Endometriosis is more common than you think. It affects 1 in every 10 women and leads to pain and infertility. As per the World Health Organisation (WHO) it is a disease in which tissue similar to the lining of the uterus grows outside the uterus. It causes severe pain in the pelvis and can start at a person's first menstrual period and last until menopause.

This happens when the tissue that lines the uterus or the womb grows outside of it and in other parts of the abdomen and pelvis, such as the bowel and bladder.

The common signs and symptoms of endometriosis include:

• Pain on or around your period or ovulation
• Pain during or after sex
• Pain during bowel movements or urinating
• Pain in the pelvic region or lower back
• Heavy bleeding or irregular bleeding

If you have these symptoms, your doctor would ask you to get an MRI, a pelvic exam and a minor surgical procedure called a laparoscopy done, to confirm endometriosis. The extremely painful conditions one faces with endometriosis lead to seeking the last resort of hysterectomy or uterus removal. However, it is not always helpful.

Dr Archana Kankal, Director, Obstetric and Gynaecology, Sahyadri Hospitals MomStory, Pune, says, "Although it can relieve symptoms, it doesn’t always completely solve the problem because endometriosis can occur outside of the uterus and remain even after the uterus is removed. Therefore, when deciding to go forward with this surgery, it's important that all the endometriosis is removed to improve the chances of relieving symptoms."

Factors That Can Lead to Hysterectomy

Several factors influence the decision to opt for a hysterectomy in cases of endometriosis, explains Dr Kankal. The severity and location of the disease play a crucial role; if endometriosis has spread to other organs like the ovaries or fallopian tubes, more extensive surgical measures may be required. Age and fertility aspirations also significantly influence this decision. "Younger patients who wish to have children may opt for more conservative treatments, while those who have completed their families or are not concerned about fertility might consider this surgery as a viable option," explains Dr Kankal.

Additionally, how well other treatments such as hormonal therapies or pain management strategies have worked can also determine whether or not to proceed with a hysterectomy. There are alternatives to avoid hysterectomy, including medical management. This is where hormonal treatments like birth control pills, patches or vaginal rings can help with the growth of endometriosis tissue and reduce symptoms. Through conservative surgery like laparoscopy, doctors can remove endometriosis tissue through small cuts in the abdomen, without removing the uterus. Some people, suggests Dr Kankal, also find changes in diet or exercise can help manage symptoms.

Things You Should Know About Endometriosis

It is possible for endometriosis to persist or to come back after a hysterectomy. "This happens if not all the endometriosis was removed during surgery or if the ovaries are left in place. These ovaries can continue to produce hormones that might cause the remaining endometriosis tissue to act up. This, a comprehensive surgical approach, sometimes including the removal of the ovaries, might be necessary to reduce the likelihood of the disease returning," says Dr Kankal.

While a hysterectomy can significantly alleviate the symptoms of endometriosis, it can come with potential long-term effects. The removal of ovaries with the uterus can lead to immediate menopause, regardless of the patient's age. "This can lead to typical menopausal symptoms like hot flashes, night sweats, and mood changes. There's also an increased risk of developing cardiovascular diseases and osteoporosis due to the decrease in hormone levels. Additionally, some women experience significant emotional or psychological impacts after the surgery, which may require support and counselling," explains Dr Kankal.

Preserving Fertility With Endometriosis

Dr Maunica Sorakayalapeta, IVF Specialist, Ferty9 Fertility Center, LB Nagar talks about the treatment for patients who want to preserve fertility. "GnRH agonists are another treatment option, inducing a temporary menopause-like state to alleviate symptoms. However, these drugs must be used with caution due to potential side effects, such as bone density loss," she says. In addition, aromatase inhibitors may be used to lower oestrogen levels and are often combined with other treatments to enhance their effectiveness.

The focus remains on effective pain management, as it is critical and usually involves non-steroidal anti-inflammatory drugs (NSAIDs) to directly address discomfort. Some patients also find relief through alternative methods such as acupuncture, physical therapy, and dietary changes, which can offer a more natural approach to symptom management.

