FDA menopause hormone therapy: The U.S. Food and Drug Administration announced on Monday that it will remove the strictest “black box” warnings from hormone therapies used to manage menopause symptoms. The move could make these treatments more accessible to women and healthcare providers, who have long avoided them due to safety concerns.

FDA Commissioner Marty Makary said the decision comes after a thorough review of scientific research, feedback from an expert panel in July, and a public comment period.

"After 23 years of outdated caution, the FDA is now stepping back from the fear-based messaging that has kept women from this life-changing—and sometimes,life-saving—treatment," Makary said at a press briefing.

"We are responding to women who have been challenging the paternalistic approach in medicine, and to female medical students calling for better menopause education in medical training," he added.

The agency is also greenlighting two new treatments for menopausal symptoms. This includes a generic version of Pfizer’s Premarin and a non-hormonal option for moderate to severe vasomotor symptoms, like hot flashes.

What Is Hormone Replacement Therapy?

Hormone replacement therapy (HRT) is a treatment for people experiencing menopause symptoms. Doctors may also call it hormone therapy (HT), especially when prescribed after age 50. Generally, “HRT” is used for people starting treatment at a younger age, often before 40.

During menopause, the ovaries produce less estrogen, which can lead to uncomfortable symptoms, including:

• Hot flashes
• Night sweats
• Vaginal dryness and painful intercourse
• Mood swings, irritability, or depression
• Insomnia
• Urinary incontinence

HRT works by replacing the hormones your body is no longer making enough of, helping to relieve these symptoms. It can also help prevent bone loss, such as osteoporosis and osteopenia, which can occur when estrogen levels drop.

Hormone Replacement Therapy: When Should You Start Hormone Therapy?

Dr. Joann Pinkerton, a menopause specialist at the University of Virginia Health, recommends starting estrogen therapy before age 60 or within ten years of the onset of menopause, which begins one year after your last period. Many women continue taking birth control through perimenopause, which can help manage hot flashes and night sweats as hormone levels fluctuate.

Once menopause is complete and pregnancy prevention is no longer a concern, continuing birth control may not make sense. “Birth control usually contains more estrogen than is used in menopause hormone therapy,” Pinkerton says, “so that’s a good time to discuss hormone therapy options with your provider.”

Menopause Hormone Therapy FDA: How Long Should You Be on Hormone Therapy?

Typically, women use hormone therapy for three to five years, though this is not a strict rule. “For those with ongoing symptoms or bone loss—which can be addressed with hormone therapy—we continue treatment,” Pinkerton explains. She emphasizes the importance of reviewing treatment annually. “It’s about working with each patient to find the safest and most effective approach.”

Lauren Streicher from Northwestern University, as per NPR, adds, “We don’t stop hormone therapy simply because three to five years have passed.” She notes that menopause symptoms can last longer for some women, with Black and Hispanic women often experiencing extended periods of discomfort.

HRT Therapy: Who Should Avoid Hormone Therapy?

Certain medical conditions can make hormone therapy risky. Women with estrogen-sensitive breast or uterine cancers, or those who have had, or are at high risk for heart attack, stroke, blood clots, or pulmonary embolism, should avoid HRT.

“Women need to have a detailed discussion with a knowledgeable healthcare provider,” Pinkerton says. “It’s crucial to understand what benefits and risks apply to you personally.”

Whether HRT is right for you is a conversation to have with your healthcare provider. While hormone therapy can ease menopausal symptoms, it carries potential risks. Discussing these benefits and risks with your doctor will help determine if HRT is suitable for your needs.

It’s almost second nature to reach for a painkiller the moment we feel a headache, backache, or joint pain. Over-the-counter (OTC) medicines like paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, diclofenac, or naproxen are often our first line of relief.

While these drugs can be highly effective when taken correctly, using them too often or in large amounts may quietly harm your kidneys. To understand this better, we spoke with Dr. Ranjeet Singh, Professor and Head of General Medicine at NIIMS Medical College and Hospital, who explained the possible risks in detail.

What Are NSAIDs?

NSAIDs, or nonsteroidal anti-inflammatory drugs, are a group of medicines that help reduce pain, inflammation, and fever. Unlike steroids, they target the chemicals in your body that trigger pain and swelling. They are often used to ease conditions like arthritis, muscle strain, and headaches.

