Breathing is essential for our lives. But for some of us who have asthma, taking a breath becomes a difficult task, and affects quality of life. Asthma has many names in India – Vaayu roga, Dama, Asthma, Saans ki bimari or Eazhai Noi. Though difficulty in breathing can occur due to multiple causes, for example heart failure, Chronic Obstructive Pulmonary Disease (COPD) or interstitial lung disease, Asthma remains one of the most common causes of difficulty in breathing.

Scope of the burden in India

About 6 to 11 people in every 100 persons in India experience breathing difficulties due to asthma, making it a very common problem. Asthma is an inflammatory condition of the airways or breathing tubes inside the lungs, which are called bronchi. These air-tubes are a sensitive structure. When we get exposed to cold air or dust, these air-tubes may decrease a little bit in size, and one may feel a cough or suffocation for a few seconds. But in patients with asthma, there air-tubes are very sensitive due to inflammation, and they shrink in size significantly causing difficulties in breathing, with a wheeze and cough for many hours, days or sometimes weeks.

An asthma diagnosis should be suspected when such wheezing or breathlessness has been occurring in episodes of few hours or weeks for few months or years. In between these episodes, a person could be completely fine. An asthma diagnosis can be confirmed with pulmonary function tests such as spirometry, oscillometry and FENO (Fraction of exhaled nitric oxide). A patient can also easily learn performing peak expiratory flow rate (PEFR) measurements from his or her healthcare provider, and the changes in PEFR readings also help in confirming an asthma diagnosis.

Treatment for asthma

After confirming the diagnosis of asthma, treatment of asthma can be started in the form of corticosteroid inhalers. The dose of the corticosteroid in inhalers is very low (in micrograms) and usually very safe for use over many months and years. Inhaled bronchodilators like Salbutamol can be used as reliever medications for in-between symptoms relief. In a few selected patients with uncontrolled symptoms, newer therapies such as monoclonal antibody treatment or biologicals can help gain control over asthma symptoms.

There are many common queries or myths about asthma in the society. Here, we will try to address these question one by one.

I often develop a cold and cough and sometimes wheeze, which then improves on its own over a few days or weeks. Do I have asthma?

Yes, it can be asthma. But it can be treated easily, and one can live a normal life.

I had a fever and cold. I took antibiotics. The fever subsided, but the cough and wheeze are still persisting. Could it be asthma?

Asthma symptoms cannot be treated with antibiotics. Inhaled corticosteroids are the main treatment for asthma.

If I have asthma, can I eat cold things? Can I eat citrus fruits and curd?

With proper treatment of asthma with inhaled corticosteroids – you can eat all food items. Curd, milk, paneer, citrus fruits, and fruit juices are good for health and they do not cause asthma symptoms.

Can my asthma be cured or do I have to use inhalers for life?

Asthma is chronic disease like diabetes or hypertension. It persists, but with proper treatment with inhaler corticosteroids and PEFR monitoring, one can live a fully normal life.

Does the inhaler have steroids? Will It harm me if I use it for long durations?

Inhalers contain medicines in micrograms and these drugs stay in lung and do not reach blood in high doses. Thus, inhalers are very very safe for use over many years, even in children, pregnant women, and elderly population.

Can you give me tablets? I do not want to get habituated to the inhaler.

The use of inhalers is not habit-forming. Tablets contains medicines in milligrams or grams which is about a thousand times of a higher dose than the inhaler. Inhalers deliver medicines in very low doses and directly into the airways, making them safe and accurate treatment options for asthma.

I do not have any asthma symptoms anymore. Why do I need to use my inhaler if I am doing well?

In asthma, lung function decreases. The aim of treating asthma with inhalers is to bring back the lung function to normal, in order tokeep the person symptom-free. So please do not stop your inhaler just because symptoms have stopped. APFT is needed to check if lung function has also improved to normal. Your asthma physician will help you achieve normal lung function

Can you tell me what am I allergic to? Can I avoid those food or exposure to that substance, and get cured?

Withasthma, our airways become verysensitive to variety of trigger factors such asdust, smoke,strong smells from cooking in the kitchen,paint or perfume and cold air. Some patients may be allergic to a particular antigen like pollen or aspirin. A complete assessment by a physician can help. But all patients of asthma should avoid common triggers factors as mentioned above.

Can I use the air-conditioner?

Yes, you can set the AC temperature to 24 degree or above and can use it.

