Vaginal Infections and Vaginitis: Symptoms, Causes, Treatment and Prevention

Vaginal Infections and Vaginitis: Symptoms, Causes, Treatment and Prevention

Vaginal itching, burning, unusual discharge or an unpleasant smell can be uncomfortable and worrying.

These symptoms are common, but they do not always mean the same thing.

Several conditions can affect the vagina and vulva, including bacterial vaginosis (BV), vaginal yeast infection and trichomoniasis. Sexually transmitted infections (STIs), skin irritation, hormonal changes and other conditions can cause similar symptoms.

This is why it is important not to assume that every episode of itching or discharge is a yeast infection.

The correct treatment depends on the cause.

First: What Is the Difference Between the Vagina and Vulva?

These terms are often incorrectly used as though they mean the same thing.

The vagina is the internal muscular canal leading from the cervix to the outside of the body.

The vulva refers to the external genital structures.

A person may therefore experience irritation primarily involving the vulva, the vagina, or both.

This distinction can be useful when describing symptoms to a healthcare professional.

What Is Vaginitis?

Vaginitis means inflammation of the vagina.

It can cause symptoms such as:

• unusual vaginal discharge,
• itching,
• burning,
• irritation,
• unpleasant odour,
• discomfort during sex,
• and sometimes discomfort when urinating.

There are several possible causes.

Some are infections, while others are not.

Is Vaginal Discharge Normal?

Yes.

Having vaginal discharge does not automatically mean you have an infection.

Normal discharge helps maintain the vaginal environment.

The amount, appearance and consistency can naturally change throughout the menstrual cycle and may also change during pregnancy, sexual activity and other hormonal stages.

Normal discharge is commonly clear or white and does not usually cause strong unpleasant odour, significant itching or pain.

The important thing is to recognise what is normal for your body.

A noticeable change from your usual discharge—especially when accompanied by odour, itching, burning, pain or bleeding—may need investigation.

The Vagina Has a Natural Microbiome

The vagina naturally contains microorganisms, including bacteria.

Many healthy vaginas contain bacteria from the Lactobacillus group.

These organisms contribute to the vaginal environment and help maintain acidity that can limit the overgrowth of some potentially harmful microorganisms.

The balance can change for many reasons.

That does not mean someone is “dirty” or has poor personal hygiene.

In fact, excessive cleaning inside the vagina can make problems worse.

Common Causes of Vaginal Symptoms

Several conditions can cause similar vaginal symptoms.

The most common include bacterial vaginosis, vaginal candidiasis and trichomoniasis.

Other STIs and non-infectious conditions can also cause symptoms.

Let's look at the differences.

1. Bacterial Vaginosis (BV)

Bacterial vaginosis occurs when the normal balance of bacteria in the vagina changes.

BV is not simply the result of poor hygiene.

It can occur even in people who have never had vaginal sex.

However, sexual activity and changes involving sexual partners can influence the vaginal bacterial environment.

Possible BV Symptoms

Many people with BV have no symptoms.

When symptoms occur, they can include:

• thin vaginal discharge,
• white, grey or sometimes greenish discharge,
• and a noticeable fish-like odour.

The odour may become more noticeable after sex or around menstruation.

Itching can occur but is not always present.

How Is BV Treated?

Symptomatic BV is generally treated with prescribed antibiotics.

The specific medicine and duration depend on clinical circumstances and local treatment guidelines.

BV can sometimes return after treatment.

If symptoms recur, seek medical advice rather than repeatedly treating yourself without confirming the cause.

2. Vaginal Yeast Infection

A vaginal yeast infection is also known as vulvovaginal candidiasis.

It usually occurs when Candida yeast—which may already be present in small amounts—grows excessively.

Common Symptoms of a Yeast Infection

Symptoms can include:

• intense itching,
• burning,
• vulval soreness,
• redness or swelling,
• discomfort during sex,
• burning during urination,
• and abnormal discharge.

The discharge may be thick, white and lumpy and often has little or no strong odour.

However, symptoms alone cannot always distinguish yeast infection from other vaginal conditions.

What Can Increase the Risk?

Factors associated with vaginal candidiasis can include:

• certain antibiotics,
• pregnancy,
• diabetes,
• and conditions or treatments that weaken the immune system.

Sometimes there is no obvious trigger.

How Are Yeast Infections Treated?

Antifungal medicines are used to treat vaginal candidiasis.

Depending on the situation, treatment may be:

• applied inside or around the vagina,
• or taken by mouth.

The appropriate treatment can differ during pregnancy and in recurrent or complicated infections.

If this is your first episode of vaginal symptoms, you are pregnant, symptoms are severe or recurrent, or treatment does not work, seek professional advice rather than repeatedly self-treating.

3. Trichomoniasis

Trichomoniasis is different from BV and yeast infection.

It is a sexually transmitted infection caused by a microscopic parasite called Trichomonas vaginalis.

It is preventable and curable.

Some infected people have no symptoms.

Symptoms Can Include

When symptoms occur, they may include:

• unusual vaginal discharge,
• yellowish or greenish discharge,
• unpleasant or fish-like odour,
• vaginal or vulval redness,
• itching,
• irritation,
• discomfort during urination,
• and pain during sex.

Because people can carry trichomoniasis without symptoms, testing is important when exposure is possible.

How Is Trichomoniasis Treated?

Trichomoniasis is treated with appropriate antimicrobial medicine prescribed or recommended according to local clinical guidelines.

Sexual partner management is important because an untreated partner can transmit the infection again.

People being treated should follow their healthcare professional's advice about when it is safe to resume sexual activity.

Correct and consistent condom use reduces the risk of sexual transmission.

4. Chlamydia

Chlamydia is a bacterial STI caused by Chlamydia trachomatis.

It is not the same infection as gonorrhoea.

Many people with chlamydia have no symptoms.

When symptoms occur in women, they can include:

• a change in vaginal discharge,
• burning during urination,
• lower abdominal discomfort,
• bleeding between periods,
• and bleeding after sex.

Untreated chlamydia can sometimes spread into the upper reproductive tract and contribute to pelvic inflammatory disease (PID) and infertility.

Chlamydia can be diagnosed through appropriate testing and treated with antibiotics.

5. Gonorrhoea

Gonorrhoea is another STI, caused by the bacterium Neisseria gonorrhoeae.

Like chlamydia, it can occur without noticeable symptoms.

Possible symptoms in women include:

• increased or unusual vaginal discharge,
• pain or burning during urination,
• bleeding between periods,
• and pelvic or lower abdominal pain.

Untreated infection can lead to serious complications, including PID.

Testing is important because symptoms alone cannot reliably distinguish gonorrhoea from chlamydia or other genital infections.

Not Every Vaginal Problem Is an Infection

This is another important correction to the original article.

Itching, burning, pain and discharge do not always mean bacteria, fungi or an STI are present.

Similar symptoms can result from:

• irritation from soaps or fragranced products,
• allergic reactions,
• skin conditions,
• hormonal changes,
• vaginal dryness,
• genitourinary syndrome of menopause,
• foreign objects such as a retained tampon,
• and other gynaecological conditions.

Treating every symptom with antibiotics or antifungal medicine can therefore be inappropriate.

Vaginal Changes Around Menopause

Falling oestrogen levels around and after menopause can affect vaginal and vulval tissues.

This may lead to genitourinary syndrome of menopause (GSM).

Symptoms can include:

• vaginal dryness,
• burning,
• irritation,
• discomfort during sex,
• urinary symptoms,
• and recurrent urinary tract infections.

