Selena Gomez, a multi-talented singer and actor, has been candid about her health challenges, opening a window into the realities of living with chronic illnesses. Recently, in an emotional interview with Vanity Fair, Gomez revealed a deeply personal struggle that resonated with many — her inability to carry children due to medical issues.

As she navigates this difficult reality, Gomez sheds light on her broader health battles, including lupus, anxiety, depression, and bipolar disorder.

The 32-year-old did not disclose the specific medical condition during the interview, but she has previously been open about her 2015 lupus diagnosis, an autoimmune disease in which the immune system attacks the body’s own tissues and organs. The following year, she was also diagnosed with anxiety and depression, both of which can be associated with lupus and the medications used to treat it.

Impact of Lupus on Gomez's Health

Gomez's journey with lupus, an autoimmune disease where the body’s immune system attacks its own tissues, has been at the forefront of her health battles. She was diagnosed with the condition in 2015, a revelation that came after years of mysterious symptoms, such as fatigue, joint pain, and swelling.

Lupus can affect various organs, including the kidneys, heart, and lungs, and its unpredictable nature makes it a particularly difficult illness to manage.

In 2017, Gomez underwent a kidney transplant, a lifesaving procedure made necessary by the damage lupus had inflicted on her kidneys. The transplant, which was donated by her close friend Francia Raisa, was a turning point in her health journey, but it also underscored the severity of her condition.

While the surgery provided some relief, lupus remains a chronic illness, and the battle is ongoing.

Lupus, as a medical condition, comes with a host of complications, many of which can affect reproductive health. Women with lupus are often advised against pregnancy, as the disease, combined with the medications required to manage it, can lead to high-risk pregnancies.

In Gomez’s case, her condition, coupled with other health concerns, has made pregnancy too dangerous, a reality she has had to come to terms with.

Bipolar Disorder and the Challenge of Medications

In addition to lupus, Gomez has also been diagnosed with bipolar disorder, a mental health condition characterized by extreme mood swings that can range from depressive lows to manic highs. Bipolar disorder can be challenging to manage on its own, but the medications used to treat it can pose additional health risks, particularly when it comes to pregnancy.

Gomez has been open about her mental health struggles, revealing in 2020 that she had been diagnosed with bipolar disorder after a particularly difficult period during which she experienced a psychotic episode. This episode, marked by hallucinations and suicidal thoughts, led her to seek treatment, and she has since found a combination of medications that helps her manage her symptoms.

However, these medications come with their own set of complications. In an interview with Rolling Stone in 2022, Gomez shared that the medications she takes for bipolar disorder could make pregnancy unsafe. This added another layer of complexity to her desire for motherhood, as the risk posed by both her mental and physical health conditions meant that carrying a child would be too dangerous.

"Did not want to put the baby’s life in jeopardy"- Grieving the Loss of Traditional Motherhood

One of the most emotional aspects of Gomez’s recent revelations is the grief she has experienced over her inability to carry a child. In her interview with Vanity Fair, she opened up about how difficult it was to accept that pregnancy would put both her life and the baby’s in jeopardy.

“That was something I had to grieve for a while,” she said, reflecting on the emotional toll that this realization took on her.

For many women, the ability to conceive and carry a child is a deeply personal and important part of their life plan. The societal expectation that motherhood is a natural next step in life can add additional pressure. For Gomez, this expectation was something she had envisioned for herself, particularly as she approached her mid-30s.

The idea of having to let go of this vision was heartbreaking, and she has been open about the emotional journey she has been on to come to terms with it.

However, Gomez’s story also speaks to the strength of her resilience. While she has grieved the loss of traditional motherhood, she has also embraced the possibility of becoming a parent through alternative means.

Adoption and surrogacy are two options that Gomez has considered, and she has expressed gratitude for the availability of these paths to parenthood. “I’m excited for what that journey will look like, but it’ll look a little different,” she said. “At the end of the day, I don’t care. It’ll be mine. It’ll be my baby.”

Infertility and Chronic Illness

Gomez’s story highlights a larger issue that affects many women — the intersection of chronic illness and infertility. Conditions like lupus, bipolar disorder, and the medications required to manage them can significantly impact reproductive health.

For women with these conditions, the decision to start a family is not always straightforward, and in many cases, pregnancy may not be a viable option.

The emotional toll of infertility, especially when it is compounded by chronic illness, can be devastating. For women, who had envisioned a future that included biological children, the reality of infertility can lead to feelings of loss, grief, and frustration.