Asthma is a treatable disease, and with proper monitoring of lung function with spirometry and with regular treatment with inhaled corticosteroids, one can live a fully productive life.

(Dr. Prince James is with the Department of Interventional Pulmonology and Respiratory Medicine, Naruvi Hospitals, Vellore. prince.j@naruvihospitals.com)

Some believe Abraham Lincoln, the 16th President of the United States, may have had Marfan Syndrome, although this is not certain.
| Photo Credit: AP Photo/NY Public Library

What is Marfan Syndrome?

Marfan Syndrome is a rare genetic condition that affects the body’s connective tissue, the material that supports and holds together skin, bones, blood vessels, and organs. When this tissue is weak or stretched, it can cause a wide range of health issues, especially in the heart, eyes, bones, and joints. The condition is named after French doctor Antoine Marfan, who first described it in 1896.

What are the signs and symptoms of Marfan syndrome?

People with Marfan Syndrome often have a tall and thin build, with long arms, legs, fingers, and toes. Their joints may be unusually flexible, and they often have loose ligaments, meaning their fingers may bend back farther than normal, sometimes even touching the back of their hand. Some may have a curved spine or a chest that sticks out or sinks in. The condition also affects the eyes, often causing the lens inside the eye to slip out of place,  known as lens dislocation, which can lead to serious vision problems if not treated in time.

The most serious complications involve the heart and major blood vessels. The walls of the aorta (the main artery carrying blood from the heart) can become weak and stretch too much, leading to aneurysms or aortic dissection, both of which can be life-threatening. Some people also have mitral valve prolapse, where a valve in the heart does not close properly.

Also Read: Telangana govt hospital doctors perform liver transplantation on patient suffering from Marfan’s and rare syndrome

Who is at risk?

Marfan Syndrome affects about 1 in 10,000 people. It is usually inherited from a parent, but in some cases, it can occur as a new genetic change without a family history. The risk is higher in consanguineous marriages (where partners are closely related), because the chances of passing on certain genetic traits are greater.

Some doctors have suggested that Abraham Lincoln, the 16th President of the United States, may have had features of Marfan Syndrome, such as his tall stature and long limbs. Both men and women are equally affected.

How is it diagnosed and treated?

Marfan Syndrome is diagnosed based on physical signs, eye exams, heart scans like echocardiograms, and genetic testing. Since the symptoms vary and may develop slowly, diagnosis can be delayed unless doctors specifically look for it.

There is no cure for Marfan Syndrome, but it can be managed effectively with the right medical care. Beta-blockers or blood pressure medications like propranolol are often prescribed to reduce stress on the heart and aorta. Regular cardiac checks help monitor the size of the aorta, and surgery may be needed if it becomes dangerously enlarged.

Routine care also includes orthopaedic monitoring for bone or spine issues and regular eye check-ups to catch and treat lens dislocation early. Ignoring vision problems can lead to permanent eyesight loss, especially in children.

Also Read: Cardiac surgeon calls for screening in schools for Marfan Syndrome

What is life like with Marfan Syndrome?

With proper precautions, most people with Marfan Syndrome can lead healthy and productive lives. However, they should avoid strenuous activities, contact sports, or heavy physical work, such as military training or physically demanding jobs which could stress the heart or joints. Regular check-ups with a cardiologist, ophthalmologist, and orthopaedic specialist are essential to monitor and manage the condition over time.

It was a scenario television presenter and actor Mini Mathur had never imagined. A few years ago, she was facing an audience of almost 5,000 people, narrating a 10-minute unscripted story on stage, at the Spoken Fest in Mumbai. “About 40 seconds in, I completely blanked out. I had no idea what I was going to say next. I lost my train of thought and couldn’t remember the point of my story — nothing.”

Mathur, then 50, was appalled. She was one of India’s most seasoned, experienced television presenters with a three-decade-long career. “It gave me so much anxiety, not knowing what was coming next. I blanked out for just five to seven seconds, but on stage that felt like five hours,” she recounts.

The moment hit her hard. She started hesitating before taking on live, unscripted events for almost six months. “I was so unsure about my memory. I would write my entire script down and have it put on to a teleprompter or use cue cards. For about a year, I couldn’t function on stage without one,” says Mathur. She had never needed one earlier. “As a television presenter, you could wake me up in the middle of the night, hand me a mic, and I’d be ready to go. But when perimenopausal brain fog started interfering with my work — it really hit me hard.”