Common examples include aspirin, ibuprofen, and naproxen, available both with and without a prescription, according to the Cleveland Clinic.

Painkillers And Kidney Failure: Is It Possible?

The kidneys serve as the body’s natural filtration system, removing excess fluids and waste. Dr. Ranjeet Singh explained, “NSAIDs block certain chemicals called prostaglandins that cause pain and inflammation. However, these same chemicals also help maintain healthy blood flow to the kidneys. When prostaglandin levels stay blocked for too long, the kidneys may receive less blood, which affects how well they filter.” Over time, this reduced blood flow can lead to analgesic nephropathy, a chronic form of kidney damage linked to long-term painkiller use.

Which Pain Medications Can Damage Your Kidneys?

Taking any pain medication irresponsibly, whether it’s aspirin, ibuprofen, acetaminophen, NSAIDs, or prescription opioids, can raise the risk of kidney damage. The biggest concern arises from consuming doses that are too high or using these medicines for longer than advised.

Among OTC options, NSAIDs carry the highest potential for long-term harm. Regular or excessive use may cause progressive kidney damage or even sudden kidney failure.

In fact, a 2019 study involving more than 764,000 U.S. Army personnel found that those who took over seven doses of NSAIDs per month had a noticeably higher chance of developing acute or chronic kidney disease.

Painkillers and Kidney Health: Who Is at Higher Risk?

According to Dr. Ranjeet Singh, certain groups are more vulnerable to kidney damage from painkillers:

• People with existing kidney disease or diabetes
• Older adults
• Individuals who are dehydrated or taking diuretics (commonly called “water pills”)
• Those who frequently use more than one type of painkiller

Warning Signs to Watch For

Pay attention to these symptoms, which could point to kidney problems:

• Unusual tiredness or weakness
• Swelling around the eyes or in the legs
• Reduced urine output
• Nausea, vomiting, or loss of appetite

Painkillers: Safe Use Tips

Always use the lowest dose that works, and for the shortest time possible.

Never combine different painkillers unless your doctor advises it.

Keep yourself well hydrated.

Consult your doctor before taking painkillers regularly, especially if you have an ongoing health condition.

Painkillers can be helpful when used correctly, but long-term or high-dose use can quietly harm your kidneys. If you often find yourself depending on these medicines, it is best to talk to a healthcare professional, your kidneys will thank you later.

Disclaimer: The information in this article is meant for general awareness and should not replace professional medical advice. Always consult a qualified healthcare provider before taking or changing any medication, especially if you have an existing health condition.

Diabetes is one of the chronic lifestyle conditions that most older adults fear developing, especially past the age of 40. This is when body's main source of energy or glucose is too high. However, recent cases show that diabetes may no longer be a disease of aging. While most people who are middle-aged or older adults develop Type 2 diabetes, there is in fact a rise in cases among the youth, including children.

As per the Centers for Disease Control and Prevention (CDC), US, 352,000 children and adolescents younger than age 20 years in the US are diagnosed with diabetes. Furthermore, in the UK, the number of children with type 2 diabetes have risen by more than 50%, as noted by the NCBI data.

In India too, there is a sharp rise in diabetes across all age groups, with many cases going undiagnosed until complications set in, says Dr Mayanka Lodha Seth, chief pathologist at Redcliffe Labs. " Diabetes cases are rising not just among older adults but also in children, teenagers, and youngsters in their 20s & 30s," says the doctor.

Why The Youth Must Know?

The doctor also says that more often than not, scientific terminology could be confusing, even, scary, in such a scenario, it is important to break down the scientific jargon for them. Dr Mayanka Lodha Seth does exactly that. He presents with the 'Five Must Knows' from what he calls a Diabetes Dictionary.

HbA1c: HbA1c reflects your average blood sugar levels over the past 2–3 months, showing how well your body has been managing glucose. This can be considered as your long-term report card and not just a day’s blood analysis.

Insulin Resistance: Insulin Resistance happens when your body stops responding properly to insulin; the hormone that helps use sugar for energy. So, even with enough insulin, sugar stays in your blood instead of fueling your cells, slowly raising your risk of diabetes.

Glycemic Index (GI): GI tells you how quickly a food raises your blood sugar after eating it. Foods with a low GI keep your energy steady, while high GI foods cause quick spikes and crashes in blood sugar.

Fasting Blood Sugar (FBS): Fasting blood sugar is your body's early morning status update. It reveals how effectively your body manages blood sugar after several hours of fasting.