GSM is not a vaginal infection.

A healthcare professional can distinguish it from infection and discuss appropriate treatment.

What Symptoms Should You Watch For?

Consider seeking medical advice if you develop a significant change from what is normal for you, particularly:

• unusual discharge,
• strong or unpleasant vaginal odour,
• persistent itching,
• burning,
• vulval redness or swelling,
• pain during sex,
• pain or burning during urination,
• pelvic or lower abdominal pain,
• sores, blisters or ulcers,
• bleeding between periods,
• bleeding after sex,
• or recurrent symptoms.

These symptoms have several possible causes.

Can You Identify an Infection by Discharge Colour?

Not reliably.

Certain patterns may provide clues, but they cannot provide a definite diagnosis.

For example:

Thick white discharge with itching may occur with vaginal candidiasis.

Thin greyish discharge with a fish-like smell may occur with BV.

Yellow-green discharge with irritation may occur with trichomoniasis.

But these patterns can overlap.

Someone can also have more than one condition at the same time.

Laboratory testing may therefore be necessary.

How Are Vaginal Infections Diagnosed?

A healthcare professional may ask about:

• your symptoms,
• changes in discharge,
• odour,
• itching or pain,
• menstrual history,
• pregnancy,
• medicines,
• antibiotic use,
• sexual history where relevant,
• previous vaginal infections,
• diabetes,
• and products used around the genital area.

Depending on your symptoms, examination and testing may be recommended.

A sample of vaginal discharge can sometimes be examined or sent to a laboratory.

Tests for STIs may also be appropriate.

Don't Assume Every Itch Is Thrush

Many people repeatedly purchase yeast-infection treatment whenever vaginal itching occurs.

This can delay diagnosis if the actual problem is:

• BV,
• an STI,
• dermatitis,
• hormonal changes,
• or another condition.

Over-the-counter antifungal treatments may be appropriate in some circumstances, particularly when someone has previously had a professionally diagnosed uncomplicated yeast infection and recognises the symptoms.

But persistent, unusual or recurrent symptoms deserve proper assessment.

Should You Douche?

No.

The vagina cleans itself naturally.

Douching means flushing or washing inside the vagina with water or another mixture.

It is unnecessary and can disturb the natural vaginal environment.

Douching may increase the risk of vaginal problems and recurrence of BV.

It should not be used to treat vaginal odour or discharge.

If an unusual smell or discharge is present, identify the cause rather than trying to wash it away.

How Should You Wash the Genital Area?

Wash the external vulval area gently.

Plain warm water is sufficient for many people.

If soap is used, avoid heavily fragranced or irritating products.

Do not scrub aggressively and do not attempt to wash inside the vagina.

The vagina does not need internal cleansing.

Avoid Fragranced Intimate Products

Products marketed specifically to make the vagina smell different are generally unnecessary.

These can include:

• feminine deodorant sprays,
• perfumed washes,
• fragranced wipes,
• vaginal perfumes,
• and scented intimate products.

They can irritate sensitive genital skin or disrupt the vaginal environment.

A healthy vagina naturally has its own mild scent.

Persistent strong or unusual odour should be investigated rather than covered with perfume.

What About Tight Underwear?

The old article presented tight clothing as a direct cause of vaginal infection.

That is too simplistic.

Very tight, non-breathable clothing can trap heat and moisture and may contribute to irritation or discomfort in some people.

Choose underwear and clothing that you find comfortable.

Changing out of wet swimwear or sweaty exercise clothing can also help keep the external genital area comfortable.

But clothing alone should not be blamed for conditions such as BV or STIs.

What About Tampons?

Correctly used tampons do not automatically cause vaginal infections.

Follow the manufacturer's instructions, use the appropriate absorbency and change tampons at recommended intervals.

Never intentionally leave a tampon in for longer than recommended.

A forgotten or retained tampon can cause unpleasant discharge or odour and needs to be removed.

Seek medical assistance if you cannot remove it yourself.

Correcting an Important Hygiene Error: Wipe Front to Back

The old version of this KandyWandy article advised readers to wipe from back to front after using the toilet.

That advice was incorrect.

If wiping after a bowel movement, the usual hygiene recommendation is to wipe from front to back rather than bringing faecal bacteria towards the urethral and vaginal area.

Can Garlic Treat or Prevent Vaginal Infections?

Garlic is a nutritious food, but do not insert garlic into the vagina to treat an infection.

There is insufficient evidence to recommend vaginal garlic as a reliable treatment for BV, candidiasis or STIs.

It can also irritate delicate vaginal or vulval tissue.

Likewise, yoghurt, vinegar, essential oils and other internet remedies should not replace proper diagnosis and evidence-based treatment.

Food belongs in your diet—not inside the vagina as an unproven infection treatment.

Are Vaginal Infections Caused by Being “Unclean”?

Usually, no.

This misconception can cause unnecessary embarrassment.

BV and yeast infections involve changes in the normal vaginal environment and are not evidence that someone has poor hygiene.

Trichomoniasis, chlamydia and gonorrhoea are sexually transmitted infections, but having an STI is not a measure of someone's cleanliness or character.

Anyone who is sexually active can potentially acquire an STI.

How Can You Reduce the Risk of Vaginal Problems?

Not every episode can be prevented, but sensible measures include:

• avoid douching,
• avoid fragranced vaginal products,
• wash the vulva gently rather than washing inside the vagina,
• follow instructions for tampons and menstrual products,
• change out of wet clothing when practical,
• use condoms correctly and consistently to reduce STI risk,
• have appropriate STI testing when indicated,
• take prescribed treatment correctly,
• and avoid repeatedly self-treating unexplained symptoms.

Condoms and STI Prevention

Correct and consistent condom use can significantly reduce the risk of many sexually transmitted infections, including trichomoniasis.

However, no prevention method other than avoiding sexual exposure eliminates every STI risk.

Regular testing may be appropriate depending on age, sexual practices, number of partners, pregnancy and local health recommendations.

What If You Are Pregnant?

Pregnancy changes the vaginal environment and can affect the risk of certain vaginal conditions.

Some vaginal infections during pregnancy may be associated with pregnancy complications.

Treatment choices can also differ during pregnancy.

If you are pregnant and develop unusual discharge, odour, itching, pain or other concerning symptoms, seek advice from an appropriate maternity or healthcare professional rather than self-treating without guidance.

When Should You See a Healthcare Professional?

Arrange an assessment if:

• this is your first significant episode of vaginal symptoms,
• symptoms are severe,
• symptoms persist after treatment,
• infections keep returning,
• you have pelvic or lower abdominal pain,
• you experience bleeding after sex or between periods,
• you have sores or blisters,
• you may have been exposed to an STI,
• you have a new sexual partner and develop symptoms,
• you are pregnant,
• or you are uncertain about the cause.

When Is Urgent Medical Care Needed?

Seek urgent medical attention if vaginal or pelvic symptoms occur with:

• severe pelvic or abdominal pain,
• high fever or feeling seriously unwell,
• fainting or severe dizziness,
• heavy unexplained bleeding,
• pregnancy with significant pain or bleeding,
• or rapidly worsening symptoms.

Contact the appropriate urgent or emergency medical service where you live.

Sexual Partners and Treatment

Whether a sexual partner needs treatment depends on the diagnosis.

For infections such as trichomoniasis, chlamydia and gonorrhoea, partner notification, testing and/or treatment can be important to prevent reinfection and further transmission.

Yeast infection generally does not require routine treatment of an asymptomatic sexual partner.

Management of BV and partners continues to evolve as new evidence emerges, so follow current advice from your healthcare professional.

