In many parts of rural India, women are facing a grim choice: keep their uterus and lose wages every month due to painful, heavy periods—or undergo a hysterectomy, a permanent surgery to remove the uterus, sometimes even in their early 30s. This quiet but serious epidemic has been unfolding for years.

According to the National Family Health Survey (NFHS-5, 2019-21), nearly 10% of Indian women aged 40–49 years had already undergone a hysterectomy. In states like Andhra Pradesh (22.5%), Telangana (21.2%), Bihar (17.2%) and Gujarat (11.7%), the numbers were far higher. More worrying is the median age, just 34 in rural India, more than a decade before natural menopause.

The Link Between Periods, Wages, and Surgery

For many rural women, particularly agricultural workers, menstruation is not just a health event but an economic setback. Migrant sugarcane workers in Maharashtra’s Beed district provide a stark example: here, hysterectomy prevalence was found to be as high as 56% in 2024, with women opting for the surgery at an average age of 35.

The reason is brutally pragmatic. Agricultural contractors often penalize women who take time off for menstruation. Period pain, excessive bleeding, and taboos around hygiene in the fields make working conditions even harder. In such an environment, hysterectomy is sold as a “permanent solution”, a way to eliminate menstrual problems and keep working without interruption.

A recent study published in Social Science & Medicine also notes that this pattern is echoed in Telangana and Bihar, where women agricultural workers also show higher hysterectomy prevalence. Studies reveal that many women are advised surgery by private doctors even for common issues like abdominal pain or white discharge, often without being informed of alternatives.

The Price of Early Hysterectomy

While hysterectomy can be medically necessary in certain cases, such as large fibroids, severe prolapse, or cancer, it is far from harmless when performed at a young age. The removal of the uterus, especially when combined with ovary removal, induces early menopause, triggering a cascade of health risks.

Research has linked early hysterectomy to:

• Cardiovascular diseases and metabolic disorders
• Bone density loss, raising fracture risk
• Pelvic organ prolapse and urinary tract issues
• Thyroid and urinary tract cancers
• Mental health concerns, including depression and anxiety

In essence, what appears to be a short-term fix to save wages ends up cutting into a woman’s long-term working life and overall quality of life.

A System That Encourages Surgery

Part of the problem lies in India’s healthcare structure. As per NFHS-5, about 70% of hysterectomies were carried out in private clinics. Research in Andhra Pradesh found that women as young as 20 were recommended hysterectomy for routine gynecological complaints, reflecting both a profit motive and lack of awareness.

Insurance schemes also play a role. Data shows that women with health insurance were more likely to undergo hysterectomy. Reports suggest that some private hospitals encourage the surgery because insurance covers it, making it financially attractive for providers.

The National Health Authority has flagged suspiciously high hysterectomy claims under Ayushman Bharat, which at one point accounted for nearly 2% of all female claims. In response, stricter pre-authorization rules were introduced, including mandatory second opinions for women under 40.

Why Women Agree: Pragmatic Agency, Not Just Victimhood

While it is easy to frame rural women as victims of predatory healthcare, research tells a more nuanced story. A 2015 study in Social Science & Medicine highlighted how women often exercised “pragmatic agency.” They weighed their options, continued monthly suffering, missed wages, social stigma of menstrual restrictions, against the perceived relief of hysterectomy. With limited non-surgical options offered by doctors and little awareness of long-term side effects, many saw it as their best way forward.

In interviews, women described themselves not just as patients but as workers and caretakers. Their health decisions were shaped less by medical advice and more by economic necessity, gendered expectations, and the absence of supportive healthcare alternatives.

Diabetes develops when the body can no longer use food efficiently for energy. In this condition, the system either produces too little insulin or does not respond to it well enough. Insulin is the hormone that moves glucose into the cells, where it can be used as fuel. When glucose stays in the bloodstream instead of entering the cells, it begins to harm the blood vessels and nerves that support every organ, including the eyes.

This raises a natural question: can diabetes lead to blindness?

To understand how this happens and what people can do to prevent it, we spoke with Dr Arpan Dev Bhattacharya, Consultant in Diabetes and Endocrinology at Manipal Hospital in Bengaluru.