Sorakayalapeta also points out that regular monitoring of the patient’s response to treatment is important to allow for timely adjustments and ensure that patients receive ongoing support as they navigate their fertility journey. "For those considering fertility treatments, these follow-ups are crucial in preparing them physically and emotionally for the next steps," she says.

There are fertility options for those who wish to conceive, including ovulation induction using hormonal medications to stimulate ovulation and increase the chances of conception. "Intrauterine insemination (IUI) may be an option for patients with mild endometriosis and no additional fertility issues. In cases of more advanced endometriosis or unsuccessful treatments, in vitro fertilization (IVF) can offer an effective solution, allowing for egg retrieval while bypassing any blockages caused by endometriosis," she explains.

Thanks to Instagram and other such social media platforms, we know a lot about our health than before. In a video, a person presses on his lower leg, and instead of the skin bouncing back smoothly, it shows small pit-like impressions. The caption on the video reads: A Visible Sign Of Congestive Heart Failure.

A throbbing dorsalis pedis pulse, the artery running along the top of the foot, might appear harmless at first glance. However, doctors caution that such a finding can be an important clinical sign, often linked to conditions such as peripheral vascular changes or fluid overload. In particular, it may reflect elevated central venous pressure (CVP), a common feature of congestive heart failure (CHF).

Medical experts recommend that whenever this sign is seen, it should not be dismissed. Instead, patients should be assessed thoroughly, including checking bilateral pulses, looking for swelling in the legs or feet, and correlating these observations with blood pressure and a full cardiac examination.

Understanding Congestive Heart Failure

Congestive heart failure, also called simply heart failure, is a long-term condition where the heart cannot pump blood efficiently enough to meet the body’s needs. While the heart is still beating, it struggles to keep up with circulation demands. As a result, blood builds up in other parts of the body, most often in the lungs, legs, and feet.

Doctors often describe it with a relatable analogy: imagine a shipping department that is constantly behind schedule. Packages pile up because they cannot be dispatched on time. Similarly, in heart failure, fluid “packages” accumulate in the body, leading to symptoms and complications.

Different Types of Heart Failure

Heart failure is not a one-size-fits-all condition. It has different forms:

• Left-sided heart failure, where the left ventricle struggles to pump blood effectively.
• Right-sided heart failure, which often results from long-standing left-sided failure and leads to blood backing up in veins.
• High-output heart failure, a rare type where the heart pumps normally but the body demands more blood than it can provide.
• Right-sided heart failure is particularly linked to distended veins and visible pulsations, as seen in cases where fluid overload is present.

How Widespread Is the Problem?

Heart failure is alarmingly common. In the United States alone, more than six million people live with the condition, making it the leading cause of hospitalization among those older than 65. With aging populations and rising lifestyle-related diseases such as diabetes and hypertension, the burden of CHF is expected to grow further.

Common Symptoms Of Heart Failure

CHF can manifest in many ways, some subtle and others unmistakable. Typical symptoms include:

• Shortness of breath, especially during activity or at night
• Chest pain and palpitations
• Fatigue and weakness
• Swelling in the ankles, legs, and abdomen
• Weight gain and frequent nighttime urination
• A persistent, dry cough or bloating in the stomach

Some patients may experience only mild discomfort, while others face severe, life-limiting symptoms. Importantly, the condition tends to worsen over time if not managed.

Causes and Risk Factors

Several factors contribute to the development of heart failure, including:

• Coronary artery disease and heart attacks
• Long-standing high blood pressure
• Cardiomyopathy, often due to genetics or viral infections
• Diabetes and kidney disease
• Obesity, tobacco use, alcohol, or recreational drug use
• Certain medications, such as chemotherapy drugs

Risk increases with age, sedentary lifestyle, poor diet, and family history of heart disease. Left-sided heart failure is the most common trigger for right-sided failure, but lung diseases and other organ issues can also play a role.

Potential Complications

Unchecked heart failure can lead to serious complications such as irregular heart rhythms, sudden cardiac arrest, valve damage, fluid buildup in the lungs, kidney or liver failure, and malnutrition. These risks make early recognition of clinical signs, such as visible dorsalis pedis pulsation, critically important.