The Bottom Line

“Vaginal infection” is not one single disease.

Vaginal symptoms can result from bacterial vaginosis, vaginal candidiasis, trichomoniasis, chlamydia, gonorrhoea, irritation, hormonal changes and several other conditions.

Because symptoms often overlap, guessing the diagnosis from discharge colour or smell can lead to inappropriate treatment.

Remember these key points:

Normal vaginal discharge is healthy.

The vagina is self-cleaning and does not need douching.

BV and yeast infection are not simply signs of poor hygiene.

Chlamydia and gonorrhoea are different infections.

Trichomoniasis is an STI caused by a parasite.

Garlic and other home remedies should not be inserted into the vagina.

Persistent, recurrent or unusual symptoms deserve proper assessment.

Getting the correct diagnosis is the best way to choose the correct treatment.

Medical Disclaimer

This article provides general health information for an international audience and is not a substitute for medical diagnosis, examination or treatment. Vaginal symptoms can have many causes, and treatments differ depending on the diagnosis. If you have persistent, severe or recurrent symptoms, are pregnant, or think you may have a sexually transmitted infection, consult an appropriate qualified healthcare professional.

Sources and Further Reading

World Health Organization — Sexually transmitted infections

https://www.who.int/health-topics/sexually-transmitted-infections

World Health Organization — Trichomoniasis

https://www.who.int/news-room/fact-sheets/detail/trichomoniasis

World Health Organization — Chlamydia

https://www.who.int/news-room/fact-sheets/detail/chlamydia

World Health Organization — Recommendations for treatment of common sexually transmitted and genital infections

https://www.who.int/publications/i/item/9789240096370

American College of Obstetricians and Gynecologists — Vaginitis

https://www.acog.org/womens-health/faqs/vaginitis

American College of Obstetricians and Gynecologists — Vulvovaginal Health

https://www.acog.org/womens-health/faqs/vulvovaginal-health

Centers for Disease Control and Prevention — Bacterial Vaginosis

https://www.cdc.gov/std/treatment-guidelines/bv.htm

Centers for Disease Control and Prevention — Vulvovaginal Candidiasis

https://www.cdc.gov/std/treatment-guidelines/candidiasis.htm

Jaundice: Causes, Symptoms, Treatment and When to Seek Medical Help

Jaundice: Causes, Symptoms, Treatment and When to Seek Medical Help

Jaundice is the yellowing of the skin, the whites of the eyes and sometimes other tissues because too much of a substance called bilirubin has accumulated in the body.

It can occur in newborn babies, children and adults.

Jaundice is not a disease by itself. Instead, it is a visible sign that something is affecting the production, processing or removal of bilirubin.

Some causes are relatively harmless, while others require urgent medical treatment.

For that reason, new or unexplained jaundice should not simply be treated at home without determining its cause.

What Is Bilirubin?

Your body continuously replaces old red blood cells.

When red blood cells are broken down, haemoglobin is processed and bilirubin is produced.

The liver plays a major role in processing bilirubin.

After bilirubin has been processed by the liver, it passes into bile and eventually leaves the body, mainly through the digestive system.

If too much bilirubin is produced, the liver cannot process it normally, or bile cannot flow properly, bilirubin can accumulate in the blood.

As levels rise, the skin and whites of the eyes may become yellow.

What Does Jaundice Look Like?

The most recognisable sign is a yellow colour in the whites of the eyes or skin.

Jaundice can be more difficult to recognise from skin colour alone in people with darker skin tones.

Looking at the whites of the eyes may make the yellow colour easier to notice.

However, visual appearance alone cannot determine the bilirubin level or identify the cause.

Medical testing may be necessary.

Is Jaundice the Same as Liver Disease?

No.

Jaundice can be a sign of liver disease, but not everyone with jaundice has the same liver problem.

Bilirubin can build up for several different reasons.

A useful way to understand the causes is to consider three broad situations:

1. too much bilirubin is being produced,
2. the liver is having difficulty processing or removing bilirubin, or
3. bile flow from the liver is blocked or impaired.

The actual cause needs to be identified before appropriate treatment can be selected.

What Causes Jaundice in Adults?

Many conditions can cause jaundice.

Viral Hepatitis

Hepatitis means inflammation of the liver.

Several viruses can cause hepatitis, including hepatitis A, B, C, D and E.

Some forms cause short-term illness, while hepatitis B and C can become chronic and eventually cause serious liver damage.

Jaundice can occur during viral hepatitis, although not everyone with hepatitis develops noticeable jaundice.

Alcohol-Related Liver Disease

Heavy alcohol consumption over time can damage the liver.

Advanced liver injury may interfere with the liver's ability to process bilirubin and can result in jaundice.

Not everyone who drinks alcohol develops liver disease, but long-term excessive consumption increases the risk.

Metabolic Dysfunction-Associated Steatotic Liver Disease

Fat can accumulate in the liver and, in some people, cause inflammation and progressive liver damage.

This condition is associated with metabolic risk factors such as obesity and type 2 diabetes.

Advanced liver disease may eventually cause jaundice.

Cirrhosis

Cirrhosis occurs when long-term liver damage causes extensive scarring.

Possible causes include chronic hepatitis B or C, alcohol-related liver disease and metabolic liver disease.

As cirrhosis progresses, jaundice can develop because the damaged liver can no longer perform its normal functions effectively.

Gallstones

Gallstones can sometimes block the tubes that carry bile from the liver and gallbladder into the intestine.

A blockage can cause bilirubin to accumulate.

Depending on the circumstances, someone may also experience significant abdominal pain, nausea, vomiting or fever.

Pancreatic or Bile-Duct Problems

Diseases affecting the pancreas or bile ducts can obstruct bile flow.

These include inflammation, narrowing of the bile ducts and, less commonly, cancer.

Jaundice accompanied by unexplained weight loss or persistent abdominal symptoms should be medically investigated.

Blood Disorders

Conditions that cause red blood cells to break down unusually quickly can produce more bilirubin than the liver can process efficiently.

This is called haemolysis.

Certain inherited and acquired blood disorders can cause haemolysis.

Certain Medicines and Toxins

Some medicines, herbal products, supplements and toxins can injure the liver or interfere with bilirubin processing.

This does not mean you should stop prescribed medicine simply because jaundice is listed as a possible side effect.

If jaundice develops while taking medication, seek medical advice promptly and tell the healthcare professional about all medicines, supplements and herbal products you use.

Inherited Conditions

Some inherited conditions affect the way bilirubin is processed.

One example is Gilbert syndrome, which can cause mild episodes of increased bilirubin.

People with Gilbert syndrome generally do not develop serious liver damage from the condition itself.

Other inherited bilirubin disorders are much rarer.

Can Malaria Cause Jaundice?

Yes, severe malaria can sometimes cause jaundice.

Malaria can damage red blood cells and, in severe disease, affect organs including the liver.

However, jaundice does not automatically mean someone has malaria.

Where malaria is present, diagnosis should be based on appropriate medical assessment and testing rather than symptoms alone.

What Symptoms Can Occur With Jaundice?

Jaundice itself causes yellow discolouration, but additional symptoms depend on the underlying condition.

These may include:

• yellow skin,
• yellowing of the whites of the eyes,
• dark urine,
• unusually pale or clay-coloured stools,
• itchy skin,
• tiredness,
• nausea or vomiting,
• loss of appetite,
• abdominal pain,
• fever,
• and unexplained weight loss.

The combination of symptoms can provide clues, but laboratory tests and sometimes imaging are required to determine the cause.