Conditions That Can Possibly Affect Pregnancy

Pregnancy is a complex process, and various physical and mental health conditions can significantly impact a woman's ability to conceive or carry a child to term. Below are some common conditions, both biological and mental, that can affect pregnancy:

1. Lupus

Lupus is an autoimmune disease in which the body's immune system attacks its own tissues and organs. For women like Selena Gomez, lupus can pose serious risks during pregnancy, including complications such as preeclampsia, premature birth, and increased risk of miscarriage. Medications taken to manage lupus may also affect fertility or the health of a developing fetus, requiring close medical supervision.

2. Polycystic Ovary Syndrome (PCOS)

PCOS is a hormonal disorder that affects ovulation and fertility. It is one of the most common causes of infertility in women, leading to irregular menstrual cycles and elevated levels of male hormones, which can hinder pregnancy. PCOS is also associated with an increased risk of miscarriage, gestational diabetes, and preeclampsia.

3. Endometriosis

Endometriosis is a condition where the tissue that lines the uterus grows outside of it, causing pain and potentially leading to fertility problems. Women with endometriosis may face difficulties with conception and are at a higher risk of complications during pregnancy, such as preterm birth.

4. Bipolar Disorder

Mental health plays a crucial role in pregnancy outcomes. Bipolar disorder, a condition characterized by extreme mood swings, can complicate pregnancy if not managed properly. The medications used to treat bipolar disorder, such as mood stabilizers, may pose risks to a developing fetus, including birth defects or developmental delays. As in Gomez’s case, ongoing treatment for bipolar disorder might make pregnancy unsafe without proper medical adjustments.

5. Anxiety and Depression

Chronic anxiety and depression can negatively affect fertility and pregnancy. These conditions can interfere with hormone regulation, making conception more difficult. In pregnant women, untreated anxiety and depression are linked to premature birth, low birth weight, and postpartum depression. Furthermore, the medications used to manage these mental health issues may need to be altered during pregnancy to minimize risks to the baby.

6. Diabetes

Uncontrolled diabetes, particularly type 1 and type 2 diabetes, can lead to complications during pregnancy. High blood sugar levels can result in birth defects, miscarriage, or stillbirth. Additionally, pregnant women with diabetes may be more likely to experience preeclampsia and premature delivery.

7. Thyroid Disorders

Both hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid) can impact fertility and pregnancy. These conditions may cause irregular menstrual cycles and ovulation problems, making it difficult to conceive. During pregnancy, thyroid disorders can lead to complications such as miscarriage, preterm birth, or developmental issues in the baby.

8. Obesity

Obesity can complicate pregnancy by increasing the risk of miscarriage, gestational diabetes, preeclampsia, and cesarean delivery. Women with obesity may also experience difficulties with fertility due to hormonal imbalances and irregular menstrual cycles. Maintaining a healthy weight before and during pregnancy is essential for reducing these risks.

9. Hypertension (High Blood Pressure)

Chronic hypertension or high blood pressure can lead to pregnancy complications, including preeclampsia, restricted fetal growth, and premature birth. Women with hypertension may need careful monitoring and medication adjustments to ensure a healthy pregnancy outcome.

However, Gomez’s openness about her journey offers a message of hope. By sharing her story, she is helping to normalize conversations around infertility, chronic illness, and the alternative paths to motherhood that many women are exploring.

Selena Gomez’s health journey serves as a reminder that chronic illness can affect every aspect of a person’s life, from their physical health to their mental well-being and even their ability to start a family. Her story is one of strength, perseverance, and the unwavering belief that, despite the obstacles, there are still countless possibilities for joy and fulfillment.

The lazy ones know that facial bleach is one beauty product that comes in handy at any point in time. Whether it was for that last-minute party glow-up or to hide a sudden tan line, facial bleach has long been a last-minute resort in Indian homes. But what really happens when you apply that potent cream on your skin and wait for its effect? We dug in to find out exactly what is going on when your face starts tingling mid-bleach.

What is facial bleach?

Facial bleach usually contains hydrogen peroxide as the main ingredient. This acts as a lightening agent, breaking down melanin, the pigment responsible for skin colour. When you apply bleach, you are not removing hair or tanning; you are just lightening it to make it blend in with your skin.

What is happening under the surface?

When you apply bleach to your skin, it sets off a chain reaction. The hydrogen peroxide oxidises, which in simple terms means it reacts with the pigment and hair proteins, breaking down melanin and making everything lighter in colour. Your facial hair goes blonde, and your skin tone appears brighter, not because it has suddenly become radiant, but because there is less visual contrast.