TV presenter and actor Mini Mathur
| Photo Credit:
Getty Images

Menopause is having a moment, says a recent headline in The New Yorker. If you are a 45-plus woman in India, your Instagram feed is most likely flooded with ads of mid-life fitness and menopause tips our mothers never discussed but we now happily share (ditch the coffee; get the tofu; stock up on magnesium; sign up for strength training; and so on, depending on your algorithm). Celebrities, from Gwyneth Paltrow to Oprah Winfrey, former news anchor Tamsen Fadal, and actor Naomi Watts, have all written books or spoken extensively about it.

Menopause care is now a booming business. According to Grand View Research, the menopause market in India is expected to reach a projected revenue of $1,632.2 million by 2030.

““I wanted to normalise this new version of myself, but I didn’t have the knowledge or tools to do so. One day, I finally stopped and said, I’ve conquered cancer; now let me conquer menopause! Being in denial was getting me nowhere. Now that I have embraced this stage, I have uncovered valuable insights about myself and I have never felt better.”Lisa RayActor, author and supermodel

Actor, author and supermodel Lisa Ray, who went into a medically induced menopause at 37 after a treatment for multiple myeloma, is vocal about her experience. While it took her time to confront the changes menopause brought, like Mathur, she has become a strong menopause advocate, using her social media to do explainers on midlife, women’s health, emotions and self-love. 

Ray noticed a change in her appearance (thinning hair, lack of energy and focus) after a cancer relapse in 2013. “I wanted to normalise this new version of myself, but I didn’t have the knowledge or tools to do so. One day, I finally stopped and said, I’ve conquered cancer; now let me conquer menopause! Being in denial was getting me nowhere. Now that I have embraced this stage, I have uncovered valuable insights about myself and I have never felt better.”

How Lisa Ray manages symptoms

• Acceptance is key

• Consult a good doctor to discuss care and treatment, if needed

• Add more protein to your daily intake and consult a clinical dietician on supplements 

• Do weight training

• Sleep is non-negotiable as is doing activities that help regulate sleep, such as meditation at night, journaling, magnesium creams or supplements

Workplace support

With over one billion women globally — including nearly 150 million in India — experiencing menopause in 2025, workplace support is crucial. The transition begins even earlier for Indian women, around the age of 46, possibly due to factors such as geography, socio-economic status and lifestyle, among others, says a study by the Indian Menopause Society. Even a casual chat reveals struggles with concentration, anxiety, brain fog and irritability among women who often have a full plate, with a demanding job, teenaged children, caregiving responsibilities and their own bodily changes.

Despite the scale of this demographic change, most Indian workplaces lack formal mechanisms to support women during this transition. Some companies have initiated wellness programmes and medical support, but stigma and lack of awareness remain barriers to an equitable workplace.

Shunali Khullar Shroff

“The fear of menopause is often worse than the reality. Yes, the hot flashes are real, and sleep becomes so erratic you worry you’ll never get a full night’s rest again. But my generation of women is entering this phase on our own terms. I do strength training three times a week; I am more mindful of what I eat and I find my fitness levels are better than ever before. I’ve realised that the menopause conversation having gone mainstream is a big support to women today. We know what to expect and how to tackle it. Basically, menopause may be the end of the period but it’s not a full stop for you as a woman. It’s a comma. And we’re not done telling our story.”Shunali Khullar ShroffCo-founder of ‘Not Your Aunty’ podcast

Global take

• In the U.K., the Labour Party has pledged that, if elected, it will mandate large companies to publish menopause action plans.

• In Europe, the fashion industry has begun to address menopause-related challenges, with companies such as Asos and Burberry implementing supportive measures.

• The Indian government acknowledges the absence of a menopause policy for women employees. The Ministry of Women and Child Development says that strong research is needed to draft such a policy.

Ray saw the changes impacting her work. “I do different sorts of work — not just in front of the camera. I give public talks, I wrote a book, I read and research a lot, and my inability to focus impacted all that. I even found myself forgetting common words. Even when I would drop menopause in casual conversations at work — in a humorous way, to gauge the room — it would be met with awkward silence,” she says.

A March 2025 Stanford study called ‘The Menopause Penalty’, conducted among Swedish and Norwegian women, found that those with menopause-related symptoms earned 10% less because they cut back on their hours or quit work. In India, a survey by healthcare firm Abbott in partnership with research and data company Ipsos, among 1,200 women, revealed that 81% women felt menopause affected their work life. 

