our readers: 

“If you are a vegetarian, do not forget to take your protein supplements! Contrarily, if you suffer from kidney disease, try to keep your protein intake low. Additionally, diabetics and hypertensives may want to avoid a high carbohydrate intake.”

A specialist can help you build these personalized plans keeping in mind your health conditions. 

How to manage your nutrition

Several specialised digital platforms are now available for patients or even regular health enthusiasts to communicate their history and dietary patterns to specialists and enable the seamless flow of conversation regarding changes an individual might notice in their health condition. Alongside, some of the more advanced platforms might even help calculate the nutrition content in a plate based on image identification and provide gentle nudges for a healthier lifestyle. And to top it all, a shared community presence- our friends, family, and other peers going through similar struggles, offers a powerful motivation to share experiences on these social health apps and help others go through with their determined resolve and decision making while choosing a healthier lifestyle, under the guidance of professional health specialists.

Our final take on this is: Reach out to a professional to discuss your history, allergies, and also identify deficiencies or symptoms of malnutrition. Any diet change must be done under strict supervision and with respect to one’s medical history. And last, but not the least, do not pay heed to social media fads on what might or not work to help one fight off the COVID-19 infection. Trust science and speak to a specialist. 

Summary

  • Consume a balanced diet, which especially includes a sufficient intake of fruits, vegetables and water. 
  • Vitamins are especially advantageous in fortifying your immune system in defence against Covid-19.
  • Consult a specialist in case of comorbidities or nutritional deficiencies.

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306972/ 
  2. http://www.emro.who.int/nutrition/news/nutrition-advice-for-adults-during-the-covid-19-outbreak.html
  3. https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/publications-and-technical-guidance/noncommunicable-diseases/food-and-nutrition-tips-during-self-quarantine
  4. https://www.uchealth.org/today/effectiveness-of-vitamins-c-and-d-against-covid-19/
  5. https://www.mdpi.com/2072-6643/9/11/1211 
  6. https://www.nature.com/articles/s41430-020-0661-0?fbclid=IwAR3yo41dvfU1HWVX_Y6z7iXFNL3X2C06A5gIfC4LcNmXzCA48A7ViMAf7N8#Sec5 
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Postpartum depression: The secret our mothers never tell

Motherhood is the biggest gamble in the world. It is the glorious life force. It’s huge and scary – it’s an act of infinite optimism.”

Gilda Radner

You can find the perfect picture of motherhood on a mother’s day card. A woman gazing lovingly at her child, surrounded by wildflowers and butterflies on a bright sunny day. However, you’ll never see a card dedicated to those new mothers who cry uncontrollably, desperate to be perfect, yet supposedly failing at every attempt. The perfect picture darkened by the shadow of depression. 

Maternal health in India is largely ignored where almost 65% of women do not even have a single medical checkup before delivery. Additionally, the idea of maternal mental health probably still stands divorced from physical health. Lack of access to mental healthcare and the stigma associated with psychiatric conditions further prevents women from seeking help. This not only creates problems for the mother but also for the newborn child. Thus there is a huge need for creating awareness around maternal mental health, to understand the causes behind maternal psychiatric disorders and to assure  new mothers that they are not alone in the struggle.

Photo by Polina Zimmerman from Pexels

Baby Blues to Postpartum Psychosis

As the name suggests, postpartum psychiatric disorders are those that occur after a woman gives birth. Approximately, 27 million women are pregnant in India each year. About 22%, or 5.9 million of these women suffer from severe depression after delivery. These depressive phases can be of three types: postpartum blues, postpartum psychosis and postpartum depression.

  • Postpartum Blues: This is a mild depressive episode that may range from a few days to a week. It is usually resolved through reassurance and family support. 
  • Postpartum Psychosis: This is a severe form of depression that may occur within the four weeks of childbirth and requires specialised treatment
  • Postpartum Depression: This might begin immediately after childbirth or may be a continuation of the depression that begins during pregnancy, also known as antenatal depression. Postpartum depression may extend for a year after childbirth and requires specialised treatment and/or hospitalisation. Postpartum depression may also affect men where it may be caused by anxiety, social factors, poverty, family history etc and is something that needs addressal. 

What causes Postpartum depression?

Pregnancy is a period of great physical, chemical and emotional change within the body. It is generally assumed that postpartum depression results from a drastic change in the hormonal levels after a baby is born. Although all women undergo the same hormonal changes not all women suffer from postpartum depression. Therefore, there must be other reasons apart from hormonal changes that result in depression.