Prediabetes: Prediabetes means your blood sugar is starting to creep up; not diabetes yet, but your body’s giving you a gentle nudge to pay attention. It’s the perfect stage to turn things around with small, healthy changes.

Why knowing these terms are necessary? The doctor says that knowing these terms will help the young patient keep a track of their sugar levels, and also to catch problems early.

Are There Ways To Manage Sugar Levels?

The doctor says yes. The doctor suggests simple steps, such as consuming low GI (≤55) foods on a regular basis, can help regulate sugar levels and prevent sudden sugar spikes. "These foods include oats, lentils, apples, milk, yogurt, green vegetables, and sweet potatoes. Additionally, high-GI foods like white bread, white rice, cornflakes, potatoes, pastries, sugary drinks,, and other junk and fried foods should be avoided. Besides regulating eating habits, simple steps such as regular exercise, brisk walking, and stress management can help control sugar levels."

Delhi is facing a health emergency as air pollution continues to rise, and the air quality continues to get worse. On November 7, Delhi Air Quality Index (AQI) logged at 727, which alarmed many, leading to a protest at India Gate. As of today, at 7am, Delhi's AQI was recorded at 421 under the 'severe' category. Today's AQI levels were marginally higher than Monday, where the AQI was recorded at 345 at 8am, under 'very poor' category.

Amid all this, while some doctors have suggested people to leave Delhi if they can, there are people who are still taking it casually. Many Delhiites are saying that since they are exposed to such air all the time, they are immune to it and that the toxins cannot harm them. This idea comes from the concept of herd immunity or community immunity. It is a form of indirect protection from an infectious disease that occurs when a sufficient percentage of a population has become immune as it was exposed to it for a long time. However, this does not work when it comes to pollutants.

What Are Doctors Saying About Pollution Immunity

Dr Arjun Khanna, Head of Pulmonology at Amrita Hospital in Faridabad, as reported in Business Standard says, "There is no physiological mechanism that lets the body get immune to polluted air. Unlike bacteria or viruses, pollutants do not trigger protective immunity.” This means if you feel "used to" the pollution, you are not actually safe from it.

In fact, long term exposure could actually worsen your health condition. “Chronic exposure worsens asthma, cardiovascular diseases, and even neurological disorders. Pollutants weaken natural defences; they do not strengthen them,” explained Dr Khanna.

Also Read: Delhi Air Pollution: As AQI Crosses 700, AIIMS Doctor Suggests 5 Ways To Keep Everyone Safe

What Happens When You Are Exposed To Air Pollution For Longer Duration

Chronic pollution exposure aggravates oxidative stress and systemic inflammation. This means, with every breath you take, you inhale a toxic swamp.

As per Pusan National University, long term air pollution exposure actually triggers allergic immune responses in the lungs. Furthermore, a 2022 study published in the International Journal of Environmental Research and Public Health also shows the negative impact on immune system with alarming and harmful air quality.

As per another 2000 study, published by the British Society for Immunology, people living in areas with higher pollution levels show measurably different immune responses than those in cleaner environment.

Air pollution contains toxins like particulate matter, ozone, carbon monoxide, nitrogen dioxide, and sulfur dioxide. It also includes hazardous air pollutants (HAPs), such as lead, mercury, asbestos, benzene, and other volatile organic compounds. When one breathes this toxic and poisonous air the respiratory system bears the initial brunt of it. The pollutants then damage the delicate tissues lining your airways, and disrupts the barrier that normally prevents harmful substances from entering your body. When this first line of defence is compromised, pathogens find it easier to established infections.

As per a 2024 study titled 'Impact of Heavy Metal Pollution in the Environment on the Metabolic Profile of Medicinal Plants and Their Therapeutic Potential', air pollution appears to alter the very composition of immune cells. Pollutants like PM2.5 enter lungs and then mix with our blood and they interfere with how our immune cells work and cause a condition known as synthetic inflammation. "Over time, it keeps the immune system in a constant state of low-grade inflammation, making you more prone to infections, allergies, and chronic illness,” says Dr Khanna.

The doctor points out that living in polluted areas does not make anyone tougher, it is just a myth. “It’s like saying smoking every day makes your lungs stronger,” Dr Khanna laments. Doctors are urging people to not step out of their houses, and if they have to, they must wear N-95 masks.