Why Can Urine Become Dark?

Certain forms of bilirubin can enter the urine when bilirubin levels rise.

This can make urine appear darker than usual.

Dark urine can have many other causes, including dehydration, medicines, foods and blood in the urine.

Dark urine combined with yellow eyes or skin should therefore be medically assessed.

Why Can Stools Become Pale?

Bile contributes to the normal brown colour of stool.

If bile cannot reach the intestine normally because of an obstruction or another problem, stools may become unusually pale, grey or clay-coloured.

Pale stools together with jaundice can be an important sign of impaired bile flow and should not be ignored.

How Is Jaundice Diagnosed?

A healthcare professional will usually begin by asking about:

• when the yellowing started,
• other symptoms,
• alcohol consumption,
• medicines,
• supplements and herbal products,
• previous liver problems,
• possible hepatitis exposure,
• recent travel,
• and relevant family or medical history.

A physical examination may also be performed.

Blood Tests

Blood tests are commonly used to investigate jaundice.

These may include:

• total and direct bilirubin,
• liver enzymes,
• blood-cell measurements,
• tests of liver function,
• and tests for hepatitis or other conditions when appropriate.

The pattern of the test results can help determine whether the problem involves the liver, increased red-blood-cell breakdown or obstruction of bile flow.

Imaging Tests

Depending on the suspected cause, imaging may be recommended.

This can include:

• ultrasound,
• CT scanning,
• MRI,
• or specialised imaging of the bile ducts.

An ultrasound is often useful when gallstones or bile-duct obstruction is suspected.

Not everyone with jaundice needs every type of scan.

Is There a Treatment for Jaundice?

There is no single treatment that simply “cures jaundice.”

Treatment depends on why bilirubin has accumulated.

For example:

• a bile-duct blockage may need to be relieved,
• some infections require specific treatment,
• chronic hepatitis may require antiviral treatment,
• medication-related liver injury may require changes directed by a healthcare professional,
• certain blood disorders require their own treatment,
• and serious liver disease may need specialist management.

The goal is to treat the underlying condition rather than merely trying to remove the yellow colour.

Can Diet Cure Jaundice?

No particular food or “liver cleanse” has been proven to cure all causes of jaundice.

A nutritious diet can support general health, but it cannot remove a gallstone blocking a bile duct, cure hepatitis C by itself or reverse every form of serious liver disease.

Be particularly cautious of products advertised online as:

• liver detoxes,
• jaundice cleanses,
• herbal liver cures,
• bilirubin flushes,
• or guaranteed hepatitis treatments.

Some herbal products and supplements can themselves cause liver injury.

Can Jaundice Be Prevented?

Because jaundice has many causes, there is no single method that prevents every case.

However, some underlying conditions can be prevented or their risks reduced.

Vaccination Against Hepatitis

Vaccination is an important way to prevent certain viral hepatitis infections.

Safe and effective vaccines are available against hepatitis A and hepatitis B.

Hepatitis B vaccination is particularly important globally because chronic hepatitis B can eventually cause cirrhosis and liver cancer.

There is currently no effective vaccine against hepatitis C.

Fortunately, modern antiviral medicines can cure more than 95% of people with hepatitis C infection.

Vaccine recommendations differ between countries, ages and risk groups, so follow the immunisation guidance where you live.

Reduce Viral Hepatitis Risk

Depending on the particular hepatitis virus, prevention measures can include:

• vaccination where available,
• safe food and drinking water,
• good hand hygiene,
• avoiding sharing needles,
• safe medical injections,
• properly sterilised tattooing and piercing equipment,
• screened blood supplies,
• and safer sexual practices.

Different hepatitis viruses spread in different ways, so prevention is not identical for every type.

Protect Your Liver From Alcohol-Related Harm

Avoiding or limiting alcohol can reduce the risk of alcohol-related liver disease.

Someone who drinks heavily every day and may be physically dependent on alcohol should seek professional advice before suddenly stopping, because alcohol withdrawal can sometimes be dangerous.

Be Careful With Medicines and Supplements

Take medicines according to instructions.

Do not exceed recommended doses.

Do not combine medicines without checking whether it is safe.

And tell your healthcare professional about supplements and herbal products you use.

“Natural” does not automatically mean harmless to the liver.

Maintain Overall Metabolic Health

Regular physical activity, nutritious eating and appropriate weight management can help reduce the risk of metabolic conditions associated with fatty liver disease.

These habits support general liver health, but they cannot guarantee that jaundice will never occur.

Jaundice in Newborn Babies Is Different

Jaundice is very common during the first days after birth.

Newborn babies naturally break down red blood cells, and their developing liver may initially be less efficient at processing bilirubin.

Many newborns therefore develop mild jaundice that resolves.

However, newborn jaundice should still be monitored carefully because very high bilirubin levels can be dangerous.

Why High Bilirubin Can Be Dangerous for Babies

If a newborn's bilirubin becomes extremely high, bilirubin can affect the brain.

Severe untreated hyperbilirubinaemia can cause a rare but serious form of brain injury known as kernicterus.

This is why significant newborn jaundice should never be dismissed simply because jaundice is common in babies.

When Does a Jaundiced Baby Need Urgent Assessment?

Seek prompt medical care for a newborn if:

• jaundice appears during the first 24 hours after birth,
• the yellow colour is becoming rapidly more intense,
• the palms or soles appear yellow,
• the baby is difficult to wake,
• the baby is feeding poorly,
• the baby has abnormal movements or seizures,
• the baby has breathing difficulties,
• the baby has fever or seems seriously unwell,
• or you are otherwise concerned.

Healthcare professionals may measure bilirubin through the skin or with a blood test.

Treatment depends on the bilirubin level, baby's age, gestational age and other risk factors.

How Is Newborn Jaundice Treated?

Many babies with mild jaundice require monitoring rather than treatment.

When bilirubin becomes high enough to require treatment, phototherapy may be used.

Phototherapy uses special light to help the baby's body eliminate bilirubin.

More severe cases may require additional hospital treatment.

Do not try to treat significant newborn jaundice by simply putting a baby in direct sunlight.

Professional assessment is important because visual inspection alone cannot reliably determine the bilirubin level.

When Should an Adult With Jaundice Seek Medical Care?

New unexplained jaundice in an adult should be medically assessed promptly.

Do not wait several weeks to see whether yellow eyes disappear on their own.

Seek medical attention particularly if jaundice occurs with:

• abdominal pain,
• fever,
• persistent vomiting,
• confusion,
• unusual sleepiness,
• bleeding,
• very pale stools,
• dark urine,
• unexplained weight loss,
• severe weakness,
• or rapidly worsening illness.

When Is Jaundice an Emergency?

Seek urgent medical attention or contact the emergency medical service where you live if someone with jaundice:

• becomes confused or difficult to wake,
• loses consciousness,
• has severe abdominal pain with fever,
• has significant bleeding or vomits blood,
• has severe breathing difficulty,
• develops seizures,
• or appears critically ill.

These symptoms can indicate a serious underlying illness and should not be managed using home remedies.

Jaundice and Liver Failure

Jaundice does not automatically mean that the liver is failing.

However, severe liver failure can cause jaundice together with other dangerous symptoms.

These can include confusion, abnormal bleeding, swelling, severe weakness and deterioration in consciousness.

Acute liver failure is a medical emergency.

This is another reason sudden jaundice combined with serious symptoms requires urgent evaluation.

What About Children Who Are No Longer Newborns?

Jaundice in an older baby or child should not automatically be assumed to be normal newborn jaundice.