  • Sleep Deprivation: Motherhood is demanding. Irregular sleep schedule and stress results in poor sleep quality. Regular exercise and a sleep routine improves sleep hygiene.  Mothers with sleep patterns that do not improve with time tend to be at a higher risk of developing postpartum depression. Also, once the depression sets in it may also result in poor sleep thereby worsening the situation. 
  • Genetic Predisposition: Researchers at John Hopkins found changes in certain genes  amongst women who are more likely to suffer from postpartum depression. These genes are associated with pregnancy hormones such as estrogen and can predict with almost 85% assurity which women will go on to suffer from postpartum depression)
  • Social Factors: Research from China points out that the expectation of a son by the family is responsible for  postpartum depression in 17.3% of the women. Similarly in India, birth of a female child may lead to development of postpartum depression in the mother and in turn result in poor breastfeeding of the girl child. Although these social factors may be an outcome of  cultural traditions, they do hint that lack of family support can result in  extensi-on of benign baby blues to full-blown postpartum depression.

Photo by NIKOLAY OSMACHKO from Pexels

How do you deal with Postpartum depression

After much struggle and debate by the American Association of Psychiatry, Postpartum depression is now categorised under perinatal depression in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the common classification system for diagnosing mental health conditions. This puts postpartum depression as a designated health issue that reduces the quality of life and must be treated by specialists. 

Medical treatment for postpartum depression may involve psychotherapy and pharmacotherapy using antidepressants and antipsychotics. These medicines are provided under strict medical supervision, therefore breastfeeding mothers should not shy away from using them. Other treatments that can impede depression include family support, realistic expectations and participation in support groups.

Impact of digital health technologies on postpartum depression.

There have been emerging reports on digital interventions that mitigate the symptoms of postpartum depression and may also help in accessing treatment, easily. For example, a digital record of family history of postpartum depression will allow for early diagnosis and treatment.  Also, support groups provide great infrastructure for effective prevention and thus reduction of postpartum depression. Several of these peer-to-peer forums are now available online, encouraging expectant mothers to come, voice their worries and concerns and find like-minded parents having gone through similar circumstances. 

Digital health platforms can also be used to deliver personalized help to a patient by tracking their health parameters and daily behaviour, especially during pregnancy. These specialized platforms support in combating stigma and achieving wellness through targeted behavioural interventions and maintenance of a systematic record of mood and medical health. Through digital health technology women suffering from postpartum depression can avail tele-consults with specialists which does not require them to leave the comfort of their home. These digital platforms also offer community support from other users who have suffered from postpartum depression  and can help those who are under the spell of the disease.

The efficacy of digital health technology in postpartum depression can be clearly seen in the recent FDA approval for WB001/Woebot, a digital therapeutic that ameliorates depression by cognitive behavior therapy and psychotherapy. The WB001 has been designed using deep understanding of the lived experience of the women going through the condition and upon combining the active elements of proven therapeutic approaches. 

Given how commonplace smartphones have become, such digital applications allow for easily delivering human-like therapeutic interventions that provide a meaningful engagement with the patient, based on their dynamic state of health, from the safety of their homes and, thus, potentially, better outcomes.

Postpartum depression is not a new problem and since the 1700s women have been masking this issue due to stigma. There is a need to fight and intervene at the right time. While the depression may seem like a mountain it can be disintegrated by pushing a few stones everyday. These nudges  could be in the form of gentle family support, a well-managed wellness routine, proper and timely health checkups, healthy habits and increased awareness. 

Summary

  • Postpartum depression is a widespread problem that may affect both sexes. The disease may last up to a year and needs specialised medical help.
  • Women may not accept that they are suffering from postpartum depression due to the fear of social stigma
  • Digital health technology can help in tracking mood and health parameters and personalizing therapies based on an individual’s specific requirements. It can offer targeted cognitive therapy and also serve as a platform for patients to meet and consult doctors immediately.

Mental Health Helpline 

KIRAN: Mental Health Rehabilitation Helpline: 1800-599-0019

National Institute of Mental Health And NeuroSciences: 080 46110007

Sangath COVID-19 Well-being Center: 011-4198666

Vandrevala Foundation: 1860-266-2345, 9999 666 555

Parivarthan: 080- 65333323

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Impact of Dental Hygiene on Cardiovascular health

What is oral hygiene ? Why is it so important ?