It comes with side effects

If you have ever felt your face heat up or sting while bleaching, you have experienced a minor chemical reaction. Bleach is harsh. It strips the skin’s protective barrier ever so slightly, which is why your skin might feel sensitive, look a bit red, or feel tight afterwards.

Sensitive skin types should deal with it very carefully. Facial bleach can cause inflammation, itchiness, or even mild burns if left on too long or applied too often. And those with active acne, eczema, or any skin condition should steer clear altogether.

Can it damage your skin in the long run?

In moderation, bleaching every now and then might not wreak havoc, especially if you are using a reputable brand and following instructions to the dot. But using it too frequently is when trouble begins. Long-term, overuse can cause skin thinning, sensitivity to sunlight, and uneven pigmentation.

Also, your skin does not get used to bleach. It tolerates it up to a point and then acts up. You might suddenly develop a sensitivity you never had before.

Should you bleach at all?

Bleach has its moment. If you are prepping for a function, want that one-off glow, or just feel like softening the appearance of facial hair, go ahead; just be smart about it. Patch test always. Stick to the recommended time. Do not pile it on like it is moisturiser. And do not expose your skin to the sun immediately.

Use facial bleach sparingly, respect your skin, and be okay with skipping it altogether if your face is already protesting. Because no glow-up is worth a full-blown skin tantrum.

Recently, BRCA testing has garnered considerable attention, especially in the realm of reproductive medicine. BRCA1 and BRCA2 mutations are known to significantly increase the risk of breast and ovarian cancers. But as we begin considering their routine inclusion in IVF workups, we must ask: Are we proactively protecting future generations, or are we crossing into ethically uncertain territory?

In India, regulatory guidelines limit the number of donations from a donor to only a single recipient, placing significant constraints on donor selection. Moreover, potential genetic risks are already evaluated during donor screening through a detailed family and medical history. Sperm banks are careful to exclude donors with a known history of hereditary diseases that could impact the offspring. In addition, donors undergo stringent infectious disease screening, including sexually transmitted diseases like HIV, hepatitis B and C, and syphilis, to safeguard recipient health. These processes significantly mitigate both genetic and health-related risks.

This is not to undermine the value of BRCA or other genetic testing when clinically indicated. BRCA testing should be offered in IVF when there is a relevant personal or family history of cancers or where BRCA genes have been detected in the family. Couples who have experienced repeated miscarriages or have had a previous pregnancy loss where a genetic abnormality was found may benefit from more comprehensive genetic testing.

For women above the age of 35, another layer of screening becomes important: preimplantation genetic testing for aneuploidy (PGT-A). This is not about hereditary mutations but chromosomal abnormalities, which are more common as maternal age advances and lead to conditions like Down’s Syndrome in the child or recurrent miscarriages and IVF failures. PGT-A screens the embryos ensure that only chromosomally normal embryos are transferred into the uterus thus improving IVF success rates in older women.

Genetic screening plays a valuable role in safeguarding the health of future generations, but its use must be balanced with clinical relevance and ethical responsibility. The patients need extensive counselling on the procedure as it is invasive testing where afew cells are removed from the embryo and tested. In a small percentage because of mosaicism in embryo, there are also false positive reports (where abnormality is detected when none exists) and false negative reports (where abnormality exists but the report states a normal embryo). Patients must also be made aware of alternative methods of testing the child during pregnancy like NIPT (non invasive prenatal testing) and level 2 ultrasound during pregnancy to help them to take an informed decision.

However, incorporating BRCA testing or any advanced genetic screening into the routine workup for all IVF patients can significantly increase the financial burden of an already expensive procedure. While such tests are undoubtedly important in certain high-risk cases, they should be recommended judiciously, based on personal or family history, recurrent pregnancy loss or IVF failures, or previously identified genetic abnormalities. A targeted, case-by-case approach remains the most ethical and effective path forward in reproductive care.

'Diagnostic Anomaly' is a Health And Me Series, where we dive deep into some of the rarest of rare diseases. Here, we trace such diseases and what causes them. We also try to bring case studies around the same.

A routine dentist appointment turned into a medical emergency for a man in his late 60s living in Australia. Just 30 minutes after having two teeth extracted, he began experiencing sudden and alarming symptoms — dizziness, vomiting, and a bizarre distortion in his vision, where the world appeared rotated 90 degrees counterclockwise.

These were not trivial side effects of anesthesia or stress. The symptoms were pointing to something much worse. When he came to the emergency room, physicians observed strange signs: abnormal eye movement to the left and a tendency to fall to the right when walking. A brain scan validated their suspicion he was having an intracerebral hemorrhage (ICH), a potentially fatal form of stroke due to bleeding in the brain.