Diagnosing Heart Failure

Doctors use a combination of medical history, physical examinations, and diagnostic tests to confirm CHF. They typically ask about family history, lifestyle habits, medication use, and other medical conditions. Key tests include echocardiograms, ECGs, chest X-rays, MRIs, CT scans, stress tests, and blood work. In some cases, genetic testing may also be used.

Stages of Heart Failure

Heart failure is classified into four stages (A to D):

Stage A: High risk but no symptoms, often due to conditions like hypertension or diabetes.

Stage B: Structural heart problems but no outward symptoms.

Stage C: Clear symptoms alongside a confirmed diagnosis.

Stage D: Advanced heart failure with severe, treatment-resistant symptoms.

In 2023, medication abortion emerged as the most common form of abortion in the United States, reflecting both the convenience and accessibility it offers. With evolving policies, telemedicine provision, and the continued demand for privacy and safety, understanding when and how medical abortion is recommended has become more critical than ever. Abortion in the United States has long been a controversial topic, but the increasing patchwork of state laws has made medical abortion all the more difficult to monitor.

Unlike surgical abortions that take place in clinics, medical abortions tend to occur in private locations with pills prescribed or even ordered over the internet something that makes it difficult to collect data. Throw in the recent round of restrictions and court battles, and researchers, policymakers, and clinicians are left with a distressing void: we just don't know how many medical abortions are being performed, where they are being performed, or what this looks like for women's health.

Although surgical abortion continues as a necessary procedure for specific circumstances, the growth of medication abortion has revolutionized reproductive health care by providing a safe and non-invasive alternative for termination during early pregnancy. This change also highlights the need for proper information, safe access, and quality follow-up care to provide positive health outcomes.

Latest figures from the Guttmacher Institute bring to fore that in the majority of U.S. states with less stringent abortion laws, medication abortion had represented 63% of total procedures offered during 2023. In Wyoming, as an example, 95% abortions were medication-related, with 84% taking the same route in Montana.

Even telemedicine is coming into play: an estimated 10% of medication abortions were provided solely online in states where telemedicine bans did not exist, with some states up to 60%. These trends highlight the importance of preserving and continuing access to abortion pills as an essential part of reproductive health care.

What is A Medical Abortion?

Medical abortion is a non-surgical and non-invasive procedure to end an early pregnancy, usually between 4 and 9 weeks. It uses a two-drug combination: mifepristone, to block progesterone required for continuing the pregnancy, and then misoprostol, which causes uterine contractions to pass the pregnancy. Dr. Rupali Mishra, sonologist and physician at Dr Rupali's Abortion Centre, describes, "Medical abortion is advised if the pregnancy is ensured to be intrauterine and the patient is medically fit".

This involves factors such as lack of severe anemia, bleeding disorders, chronic asthma, or allergies to drugs. She reiterates that availability of follow-up care, such as ultrasound scans to exclude retained products of conception (RPOC), is fundamental to the safe outcome.

When Is Medical Abortion Recommended By The Physician?

Medical abortion is most effective in the early weeks of pregnancy. For pregnancies nine weeks or less, the procedure may frequently be carried out outside of hospital facilities by trained health-care practitioners like gynecologists, nurse-midwives, or certified midwives. However, beyond nine weeks, medical abortion is carried out in hospitals with medical care because risks become greater and complications may arise. "Medical abortion is a convenient and non-invasive procedure, hence suitable for patients who value such factors," remarks Dr. Mishra.

The eligibility criteria too are medically oriented. The patient should not have ectopic pregnancy, severe chronic illnesses of heart, kidney, or liver function, or known contraindications to the medication. Written informed consent is legally mandatory in registered MTP centers to confirm understanding and safety of the patient.

Procedure and Follow-Up Care

After administration, patients can suffer from abdominal cramps, pain, and bleeding for 15–20 days. In most instances, there are no complications, but excessive bleeding, severe pain, or incomplete abortion can lead to a suction evacuation procedure. A follow-up ultrasound after about three weeks confirms the uterus is clear, marking the success of the procedure. Dr. Mishra states, "Even with high success rates, routine follow-up is critical to manage potential complications such as infection, prolonged bleeding, or retained tissue."