We can still probably hear our mom scolding us about not brushing our teeth at night or having spent very little time brushing while we quickly rinsed our mouths and ran to catch the school bus. Well, turns out that mom was right, clean teeth may not only give you a beautiful smile but might also be good for the heart!

Oral hygiene or the practice of brushing one’s teeth regularly to keep the mouth healthy and free of disease is an important part of our daily lives. Unfortunately, it is often overlooked. While maintaining oral health may seem simple and mundane, the practise of oral hygiene is a combination of personal and professional care. Regular and proper brushing along with flossing and use of mouthwash all comprise of what we can do at home. Professional teeth cleaning is recommended every six months which includes tooth scaling, polishing, and debridement. These processes entail loosening and removing deposits from the teeth with a variety of advanced equipment and technologies. 

Photo by Lisa Peh on Unsplash

Can improper dental hygiene have systemic manifestations?

In a population based study done by Shin-Young et. al. in Korea; chronic oral disease, such as gum disease, or a more severe form of this infection, called periodontitis and dental abscesses i.e. infection in the teeth cavity or in the gums, was empirically  linked to other systemic disorders such as cardiovascular disease. A clear association is also emerging between high-risk procedures such as heart valve replacement or other cardiovascular procedures and lack of dental hygiene[1] . Given most of us never imagined dental caries to result in heart disease, it is comforting to know that regular dental cleanings can lower occurrence of cardiovascular disease by almost 14%.[1] In the same study, it was established that brushing teeth twice a day resulted in a 9% reduction of cardiovascular risk .[1] 

Photo by CDC on Unsplash

What is Periodontitis and how is it related to cardiovascular disease (CVD)?

Periodontitis or the inflammation of the tissue around the teeth commonly results in gum shrinkage and tooth loosening. Patients with active periodontitis have higher numbers of bacteria such as P.Gingivalis, around their gums. These bacterial colonies may enter the circulatory system, resulting in systemic bacteremia and  settle in vital organs like the heart, leading to inflammatory conditions such as infective endocarditis. The bacteria can also accumulate in the blood vessels causing infective plaques or deposits to build up that may contribute to blockages in blood vessels. It is highly indicative that these bacteria link Periodontitis and CVD.[2][3][4]

What actions can help achieve good dental hygiene and health and so also reduce the risk of cardiovascular disease (CVD)?

It’s not just about looking fine when it comes to your teeth. As established, poor dental hygiene can lead to issues that are much more serious than an unattractive smile including increased chances of CVD. 

While one practises good personal oral hygiene and goes for the regular dental check, what can further benefit is maintaining one’s health records, whether that be diagnostic reports or medical prescriptions. These meticulous records can lead to a quicker and more insightful diagnosis by your doctor. However, the problems of maintaining paper records are evident in terms of managing physical files and the chances of them being misplaced and also, sharing these documents with a doctor can be challenging especially in these times of the COVID-19 pandemic when physical visits to a doctor are constrained. 

To assist in this process, specialized digital health platforms are available nowadays where patients can safely store their medical reports digitally, in a chronological manner. These platforms allow patients to access specialists, even via video-call for an initial consult and also, help doctors refer patients easily to other specialists, based on their health requirements. When digitized, accurate medical files may help link chronic dental infections and heart disease and enable doctors from different specialties and departments work together to identify the root cause of the disease, and thus, plan your treatment better. 

Summary 

  • Oral hygiene is an important part of personal care and involves use of appropriate brushing techniques, regular use of floss and mouthwash.
  • Improper dental hygiene has systemic manifestations in the long run and reports suggest a link between poor dental hygiene and cardiovascular disease.
  • A blend of personal and professional care with regards to oral hygiene has proven to reduce the risk of cardiovascular disease.

References

[1]https://academic.oup.com/eurheartj/article-abstract/40/14/1138/5251907

[2]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035434/

[3]https://www.ajconline.org/article/S0002-9149(16)30939-0/fulltext

[4]https://www.sciencedirect.com/science/article/abs/pii/S0002817714645608– 





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Menopause: Healthy Ageing, what it entails

Clinically Verified by Dr Mehak Segan, B.D.S, M.P.H, PGD (Health Promotion) Assistant Professor, Amity Institute of Public Health, Noida

Sunita Sharma was 46 when she began her journey to menopause. Heavy bleeding, cramps, loss of appetite and sleeplessness all came upon her suddenly. All these coupled with household chores and responsibilities of her three children weighed her down. She used to remain uncomfortable all day and sometimes, even melancholic. She stopped talking to her family members. 