Intracerebral hemorrhage constitutes 10–15% of all strokes and entails a ruptured vessel bleeding into the brain tissue. Ischemic strokes caused by obstructions do not need such immediate intervention, while ICH needs to be urgently treated to stop bleeding, reduce brain pressure, and avoid irreversible neurological injury.

In this patient, the bleeding was in the lower-left side of his brain — a region that affects balance, coordination, and vision. His health care team reacted quickly to treat the hemorrhage, decrease his blood pressure, and relieve intracranial pressure. Thankfully, after receiving immediate treatment, he was stabilized and released with medication to regulate his blood pressure.

Three months after that, he made a dramatic recovery. His eyesight was back to normal, and his balance also considerably improved. To prevent future strokes over the long term, he was put on aspirin, which prevents narrowing of the blood vessels in the brain by keeping the blood thin.

Although clinically managing the case was according to typical stroke procedure, what makes this case uncommon is the suspected etiology: a simple dental treatment.

The man’s symptoms began just half an hour after his tooth extraction. Medical literature contains a few rare reports of individuals experiencing ICH following dental procedures, possibly due to sharp spikes in blood pressure triggered by pain, anxiety, or physiological stress. In this case, the working theory is that the dental procedure, coupled with an undiagnosed underlying condition, created the perfect storm for a stroke.

What Is White Matter Disease?

As the medical staff delved deeper into his background, they discovered further hints. Only six weeks earlier, the man had received neurological tests for potential Parkinson's disease. Scans at the time had already indicated signs of white matter disease — abnormalities in the network of wiring in the brain, which can cause thought to be slower, lead to loss of balance, and predispose to stroke and dementia.

White matter disease targets the brain's "communication highways," the nerve fibers (axons) that carry signals between different areas of the brain and spinal cord. The fibers need a continuous supply of oxygen and nutrients. When blood flow is slowed — because of age, high blood pressure, or damaged vessels — the white matter breaks down, creating lesions that are seen on MRI scans.

Symptoms of white matter disease may range from memory loss, difficulty with coordination, sluggish movement, mood changes, and even urinary incontinence. The symptoms are worse if the damage is more extensive.

But the story didn't end there. Genetic studies of the man revealed he had an uncommon mutation associated with CADASIL-Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy. This inherited disorder is found in approximately 2 in 100,000 and causes blood vessel walls to thicken. This compromise results in reduced flow of blood into the brain and a drastically increased risk of stroke.

Other research implies ICH can be an complication of CADASIL, particularly when added on top of other influences such as high blood pressure or physical stress.

The course of events now makes sense. The patient's existing white matter disease already compromising brain connectivity and his unknown CADASIL mutation had left his brain's blood vessels particularly susceptible.

The dental removal, though apparently innocuous, perhaps triggered an increase in blood pressure due to stress or pain, a normal physiological reaction in a medical context. For a person with healthy blood vessels, this may not have resulted in anything. But with a brain containing constricted, weakened vessels, the pressure was sufficient to rupture a vessel resulting in an intracerebral hemorrhage.

How Small Triggers Meet Big Risks

This case is an admonition regarding the intricate intersection of genetics, chronic illness, and acute medical stressors. It also highlights the need for recognition and control of risk factors such as hypertension, white matter disease, and unrecognized genetic disorders that affect brain function.

For individuals with cardiovascular risk factors — for example, diabetes, hypertension, or high cholesterol — regular procedures, including dental treatment, might necessitate closer follow-up. Preventive interventions, such as brain imaging in individuals with neurological symptoms and a history of stroke or dementia in first-degree relatives, might detect conditions such as CADASIL before complications arise.

Can White Matter Disease Be Prevented?

Although some white matter changes are inevitable with aging, progression can be slowed down. Good management of heart and vascular health is key. Here's what doctors say:

• Keep blood pressure under control
• Manage high cholesterol and diabetes
• Stop smoking
• Be physically active
• Eat a heart-healthy diet (such as the Mediterranean diet)

Studies have established that lowering cardiovascular risk has been proven to reduce white matter lesions, thus reducing stroke, dementia, and physical disability risks later in life.

A routine dentist visit triggered a series of events that almost resulted in a catastrophe for this Australian man but with timely rescue and extensive diagnostic procedures, not only did he recover well, but the doctors also discovered a rare genetic disorder that might have been a future threat.

Occasionally, the body's reaction to less invasive procedures can expose deep-rooted problems. Paying attention to your body, reporting new symptoms, and being proactive about brain and heart health can be the difference-maker — particularly when the indicators are easy to miss.