Possible causes differ by age and circumstances.

A child who develops yellow skin or yellow eyes should be medically assessed so the underlying cause can be identified.

Five Important Things to Remember About Jaundice

1. Jaundice is a sign, not one disease.
Many different conditions can cause bilirubin to accumulate.

2. Yellow eyes matter.
New unexplained yellowing of the whites of the eyes deserves medical attention.

3. Don't diagnose the cause yourself.
Jaundice can result from liver disease, blood disorders, bile obstruction, infections and other conditions.

4. Babies require special attention.
Newborn jaundice is common, but very high bilirubin can be dangerous.

5. Treat the cause—not just the colour.
There is no universal food, supplement or detox remedy for jaundice.

The Bottom Line

Jaundice occurs when bilirubin accumulates and causes yellowing of the skin and whites of the eyes.

It is a sign of an underlying process rather than a disease itself.

In adults, possible causes include viral hepatitis, liver disease, gallstones, bile-duct obstruction, blood disorders, certain medicines and other medical conditions.

In newborns, jaundice is common, but high bilirubin levels can occasionally cause serious complications and therefore need appropriate monitoring.

Treatment depends entirely on the cause.

There is no single diet, herbal remedy or “detox” that safely treats every form of jaundice.

If you or your child develops unexplained jaundice, seek appropriate medical assessment rather than trying to determine the cause from skin colour alone.

Medical Disclaimer

This article provides general health information for an international audience and is not a substitute for medical diagnosis or treatment. Jaundice has many possible causes, some of which can be serious. New or unexplained jaundice should be assessed by an appropriate healthcare professional. For severe or rapidly worsening symptoms, seek urgent medical care or contact the emergency medical service where you live.

Sources and Further Reading

World Health Organization — Hepatitis A

https://www.who.int/news-room/fact-sheets/detail/hepatitis-a

World Health Organization — Hepatitis B

https://www.who.int/news-room/fact-sheets/detail/hepatitis-b

World Health Organization — Hepatitis C

https://www.who.int/news-room/fact-sheets/detail/hepatitis-c

World Health Organization — Caring for a Newborn

https://www.who.int/tools/your-life-your-health/life-phase/newborns-and-children-under-5-years/caring-for-newborns

National Institute of Diabetes and Digestive and Kidney Diseases — Liver Disease

https://www.niddk.nih.gov/health-information/liver-disease

Low Sperm Count: Causes, Testing, Treatment and Ways to Support Fertility

Low Sperm Count: Causes, Testing, Treatment and Ways to Support Fertility

Low sperm count is one possible factor in male infertility, but fertility is more complicated than simply having a particular number of sperm.

A person can have a low sperm count and still contribute to a pregnancy. Likewise, having a sperm count within a reference range does not guarantee fertility.

Sperm movement, shape, semen quality, reproductive health and the fertility of both partners can all affect the chance of conception.

If you are concerned about fertility, proper medical assessment is much more useful than relying on foods, supplements or products advertised as “sperm boosters.”

What Is a Low Sperm Count?

Sperm are reproductive cells produced in the testicles and released in semen during ejaculation.

A lower-than-expected concentration of sperm in semen is commonly called a low sperm count or oligospermia.

A complete absence of sperm from semen is called azoospermia.

But sperm count is only one component of semen quality.

A semen analysis can also assess characteristics such as:

• sperm concentration,
• total sperm number,
• sperm movement, known as motility,
• sperm shape, known as morphology,
• semen volume,
• and other characteristics.

A single number should therefore not be used to judge someone's entire fertility potential.

Low Sperm Count Does Not Mean Sterility

This is important.

A low sperm count does not automatically mean that someone cannot contribute to a pregnancy.

Lower sperm numbers may reduce the probability of fertilisation, but conception may still occur naturally in some cases.

Similarly, someone can have a sperm count within a reference range and still experience fertility difficulties.

WHO explains that semen analysis can provide useful information about male reproductive function, but it cannot by itself confirm whether an individual is fertile or infertile.

Fertility involves several factors.

How Common Is Infertility?

Infertility is a major global health issue.

The World Health Organization estimates that approximately 1 in 6 people of reproductive age worldwide experience infertility during their lifetime.

WHO defines infertility as failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse.

Infertility can result from:

• male factors,
• female factors,
• a combination of factors affecting both partners,
• or unexplained causes.

This is why fertility problems should not automatically be blamed on either partner.

What Can Cause Low Sperm Count?

Producing healthy sperm requires several parts of the reproductive and hormonal systems to function properly.

Sometimes doctors can identify a cause.

In other cases, the exact cause remains unclear.

Possible causes and contributing factors include the following.

1. Varicocele

A varicocele is an enlargement of veins within the scrotum.

It is associated with male infertility and may affect sperm production or quality in some people.

Not every varicocele requires treatment.

A fertility specialist can determine whether treatment is appropriate based on symptoms, examination, semen results and individual circumstances.

2. Hormonal Problems

Sperm production depends on hormones involving the brain, pituitary gland and testicles.

Hormonal disorders can therefore affect sperm production.

Blood tests may sometimes be required when a healthcare professional suspects an underlying hormonal problem.

3. Infections

Certain infections can affect reproductive health.

Some infections may interfere with sperm production or sperm health, while others may cause inflammation or scarring that affects the reproductive tract.

Sexually transmitted infections can also affect fertility.

If an infection is suspected, appropriate testing and treatment are important.

4. Blockages in the Reproductive Tract

Sperm travel through a system of small tubes before being released in semen.

These tubes can sometimes become blocked because of:

• previous infection,
• injury,
• surgery,
• or conditions present from birth.

Treatment depends on where the blockage is located and what caused it.

5. Undescended Testicles

Some males are born with one or both testicles that did not descend normally into the scrotum.

A history of undescended testicles can be associated with reduced fertility later in life.

6. Genetic Conditions

Certain genetic conditions can interfere with sperm production.

When sperm numbers are extremely low or sperm are completely absent, a fertility specialist may recommend genetic testing in appropriate cases.

7. Some Medical Treatments

Certain treatments can affect sperm production.

These can include some:

• chemotherapy treatments,
• radiation treatments,
• hormonal treatments,
• medicines,
• and surgeries involving reproductive structures.

The effect varies depending on the particular treatment.

If future fertility is important before cancer treatment or another treatment known to affect fertility, ask about fertility preservation such as sperm freezing before treatment begins.

8. Anabolic Steroids and Testosterone

This deserves special attention.

Anabolic steroids used for bodybuilding can interfere with the hormonal signals needed for normal sperm production.

Taking external testosterone can also suppress sperm production.

Someone hoping to conceive should tell their healthcare professional about testosterone, anabolic steroids or other hormone products they use.

Never stop prescribed treatment without discussing it with the healthcare professional who manages it.

9. Smoking

Smoking tobacco is associated with poorer reproductive health and may negatively affect semen quality.

Stopping smoking benefits much more than fertility—it also reduces risks involving the heart, lungs and many other areas of health.

10. Excessive Alcohol

Heavy or ongoing alcohol consumption can affect testosterone and sperm production.

People trying to conceive should avoid excessive alcohol consumption.

11. Recreational Drugs

Some recreational drugs may negatively affect male reproductive function.

Drug use can also affect sexual function, hormone levels and general health.

If stopping a substance is difficult, professional support may help.

12. Obesity

Obesity is associated with male infertility and can affect reproductive hormones and sperm quality.

However, fertility problems should not simply be blamed on someone's body weight.

Many factors may be involved.