It was hard for the family to see her like that, and they would often complain about her erratic behaviour. Unbeknown to them, in silence did she suffer — and got detached from the family. Desperate to pour out her feelings and pain, she tried to confide in her friends, but their comments on her now fading beauty and loss of weight stressed her more.  

Sunita’s struggle continued for more than five years, till she had her menopause at the age of 51. 

Sunita is not alone. According to the Indian Menopause Society (IMS), the country has 43 million women living with menopause.1

Lack of awareness and ignorance about the health conditions of women during menopause has made them devoid of the necessary care in terms of nutrition and emotional help, that is much needed for their physical and mental health.  

Menopause: Symptoms and causes

Menopause is a natural biological process defined as the end of a woman’s menstrual cycles. It is marked by the complete cessation of menstruation for 12 months. During this phase, the ovaries cease to produce Estrogen — the female sex hormones responsible for normal sexual and reproductive development in women.

The period of menopausal transition or perimenopause is hard for most women as they experience changes in their monthly cycles. It is often accompanied by hot flashes, trouble in sleeping, moodiness and irritability, pain during sex, and even depression. Women with hot flashes after menopause are 70% more likely to have heart attacks, angina and strokes.The more severe the hot-flashes are, the higher is the risk for cardiovascular diseases.2

The condition usually commences between ages 45 and 55. A majority of women first begin developing menopause symptoms about four years prior to their last period, while some experience the symptoms for up to a decade before menopause actually occurs.  

While menopause is a natural process, it can also be triggered by: 

  • Naturally declining reproductive hormones 
  • Oophorectomy —  surgery for removal of ovaries 
  • Cancer therapies — chemotherapy and radiation therapy directed at the ovaries
  • Primary ovarian insufficiency — loss of normal function of ovaries mostly before age 40.
  • Hysterectomy — a surgical procedure in which the uterus is removed

Insomnia, vaginal dryness, weight gain, depression, anxiety 3, memory problems, reduced sex drive, dry skin and eyes, and increased urination, among several others are some common symptoms of menopause. All these can likely begin in the perimenopause stage and lead to disruption in sleep and circadian rhythm (our biological clock), and feelings of low energy. While some women cope with these symptoms without revealing much to their family, others seek medical help through hormone therapy and non-hormonal treatments.

Risks involved

Globally, the average age of menopause is 51 years. But, for Indian women it is 46.2 years. According to data from National Family Health Survey-3, by 40-41 years of age 19% of women have already reached menopause.4 Changing food habits, strenuous work culture, increased stress levels, lifestyle behaviours such as smoking, drinking and even genetic factors  could be some of the reasons.5

Well, it’s not a new thing to say that Indian women have always ignored their health but menopause is one phase when they are most vulnerable and at this stage, they need to take utmost care of themselves.

Support from a close friend can help menopausal women feel connected and alleviate their symptoms. Source: Pixabay.com

The drop in estrogen levels, a protective hormone, makes them prone to a number of diseases, including cardiovascular diseases.6 Adding to the risk is weight gain due to slow metabolism. In some women, the estrogen decline can cause them to under-eat and make them lose weight at a rapid rate.

Another major risk is loss of bone density, which raises the chance of Osteoporosis — a condition which causes brittle and weak bones. 

A similar, but different condition is Osteopenia — when your bones are weaker than normal but not so far gone that they break easily, which happens in the case of osteoporosis. As estrogen levels dip, which is seen during Menopause, there is a loss in bone mass resulting in the increased risk of osteopenia.

Both conditions vary in degrees of bone loss and are measured by bone mineral density — a marker for how strong a bone is and the risk that it might break. Bone density measurement tests should be done at the onset of menopause, especially if any signs are noticed of weakening or unusual discomfort in the joints and bones. 

Menopause also results in loosening of elasticity in the tissues of the vagina and the urethra. As a result, women are more prone to frequent, sudden and strong urges to urinate, followed by incontinence i.e. involuntary loss of urine. The chances of urinary tract infection (UTI) are also high in such cases. It also lowers the sexual drive.7

Lifestyle Improvements for better Health 

Regular exercise, healthy eating habits and maintaining normal weight is important. Exercises such as Kegels’ can help strengthen pelvic floor muscles, while using a topical vaginal estrogen cream may help relieve symptoms of incontinence. 