Bengaluru’s Chaitra Vedullapalli, 52, entrepreneur and president of Women In Cloud — a community-led $1 billion economic access initiative for women innovators in technology — knows first-hand the challenges women face balancing leadership, well-being, and career. After years battling perimenopause symptoms, she openly shares her journey of managing executive functioning — what she describes as the ability to manage oneself and one’s resources effectively to achieve personal and professional goals.

Vedullapalli faced stress, burnout, brain fog, and memory challenges, all of which impacted her ability to lead and parent at her usual high level. “I would forget things, so I started documenting everything because I felt like I was losing my mind,” she recalls. These struggles, compounded by chronic fatigue and cognitive shifts, forced her to rethink how she prioritised self-care, leadership responsibilities, and personal health.

Chaitra Vedullapalli, entrepreneur and president of Women In Cloud — a community-led economic access initiative for women innovators in technology.

Challenges of transition

Cheryl S., 48, vice-president at a multinational technology company in Pune, has been struggling with sleepless nights. “I’m on the run from the moment I’m up — packing off children to school, instructing the house help, sorting my day — and all I can think of is how little I’ve slept. I struggle to focus during morning work calls that I often lead. I’m also getting irritable very quickly, and it’s something I need to consciously watch with my team. I’m often tempted to leave it all and sit at home if I could,” she says.

Obstetrician and gynaecologist Nina Mansukhani has come across such challenges often. The template is often similar. “This period coincides with women holding senior positions in the workplace and making important decisions. As a result, the transition can become mentally, physically, and emotionally exhausting. Women may find that their tolerance for mistakes diminishes, and their capacity to handle errors decreases.”

Dr. Mansukhani says sleep deprivation can shorten one’s patience. “Essentially, the capacity to manage errors and mistakes, as well as responsibilities at the managerial level, becomes reduced. Many women tell me that they feel like they are losing control frequently, and this experience is something we all encounter at some point.”

Finding the right work-life balance during this time is crucial, says Dr. Nina Mansukhani, obstetrician and gynaecologist

• Start with lifestyle changes such as diet, exercise, and building small, consistent routines.

• Seek support through therapy, whether with a life coach or a cognitive behavioural therapist

• Take short holidays, or attend healing courses for some much-needed relief

• If menopause symptoms significantly strain daily life, menopause hormone therapy (MHT) might be recommended. When carefully selected and used for a short period (under medical supervision), MHT is extremely safe and can dramatically improve relationships, work dynamics, and overall quality of life.

Taboos persist

Menopause discussions are now gaining traction in workplaces globally. Across the U.S., U.K., and Europe, legislative discussions, policy proposals, and corporate initiatives are addressing the issue. In India, a few forward-thinking companies are taking action.

Standard Chartered Bank is one of them. They partnered with the Financial Services Skills Commission in the U.K. five years ago to understand the impact of menopause on career and talent retention. “Learnings from this have been applied across countries, including India,” says Shivshanker S.V., India and South Asia Head of Human Resources at Standard Chartered Bank. 

A signatory to the ‘Wellbeing of Women’s Menopause Workplace Pledge’ and a member of the ‘Menopause Friendly Employer’ organisation, the bank provides counselling and full medical coverage for menopause-related consultations for employees and their partners.

“We take a data-led approach to better understand the challenges. Specific initiatives include wellness resources, flexible work arrangements, awareness sessions with gynaecologists, manager training, and a closed-group ‘Lean-In Circle’ for open conversations,” says Shivshanker.

Shanti Kurupati, Director of Product Development at Intuit

Bengaluru-based Shanti Kurupati, Director of Product Development at Intuit, a global software company, thinks the key is in building inclusive environments that enable fearless sharing. At Intuit, this is done through internal communities such as Tech Women at Intuit (TWI) that create safe spaces for discussing sensitive topics such as menopause. Talks with specialists further help normalise conversations, says Kurupati.

Intuit’s ‘Well-being for Life programme’ provides ₹60,000 annually for physical or mental wellness. Employees can access Maven, a 24/7 digital health platform offering menopause support. It’s anonymous and extends to employees’ dependants, too. 