If weight management is appropriate, gradual improvements in nutrition, physical activity, sleep and overall health are preferable to extreme diets or unproven fertility supplements.

13. Environmental and Workplace Exposures

Certain environmental exposures may affect fertility.

Examples include excessive exposure to:

• some pesticides,
• organic solvents,
• heavy metals such as lead,
• radiation,
• and other reproductive toxins.

People who work around potentially hazardous substances should follow appropriate occupational safety procedures and use recommended protective equipment.

14. Excessive Heat

The testicles function at a temperature slightly below normal core body temperature.

Repeated or prolonged overheating of the scrotum may temporarily affect sperm production or function.

If you are trying to conceive, avoiding unnecessary prolonged heat exposure around the testicles is a reasonable precaution.

However, fertility is complicated, and occasional heat exposure does not mean someone will become infertile.

What About Laptops on the Lap?

The old version of this article stated that putting a laptop on your lap causes low sperm count.

The evidence is not strong enough to make such a simple cause-and-effect claim.

A laptop can generate heat, however, and prolonged direct use on the lap can increase temperature around the scrotum.

Using a desk or other suitable surface during long computer sessions is a reasonable way to reduce unnecessary heat exposure.

But a laptop should not automatically be blamed when someone has fertility difficulties.

Does Cycling Cause Low Sperm Count?

Cycling should not simply be listed as a cause of infertility.

Cycling provides valuable cardiovascular and general health benefits.

Very prolonged or intensive cycling may sometimes cause genital discomfort, numbness or other problems, particularly when bicycle fit or saddle position is poor.

Evidence concerning cycling and male fertility is mixed.

There is therefore no reason for most people to stop normal recreational cycling because they fear becoming infertile.

If cycling causes persistent genital numbness, pain or other symptoms, consider adjusting the bicycle setup and seek professional advice if symptoms continue.

Can Stress Affect Fertility?

Severe or prolonged stress can affect overall health, sexual function and wellbeing.

Research has also explored relationships between psychological stress and semen quality.

But infertility should not be dismissed as being caused simply by “stress.”

Fertility difficulties themselves can be extremely stressful.

Support from a healthcare professional, counsellor or fertility service may help individuals and couples cope with the emotional impact.

How Is Low Sperm Count Diagnosed?

The main test is a semen analysis.

A semen sample is examined in a laboratory to evaluate sperm and semen characteristics.

Because sperm numbers naturally vary and sample collection can influence results, a healthcare professional may recommend more than one semen analysis rather than making an important diagnosis from one sample.

Sperm production also takes time.

This means lifestyle changes made today may not be reflected immediately in a semen test.

What Happens During a Semen Analysis?

The laboratory examines the semen sample according to standardised procedures.

Instructions for collection should be followed carefully because an incomplete sample can affect the result.

Depending on the laboratory or fertility service, you may be asked to avoid ejaculation for a specified number of days before providing the sample.

WHO publishes an international laboratory manual designed to standardise the examination and processing of human semen.

If an initial result is abnormal, additional testing may be needed.

What Other Tests May Be Needed?

Depending on the results and medical history, further investigation can include:

• physical examination,
• hormone blood tests,
• scrotal ultrasound,
• genetic testing in selected cases,
• urine testing after ejaculation,
• tests for infection,
• and other specialised investigations.

Not everyone requires all of these tests.

The investigation should be tailored to the individual.

Can You Increase Your Sperm Count Naturally?

There is no guaranteed natural method that will increase sperm count in every person.

This is because low sperm count has many possible causes.

If the problem is caused by a hormonal disorder, obstruction, varicocele, genetic condition or another medical issue, eating a particular food is unlikely to solve the underlying problem.

Nevertheless, maintaining good overall health and avoiding known reproductive risks may help support normal fertility.

Lifestyle Habits That May Support Male Fertility

Don't Smoke

If you smoke, stopping is one of the most worthwhile changes you can make for your overall health and may also benefit reproductive health.

Avoid Recreational Drugs and Anabolic Steroids

Anabolic steroids are particularly important because they can substantially suppress sperm production.

Avoid Excessive Alcohol

Keep alcohol consumption moderate or avoid it, particularly when trying to conceive.

Eat a Balanced Diet

Aim for a varied diet containing:

• vegetables,
• fruits,
• whole grains,
• suitable protein sources,
• healthy fats,
• and a range of nutrient-rich foods.

Good nutrition supports general health and normal body function.

Exercise Regularly

Regular physical activity supports cardiovascular health, metabolic health, body-weight management and mental wellbeing.

Extreme exercise or anabolic-steroid use should not be confused with ordinary healthy physical activity.

Get Adequate Sleep

Sleep is an important part of overall health.

Maintain a regular sleep routine and aim for adequate, good-quality sleep.

Manage Excessive Heat Exposure

Avoid unnecessarily overheating the testicles for prolonged periods, especially when actively trying to conceive.

Reduce Harmful Chemical Exposure

Follow workplace and environmental safety guidance when working with pesticides, solvents, heavy metals or other potentially hazardous chemicals.

Do Oysters Increase Sperm Count?

The old KandyWandy article recommended eating eight or more oysters every week because oysters contain zinc.

That specific recommendation should be removed.

Zinc is an essential nutrient involved in normal reproductive function, and oysters are rich in zinc.

But this does not establish that eating eight oysters every week treats low sperm count.

More zinc is not automatically better.

A varied diet can provide zinc from several foods.

People with a diagnosed nutritional deficiency should receive appropriate dietary or medical advice rather than attempting to treat infertility with large amounts of one food.

Does Dark Chocolate Boost Sperm Production?

There is no strong evidence that eating dark chocolate is a reliable treatment for low sperm count.

Dark chocolate contains various plant compounds, but describing it as a “sperm booster” goes beyond the evidence.

It can certainly be enjoyed as part of a balanced diet, but it should not be marketed as fertility medicine.

What About Garlic, Walnuts and Ginseng?

Some foods and herbal products have been studied for possible effects on semen parameters.

But individual studies do not justify promising that garlic, walnuts, ginseng or another single food will correct male infertility.

A healthy dietary pattern matters more than searching for a miracle fertility food.

Do Fertility Supplements Work?

Many products are marketed to men using terms such as:

“increase sperm count,” “boost testosterone,” “male fertility formula” or “supercharge sperm.”

Be cautious.

Antioxidants, vitamins, minerals and herbal products have been studied for male infertility, but evidence is inconsistent and product quality varies.

Supplements can also:

• contain unnecessarily high doses,
• interact with medicines,
• cause side effects,
• or distract someone from finding the actual cause of infertility.

Do not assume that “natural” means effective or risk-free.

Discuss supplements with an appropriate healthcare professional, particularly if you take regular medication or have a medical condition.

How Is Low Sperm Count Treated?

Treatment depends on the underlying cause.

Options may include:

Treating an Underlying Medical Problem

An infection, hormonal disorder or other condition may require specific treatment.

Surgery

Surgery may be appropriate in selected cases, such as certain varicoceles or blockages.

Surgery is not appropriate for every person with low sperm count.

Hormonal Treatment

Certain hormonal problems can be treated with medicines under specialist supervision.

Treatment for Sexual Problems

Erectile dysfunction, ejaculation problems and other sexual difficulties can sometimes interfere with conception and may be treatable.

Assisted Reproductive Technology

When natural conception is difficult, fertility specialists may discuss assisted reproductive options.

These can include:

• intrauterine insemination (IUI),
• in vitro fertilisation (IVF),
• and intracytoplasmic sperm injection (ICSI).