Hormone therapy may also be an effective treatment option for menopausal urinary tract and vaginal changes.8 It is the most effective treatment for the relief of hot flashes and also reduces bone loss and fracture risk.9 However, hormone therapy is optional, and just a  supplementary treatment and should be started only upon recommendation by a doctor/gynaecologist. 

Dr Mehak Segan, Noida based public health expert, says that it is essential for women to take a consult from a gynaecologist during menopause and receive proper medical guidance for their condition. Every woman is different in her journey towards menopause.

Menopausal women are also prone to depression and anxiety issues. A study showed that 70% menopausal women are likely to be depressed.10 Greater family support can help lower the menopausal symptoms.11 Support from a close friend or relative who themselves are or were menopausal women can help them talk about the symptoms and feel connected.

Menopause and COVID- 19 infection

Recent research suggests that women who are/or have undergone menopause are at a greater risk of getting infectious and more long-lasting symptoms of COVID-19 disease.12 Research points to a possible link between menopause and COVID-19, especially in older women, again, due to the falling levels of estrogen and its protective role to play in the body.13 There is evidence that estrogen can work as an antiviral for infections including Hepatitis C, Ebola and HIV infections. More specifically to COVID-19 infections, the SARS-COV-2 virus targets angiotensin-converting enzyme (ACE) and inhibits its action.14 ACE-2 is known to have a protective effect on the heart, lung, kidneys, central nervous system and gut.15 Anecdotally, many women with Long COVID  (sometimes called Post-COVID-19 syndrome) have improved with estrogen and testosterone replacement, the same procedure carried out during hormone replacement therapy.

No more hush hush!

For years, females have been conditioned to remain secretive about their reproductive health, particularly menstruation and menopause. These topics were never discussed, even amongst females. While the physical symptoms and changes are mostly visible, its psychological effects have been long ignored. A study showed that menopausal awareness in husbands lowered depression levels in women.16

Menopausal women were traditionally not encouraged to go to a doctor and were made to deal with it themselves. Thankfully, in the current post-modern times, things are changing for the better. As more and more females have started  opening up to their male counterparts about  their pains and discomforts of menstruation, their partners are receptive to supporting with household chores, and also provide emotional care that can make this time easier. 

Dr Mehak says, unlike maternal health, menopause has not received ample attention from policymakers. As women age, it is essential that they be given a choice to take some time off to deal with their changing bodies during menopause, akin to ‘period leaves’.  She believes that there is a pressing need to train public health workers including Anganwadis and ASHA workers on women’s age related challenges as these community health workers play a central role in the developmental health of women in both semi-urban and rural areas.

Menopause is just a natural transition and can thus involve unwanted physical and mental changes but, one must not be worried. This is the time for everyone to come talk about these changes and see how to make the transition easier for women, everywhere!

Key Points:

  • Menopause is a natural biological process 
  • Menopause increases the risk of heart diseases, obesity, bone loss conditions
  • A visit to the gynaecologist, coupled with exercise and nutrition is necessary 
  • Family members must be taken into confidence as they can provide crucial emotional support
  • Policy interventions for menopausal women in both urban and rural areas is an important call to action

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139265/#:~:text=THE%20SCOPE%20OF%20THE%20PROBLEM,menopausal%20women%20about%2043%20million.

https://www.ajog.org/article/S0002-9378(20)30664-5/fulltext

https://www.thehindu.com/sci-tech/health/Indian-women-facing-early-menopause-Survey/article14403551.ece

https://www.menopause.org/for-women/sexual-health-menopause-online/changes-at-midlife/changes-in-the-vagina-and-vulva

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139265/#:~:text=THE%20SCOPE%20OF%20THE%20PROBLEM%20OF%20MENOPAUSE%20IN%20INDIA&text=Projected%20figures%20in%202026%20have,life%20expectancy%20of%2071%20years.

https://www.frontiersin.org/articles/10.3389/fendo.2021.564781/full

https://www.newsonhealth.co.uk/media/files/Female-hormones-and-Covid.pdf

https://www.sexualhealthtayside.org/wp-content/uploads/2020/03/COVID-and-menopause-web-content.pdf

https://www.forbes.com/sites/alicebroster/2021/12/29/there-may-be-links-between-menopause–severe-coronavirus-symptoms-study-suggests/?sh=26d268879ff2

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