But many women still feel uncomfortable and fear ageism may rear its head. Shuja, 49, works in a Pune-based boutique travel firm, and often accompanies clients on day trips near the city. “My gut health has suffered, I urinate frequently and I’m finding it tough to be out the whole day.” But she would rather endure the discomfort than speak to her boss, fearing reduced responsibilities. “They’ll start viewing me as an old lady,” she laughs. 

Kurupati acknowledges this fear of losing out, across a woman’s life phases — from childbirth to menopause. She thinks sharing experiences resonates with people and ally-ship between women is important. “Intuit’s initiatives aren’t just policies — they are born from the lived experiences of senior women who’ve gone through these life transitions.”

Stage of change

Perimenopause is the phase where periods haven’t completely stopped, but hormonal changes have begun. It typically lasts two to four years before menopause — marked by 12 consecutive months without a period. During perimenopause, oestrogen levels gradually decline, causing hot flashes — sudden spells of intense heat in the face, neck, and upper body — as the brain’s temperature regulation gets affected. Irregular periods and a slowing metabolism are other early signs of approaching menopause, says Dr. Nina Mansukhani.

A recent Women In Cloud survey (Feb-March 2025) of more than 1,000 respondents found that over 60% of women experience cognitive, mood, and stress management challenges — yet few receive targeted care. Only 25% of those seeking medical help for hormonal or stress-related concerns received an accurate diagnosis and treatment, largely due to gaps in healthcare system preparedness. Vedullapalli sees this as a call to action.

“If we want to empower women as innovators, executives, and changemakers, we must address the full ecosystem of support — skills development, economic access, health, and wellness readiness,” she says.

Armed with information

When she first started reading about menopause, Mathur asked her mother when she had gone through it. Her mum’s reply — “maybe at 45, maybe 55” — made her realise how little the older generation understood or catalogued it. When she probed further, her mother admitted not fully understanding what she was going through. “Nobody was sensitive enough to notice how women of her generation felt.”

Even today, Vedullapalli points out, awareness and sensitivity around women’s health challenges is lacking. Early on, many healthcare providers dismissed her symptoms, advising more exercise or stress management without addressing the underlying hormonal shifts. Some even suggested her challenges were psychological rather than physiological.

After finally receiving a clear diagnosis, Vedullapalli took a proactive approach: embracing a holistic lifestyle that included hormone therapy, inflammation-reducing supplements, metabolic and hormonal tracking, and prioritising restorative habits. “I’m fanatic about my eight hours of sleep,” she says.

Women’s health is so under-served, Ray notes. “From the research to finding the best informed doctors, it’s a journey.” It’s probably the reason women are coming together to create platforms, groups and resources that demystify menopause.

Menopause coach Juilee Dandekar 

When Juilee Dandekar entered surgical menopause at the age of 37 after battling endometriosis, she felt information could be her rescue. Her Instagram page @livefearlessofficial documents her surgical menopause journey and is a platform to share experiences and insights. “Not too many people talk about menopause, and at 37, it was overwhelming,” says Dandekar, India director for strategy and business development with a leading healthcare company. She got certified by the British Menopause School in 2021 to become a menopause coach. Dandekar believes “education is the first step” and at the moment, offers free support.

The Chennai Menopause Society (CMS) conducts public awareness sessions to help women understand menopausal symptoms and advise them on simple measures. Even incorporating a few menopause-changes at the workplace can be useful, says urogynaecologist A. Tamilselvi, member and former secretary of CMS. “Organising annual health check-ups with a gynaecologist consult is one. Employees should also be able to discuss their health issues, including mental health, without the fear of being labelled, losing their jobs or being passed up for promotions,” she says.

Urogynaecologist A. Tamilselvi, member and former secretary of Chennai Menopause Society

Struggling to find the right information around her symptoms, Mathur, now a certified women’s health coach from the National Board of Health and Wellness Coaches, took a one-and-a-half-year course in the U.S. to find credible information that could help her and other women figure out their bodies. Equipped with knowledge and certification, she is now curating a platform of resources for women over 45. She’s writing a book, planning a podcast, and even working on a documentary, aiming to connect more women to credible resources around fitness, nutrition, hormone therapy and emotional well-being.

“Ours is the first generation of women that is asking questions, refusing to suffer endlessly without solutions behind hushed or subdued narratives around women’s health and midlife,” she says.

Instead, it’s a generation determined to change the narrative — by talking, supporting each other, and refusing to stay invisible. At home and more importantly, at work.

The writer is a freelance journalist and the co-author of ‘Rethink Ageing’.