ICSI involves injecting a single sperm directly into an egg and can be useful in some cases of male-factor infertility.

Which treatment is appropriate depends on both partners' circumstances.

When Should You Seek Fertility Advice?

WHO defines infertility as not achieving pregnancy after 12 months or more of regular unprotected sexual intercourse.

At that stage, both partners should generally be evaluated rather than assuming the problem belongs to one person.

Earlier medical advice may be appropriate if there are known fertility risk factors.

For men, these can include:

• previous testicular injury,
• undescended testicles,
• testicular surgery,
• chemotherapy or radiation,
• problems with erections or ejaculation,
• pain, swelling or a lump in the testicle,
• previous reproductive tract surgery,
• or another known reproductive condition.

Age and reproductive history of the other partner may also influence when fertility assessment should begin.

Male Infertility Is Not a Measure of Masculinity

Fertility problems can have a major emotional impact.

A low sperm count does not make someone less masculine, and infertility should not be treated as a source of shame.

WHO recognises infertility as a disease of the reproductive system and a global health issue affecting millions of people.

It can affect individuals, relationships and families.

Seeking appropriate medical care is a responsible health decision.

Fertility Is a Shared Issue

When a couple has difficulty conceiving, it is important not to automatically blame either person.

Male factors can contribute.

Female factors can contribute.

Both may contribute simultaneously.

And sometimes no definite cause can be found.

A fertility assessment therefore often involves evaluating both partners.

This approach is more medically accurate and can prevent unnecessary blame or stigma.

The Bottom Line

Low sperm count means that semen contains fewer sperm than expected, but sperm count alone does not determine whether someone is fertile.

Sperm movement, shape and function—as well as the reproductive health of both partners—also matter.

Possible causes of low sperm count include medical conditions, hormonal disorders, varicocele, infections, genetic factors, certain medicines and treatments, smoking, excessive alcohol, anabolic steroids, obesity, excessive heat and some environmental exposures.

Healthy lifestyle choices may support reproductive health, but there is no single food, herb, vitamin or supplement proven to “boost” sperm count in everyone.

Oysters, dark chocolate, garlic, walnuts and ginseng should therefore not be presented as guaranteed treatments.

If you are concerned about fertility, the most useful next step is appropriate medical evaluation, beginning with a health assessment and semen analysis when indicated.

Identifying the underlying cause gives you and your healthcare professional a much better basis for deciding what treatment—if any—is likely to help.

Medical Disclaimer

This article provides general health information for an international audience. It is not a substitute for individual medical advice, diagnosis or fertility treatment. Do not stop prescribed medication, testosterone or other medical treatment without consulting an appropriate healthcare professional. Anyone experiencing fertility difficulties or concerning reproductive symptoms should seek assessment from a qualified healthcare professional or fertility specialist.

Sources and Further Reading

World Health Organization — Infertility

https://www.who.int/news-room/fact-sheets/detail/infertility

World Health Organization — Guideline for the prevention, diagnosis and treatment of infertility

https://www.who.int/publications/i/item/9789240115774

World Health Organization — Laboratory manual for the examination and processing of human semen

https://www.who.int/publications/i/item/9789240030787

Mayo Clinic — Low sperm count: Symptoms and causes

https://www.mayoclinic.org/diseases-conditions/low-sperm-count/symptoms-causes/syc-20374585

Mayo Clinic — Low sperm count: Diagnosis and treatment

https://www.mayoclinic.org/diseases-conditions/low-sperm-count/diagnosis-treatment/drc-20374591

Back Pain: Causes, Prevention, Treatment and Warning Signs

Back Pain: Causes, Prevention, Treatment and Warning Signs

Back pain is extremely common and can affect people of almost any age.

It may appear suddenly after lifting something, develop gradually, or occur without an obvious cause.

For some people it lasts only a few days or weeks. For others, it can persist or repeatedly return.

The good news is that most low back pain is not caused by a serious disease, and many people recover with time, appropriate movement and self-care.

Understanding back pain can help you respond appropriately without either ignoring important symptoms or becoming unnecessarily frightened.

How Common Is Low Back Pain?

Low back pain is one of the world's most common health problems.

According to the World Health Organization (WHO), approximately 619 million people worldwide were living with low back pain in 2020.

WHO estimates that this could increase to about 843 million people by 2050, partly because populations are growing and ageing.

Low back pain is also the leading cause of disability worldwide.

It is therefore not simply a problem affecting office workers, older adults or people who perform heavy physical work.

It can affect almost anyone.

What Is Low Back Pain?

Low back pain generally describes pain between the lower edge of the ribs and the buttocks.

It may feel like:

• a dull ache,
• stiffness,
• soreness,
• muscle tension,
• burning,
• or a sharp pain.

Sometimes pain can spread from the lower back into the buttock or leg.

Pain travelling down a leg may sometimes involve irritation or compression of a spinal nerve and can be accompanied by tingling, numbness or weakness.

What Causes Back Pain?

There isn't always an identifiable cause.

In fact, WHO reports that approximately 90% of low back pain is non-specific.

This means healthcare professionals cannot confidently attribute the pain to one particular disease or structural abnormality.

Back pain may involve a combination of muscles, joints, ligaments, discs, nerves and other factors.

Possible causes or contributing factors can include:

• muscle or ligament strain,
• lifting or moving loads,
• awkward or repetitive movements,
• prolonged static positions,
• physical inactivity,
• falls or other injuries,
• certain spinal conditions,
• inflammatory conditions,
• fractures,
• and, less commonly, other diseases.

Psychological and social factors such as stress can also influence persistent pain.

Back pain is therefore often more complicated than simply having “bad posture.”

Is Sitting All Day Bad for Your Back?

Long periods of sitting can contribute to discomfort, particularly when combined with little movement.

But the old idea that sitting in one imperfect position automatically damages your spine is too simplistic.

Work-related musculoskeletal problems are influenced by several factors, including:

• prolonged static positions,
• repetitive movements,
• awkward postures,
• heavy physical work,
• lifting,
• pushing or pulling,
• vibration,
• workload,
• and psychosocial factors.

Rather than trying to maintain one supposedly “perfect” posture throughout the entire day, focus on having a reasonably comfortable workstation and changing position regularly.

Movement matters.

Is There a Perfect Sitting Posture?

There is no single sitting position that everyone must maintain every minute of the day.

A comfortable workstation can still make a significant difference.

When working at a desk, consider:

• supporting your back,
• keeping your feet comfortably supported,
• positioning your screen so you do not constantly bend your neck,
• keeping frequently used items within easy reach,
• avoiding unnecessary twisting,
• and changing position regularly.

If your feet cannot comfortably reach the floor, a suitable footrest may help.

The important principle is not to become rigidly obsessed with sitting perfectly straight.

Comfort, support and regular movement are more realistic goals.

Take Regular Movement Breaks

Remaining in one position for a long time can contribute to muscle fatigue and discomfort.

If your work involves prolonged sitting, regularly:

• stand up,
• walk for a short period,
• gently change position,
• stretch if comfortable,
• or perform another appropriate movement.

The same principle applies to jobs involving prolonged standing.

Your body generally benefits from variation rather than remaining in one position throughout the day.

How to Lift More Safely

Manual lifting is an important consideration for many workers and people performing everyday tasks.

Before lifting something heavy or awkward:

• consider whether you actually need to lift it manually,
• use lifting equipment where available,
• ask someone to help with heavy or bulky objects,
• keep the load reasonably close to your body,
• avoid unnecessary twisting while carrying it,
• move your feet when changing direction,
• and avoid sudden uncontrolled movements.