Safety Precautions and Possible Side Effects

Medical abortion is normally safe, but improper use or self-administration under unsupervised conditions can prove fatal. Heavy bleeding, incomplete abortion, infection, or, in exceptional cases, shock caused by undiagnosed ectopic pregnancy are serious side effects. Dr. Mishra cautions, "Selling abortion pills over the counter without a prescription is illegal and very risky. Medical supervision is a non-negotiable factor to avoid severe complications."

Medical Abortion vs. Surgical Abortion

Knowing the distinction between surgical and medical abortion enables proper patient decision-making. Surgical abortion is instant and appropriate for later gestation or incomplete medical abortion, whereas medication abortion is non-surgical and appropriate for early pregnancy. Both need follow-up for completion assurance and checking for complications.

What Role Telemedicine Play In Successful and Safe Abortion?

Telemedicine has revolutionized access to medication abortion, especially in states with less-restrictive laws. Virtual consultations with trained providers enable patients to get prescriptions and instructions without face-to-face visits, providing greater privacy and ease. However, according to Isabel DoCampo of the Guttmacher Institute, legal safeguards and access need to keep evolving in order to provide safe provision across states.

Medical abortion is safe, effective and becoming increasingly prevalent for the ending of early pregnancy if under qualified medical care.

Eligibility, procedure, and follow-up must be explained to patients so that safety and health can be assured. As reproductive health policy continues to change, maintaining access to safe abortion care—including medication and telemedicine—remains paramount. Open dialogue with objective medical professionals, coupled with adequate support and counseling, continues to be imperative for enabling individuals to make responsible decisions regarding their reproductive well-being.

Disclaimer: This article is provided for informational purposes and is not medical or legal advice. Readers are urged to seek advice from qualified healthcare providers for medical advice and to consult state or federal authoritative resources for updates on the laws of abortion in the United States.

In life we are always chasing the next adventure or new things, looking for ways we can make our lives easier. However, in this constant state of change, our bodies also struggle.

Sometimes, the secret to a better life isn't a complex new plan or a dramatic change. It's found in the simple, "boring" habits you do every day. Experts believe that by focusing on a few consistent, easy-to-do routines, you can make a huge difference in your long-term health and well-being. These are the small actions that, over time, build a foundation for a healthier, more successful life.

A heart surgeon named Dr. Jeremy London believes that success comes from doing simple, consistent things every day. He calls these "boring habits" because they aren't exciting, but they add up over time to make a big difference in your health and life.

Boring Habits That Can Change Your Health

In a YouTube video, Dr London said that although these habits may be slow and seem boring, they are the reason why he was able to accomplish so much.

Get Up Early

Dr. London says that waking up early is a game-changer. Even though he wasn't a morning person, he started getting up at 4 a.m. This quiet time is perfect for focusing on your most difficult task of the day. Finishing something hard early on gives you a feeling of freedom and success for the rest of the day.

Move Your Body Daily

Moving is like medicine for your body. You don't need to be a serious athlete; even a daily walk is helpful. Regular movement keeps your body healthy, improves your mood, and helps prevent disease.

Get Sunlight

Exposure to sunlight helps your body's internal clock, which improves your sleep. It also helps your body make vitamin D, strengthens your bones, and can even help with your mood. Try to get outside and into the sun every day, even for a short time.

Lift Weights

As we get older, we naturally lose muscle. Lifting weights or doing bodyweight exercises is the best way to fight this. Being strong as you age helps you stay active and healthy. It also helps your body control blood sugar and reduces inflammation.

Cook Your Own Food

Cooking at home most of the time gives you control over what you eat. You can choose high-quality ingredients and avoid extra sugar, bad oils, and preservatives that are often in restaurant food. Eating whole, healthy foods is key to keeping your body at its best.

Don't Drink Alcohol

Dr. London says that quitting alcohol was one of his best decisions. He realized that drinking was hurting his body, even as he tried to be healthy in other ways. Being sober provides clarity and allows you to experience life's good and bad moments without a filter.

Make Time for Loved Ones

According to Dr. London, this is the most important habit of all. Spending time with family and friends is essential for your happiness and well-being. He says that people on their deathbeds don't wish they had worked more; they wish they had spent more time with the people they love. Making an effort to maintain these relationships is what truly makes life meaningful.