Can Diabetes Lead To Blindness?

High blood sugar, especially in people living with diabetes, can lead to serious eye problems and even permanent vision loss. When glucose stays elevated for long periods, it harms the fine network of blood vessels that nourish the retina. This injury is known as diabetic retinopathy, a condition that may begin with mild blurring and gradually progress to significant loss of sight if it is not treated in time.

Other eye diseases linked to diabetes include diabetic macular edema, cataracts, and glaucoma, each adding to the risk of visual decline.

Dr Arpan Dev Bhattacharya said, “Earliest changes almost always appear in the retina, the light-sensitive layer at the back of the eye. The vessels here are extremely delicate. When sugar levels remain high, these vessels become fragile or start to leak, creating the groundwork for diabetic retinopathy.”

Diabetes And Blindness: Early Warning Signs Are Easy to Miss

Diabetic eye disease often begins without noticeable symptoms. Some early clues include blurred or shifting vision, faded colours, difficulty seeing in low light, or small dark floaters that drift across the field of sight. These symptoms can come and go, which makes people dismiss them. Routine eye exams with dilation remain the most reliable way to detect trouble before vision begins to decline.

Blood Sugar Targets That Protect the Eyes

Good metabolic control offers the strongest defence. For most adults with diabetes, the recommended targets include an HbA1c below 7 percent, fasting glucose between 70 and 130 mg per decilitre, and post-meal readings under 180 mg per decilitre. According to Dr Bhattacharya, keeping blood pressure and cholesterol within recommended ranges also helps lower the risk of retinal complications.

Innovative Therapies For Treatment

Researchers are also studying whether certain diabetes medications may offer additional protection. Semaglutide, a GLP-1 receptor agonist widely used for type 2 diabetes and weight management, has drawn particular interest. Dr Bhattacharya said, “Early studies suggest it may reduce stress on retinal cells and slow processes linked to cell injury. Later reviews show that semaglutide does not significantly raise retinopathy risk when compared with other treatments, and some findings even point toward possible benefits. More clinical trials are underway to define its role.”

While new therapies may strengthen prevention strategies, the core advice remains unchanged. Consistent glucose control, regular screening, and timely care provide the best protection against vision loss.

Lone Star Tick disease: Scientists have verified the first known death tied to a serious meat allergy brought on by a tick bite. The man, who passed away in 2024 after eating a burger, had alpha-gal syndrome. This condition begins after certain tick bites and leads to dangerous allergic reactions to red meat and other foods made from animals. Two weeks before his death, he had already reacted badly after eating a steak.

“The sad part is that no one recognised that earlier incident as anaphylaxis, so it was never linked to the beef,” said study co-author Thomas Platts-Mills, an allergist at the University of Virginia School of Medicine who helped identify alpha-gal syndrome and diagnosed the New Jersey case, during an interview with NBC News. But how did he develop this condition in the first place?

Lone Star Tick: What Are Lone Star Ticks?

A tick marked with a small white dot is known as the lone star tick (Amblyomma americanum). Many people already know that certain tick species can threaten human health. Lone star ticks are mainly found in Texas and Oklahoma, stretching across the Southern states and moving up the Atlantic coastline to parts of Maine. They live in wooded regions and are most common from April to September.

Falling ill after a lone star tick bite can take several days or even a few weeks. A bite can trigger various problems, including a serious meat allergy known as alpha-gal syndrome.

Lone Star Tick: What Is Alpha Gal Syndrome?

Bites from lone star ticks can lead to another major effect. The bite can cause the body to develop an allergy to meat. Substances from the tick, including alpha-gal, enter the bloodstream when it bites, which alerts the immune system and prompts the body to create antibodies to the alpha-gal molecule. Humans do not naturally produce this sugar, so the body treats it as foreign.

This reaction can make a person allergic to the sugar. Alpha-gal is present in many common foods, including beef, pork, lamb, dairy products, and gelatin. Once the allergy develops, a person can fall sick after eating these foods.

Experts believe that many people with alpha-gal syndrome have no idea they carry it. In the New Jersey case, it took scientists months to confirm that the man had the syndrome and had died as a result of it. Warmer winters have also allowed ticks to remain active for longer periods, raising the chances of bites throughout the year.

Anyone who thinks they may have this allergy can undergo testing to check. Although there is no cure for alpha-gal syndrome, doctors advise people with the condition to avoid all forms of meat, as well as dairy, gelatin, and some medicines that include these ingredients.

Lone Star Tick: How To Know if You Have the Alpha-Gal Allergy

Many people never realise they were bitten, unless a rash becomes visible. The symptoms of alpha-gal syndrome vary widely and may take weeks to appear, which makes it difficult to diagnose.

Signs of an alpha-gal allergy can include gastrointestinal discomfort after eating foods such as:

• Dairy products, which trouble about 10 to 20 percent of individuals with the allergy
• Red meats like beef, pork, lamb, or venison
• Foods and items that contain gelatin

Other signs may involve hives or, in severe situations, anaphylaxis. The allergy can take four to six weeks to form after the tick bite. Reactions may also be delayed for several hours after a person eats the food that triggers it.

A healthcare professional can test for the alpha-gal IgE antibody through a blood sample. Food challenge tests may also be carried out under medical supervision, in case a severe reaction occurs.

Doctors usually recommend taking daily medications in the morning, making it part of a morning routine. However, recent research suggests that taking blood pressure (BP) medications at night may provide additional cardiovascular protection. Still, consistency like taking your BP medicine at the same time every day—is more important than whether it’s morning or evening.

Numerous studies have examined the timing of BP medications, but none have produced conclusive evidence favoring morning or evening doses. To gain more insight, we spoke with Dr. Kiran Aithal, Vice Principal, Professor, and HOD of General Medicine at SDMCMS&H, SDM University, Dharwad who shared his perspective on the topic.

When Is The Best Time To Take Blood Pressure Medicine?

One of the largest trials, including over 21,000 participants, did not find clear evidence that taking BP medication in the morning is superior to taking it at night. Dr. Kiran suggests linking the timing to a daily activity that’s hard to forget, like breakfast or dinner, so doses aren’t missed. Skipping a dose is a common reason for hypertensive emergencies.

Dr Kiran said, “Sometimes, patients on multiple BP medications may need to split doses between morning and night, following the doctor’s instructions. Certain drugs, such as diuretics, are advised in the morning as they can increase urination. In some patients whose blood pressure doesn’t naturally dip at night (detectable through Ambulatory BP monitoring), physicians may recommend taking medication at night to achieve better control. Following your doctor’s advice is key.”

In general, most BP medications can be taken either in the morning or evening. The critical factor is taking them consistently at the same time every day to prevent complications. It’s important to remember that hypertension cannot be cured but can be effectively controlled. Lifestyle changes combined with regular, timely medication are crucial for managing high blood pressure successfully.

What Should You Avoid While Taking Blood Pressure Medicine?

Certain foods, drinks, and medications can interfere with blood pressure medicines. These include grapefruit juice, high-potassium foods, and salt substitutes, as well as alcohol and caffeine. Over-the-counter drugs like decongestants and NSAIDs (such as ibuprofen or naproxen) should also be avoided.

Some herbal supplements, including St. John’s Wort and licorice, can affect your blood pressure, and recreational drugs should be completely avoided. Always check with your doctor or pharmacist before starting any new medication, supplement, or making significant changes to your diet, says the Heart Organisation.

Understanding Blood Pressure Categories

Blood pressure is measured using two numbers: systolic (the top number) and diastolic (the bottom number). Based on these readings, blood pressure is classified as normal, elevated, or high. A normal reading is below 120/80 mmHg. Elevated blood pressure falls between 120–129 systolic with a diastolic under 80. Stage 1 hypertension is defined as 130–139 systolic or 80–89 diastolic, while Stage 2 hypertension is 140 or higher systolic or 90 or higher diastolic.

Readings of 180/120 or above are considered a hypertensive crisis and require immediate medical attention, according to the Heart Organisation.

Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider before making any changes to your medication, diet, or lifestyle.