There is no single lifting technique that eliminates all risk.

The object's weight, size, shape, frequency of lifting and workplace environment all matter.

People whose jobs involve frequent manual handling may need appropriate workplace training and ergonomic assessment.

Does Exercise Help Back Pain?

Physical activity is an important part of maintaining overall musculoskeletal health.

For most non-specific back pain, prolonged inactivity is generally not helpful.

Appropriate movement and exercise can help improve:

• strength,
• mobility,
• physical function,
• confidence in movement,
• and ability to return to everyday activities.

Exercise does not have to mean intense gym training.

Depending on your circumstances, activities might include:

• walking,
• swimming,
• appropriate strengthening exercises,
• mobility exercises,
• or another form of activity you enjoy and can perform safely.

People with significant pain, injuries or medical conditions may need advice from an appropriate healthcare professional or physiotherapist before beginning a new exercise programme.

Should You Rest in Bed When Your Back Hurts?

A short period of reduced activity may sometimes be necessary when pain is severe.

However, prolonged bed rest is generally not recommended for ordinary non-specific back pain.

Try to continue normal activities as much as reasonably possible and gradually increase movement according to what you can tolerate.

Being afraid to move at all can sometimes make recovery more difficult.

This doesn't mean exercising aggressively through severe pain.

The aim is sensible, gradual activity.

Can Maintaining a Healthy Weight Help?

Body weight is only one of many factors associated with back pain.

WHO identifies obesity among the risk factors associated with non-specific low back pain.

Maintaining a healthy weight can also benefit overall health.

However, people with back pain should not be made to feel that their pain exists simply because of their weight.

Back pain is usually influenced by multiple factors.

If weight management is appropriate for you, gradual sustainable changes involving nutrition, activity, sleep and other lifestyle habits are preferable to extreme diets.

Does Your Mattress Cause Back Pain?

People often assume that back pain means they need an extremely hard mattress.

There is no universal mattress that is best for everyone.

Comfort and individual preference matter.

A mattress should ideally allow you to sleep comfortably and provide suitable support.

If you consistently wake with pain that improves after getting out of bed, it may be worth considering whether your sleeping environment contributes to your discomfort.

But persistent back pain should not automatically be blamed on the mattress.

What Is the Best Sleeping Position for Back Pain?

There isn't one compulsory sleeping position for everyone.

Choose a position that allows you to sleep comfortably.

Some people with back pain find it comfortable to sleep on their side with a pillow between their knees.

Others prefer sleeping on their back with suitable support.

The goal is comfort rather than forcing your body into a particular position because an internet article claims it is the only healthy way to sleep.

What About High-Heeled Shoes?

The old version of this article simply instructed everyone to avoid high heels.

The relationship between footwear and back pain is more complicated.

If particular footwear consistently causes discomfort or changes the way you walk, choosing a more comfortable alternative may help.

But avoiding one particular type of shoe cannot guarantee that you will never develop back pain.

Comfortable footwear appropriate for your activity is a more practical principle.

Do Tight Clothes Cause Back Pain?

There is not sufficient evidence to list ordinary tight clothing as a major cause of low back pain.

The old article therefore overstated this point.

Clothing that severely restricts movement may be uncomfortable, but back pain usually involves much more important factors.

This claim should not form part of evidence-based back-pain prevention advice.

Do You Need an X-Ray or MRI for Back Pain?

Usually, not immediately.

One of the biggest misconceptions about back pain is that everyone needs an X-ray or MRI scan to find the damaged part of the spine.

Most low back pain is non-specific.

Imaging is therefore not routinely required for uncomplicated back pain.

Scans can also show age-related changes in people who have no back pain at all.

A healthcare professional may recommend imaging when there is reason to suspect:

• a fracture,
• serious injury,
• cancer,
• infection,
• significant nerve involvement,
• or another condition where the result would change treatment.

The decision should be based on your individual circumstances rather than assuming every painful back needs to be scanned.

How Is Back Pain Treated?

Treatment depends on the cause, duration, severity and individual circumstances.

For many episodes of non-specific low back pain, management may include:

• education and reassurance,
• staying appropriately active,
• gradually returning to normal activities,
• exercise,
• physical therapy when appropriate,
• heat or cold for short-term symptom relief,
• and carefully selected medicines when needed.

Persistent back pain may require a broader approach that considers physical, psychological and social factors.

There is rarely one treatment that works for everybody.

What About Painkillers?

Medicines may sometimes help manage symptoms, but they should not be the entire strategy for persistent back pain.

Which pain medicine is appropriate depends on factors such as:

• your age,
• other medicines you take,
• kidney health,
• stomach problems,
• heart conditions,
• pregnancy,
• and other medical conditions.

Do not assume that an over-the-counter medicine is safe for everyone.

Ask a pharmacist, doctor or another qualified healthcare professional if you are uncertain.

Long-term use of strong pain medicines can also create significant risks.

WHO advises against routinely using opioid painkillers for most people with chronic primary low back pain because potential harms can outweigh benefits.

Can Back Pain Be Completely Prevented?

Not always.

This is another correction to the original article.

Even people who exercise regularly, lift carefully and use well-designed workstations can sometimes develop back pain.

Rather than promising complete prevention, focus on reducing modifiable risks and maintaining function.

Helpful habits include:

• regular physical activity,
• maintaining strength and mobility,
• avoiding smoking,
• getting adequate sleep,
• maintaining an appropriate weight,
• varying your position throughout the day,
• reducing unnecessary physical strain,
• using appropriate manual-handling techniques,
• and addressing workplace ergonomic problems.

When Should You Seek Medical Advice?

Consider speaking with a healthcare professional if your back pain:

• is severe or worsening,
• does not improve over time,
• repeatedly returns,
• significantly interferes with everyday activities,
• follows a significant fall or injury,
• is accompanied by unexplained weight loss,
• occurs with fever,
• causes persistent numbness or weakness,
• or concerns you for another reason.

People with cancer, osteoporosis, significant immune problems or other serious medical conditions may need earlier assessment depending on their symptoms.

Warning Signs That Need Urgent Medical Attention

Most back pain is not an emergency.

However, certain symptoms require prompt medical assessment.

Seek urgent medical care or contact your local emergency medical service if back pain occurs with serious symptoms such as:

• new difficulty controlling your bladder or bowel,
• inability to urinate,
• significant numbness around the genitals, buttocks or inner thighs,
• rapidly worsening weakness or numbness in one or both legs,
• major trauma,
• severe back pain accompanied by serious illness,
• or other rapidly worsening neurological symptoms.

These symptoms can occasionally indicate a serious problem affecting nerves in the lower spine.

Do not wait for an internet remedy if serious warning signs are present.

Back Pain Can Affect Mental Wellbeing Too

Persistent pain doesn't affect only muscles and joints.

Long-lasting back pain can interfere with:

• sleep,
• employment,
• family life,
• exercise,
• social activities,
• mood,
• and confidence.

Stress, anxiety and low mood can also influence how pain is experienced.

This does not mean that the pain is imaginary.

Modern back-pain management recognises that physical, psychological and social factors can interact.

Addressing several of these factors together can be more effective than focusing only on a scan or a single painful body part.

Seven Practical Ways to Look After Your Back

1. Keep moving.
Regular physical activity helps maintain strength, mobility and general health.

2. Change position regularly.
Avoid remaining seated or standing in exactly the same position for very long periods.

3. Make your workspace fit you.
Adjust your chair, desk, screen and frequently used equipment where possible.

4. Handle loads sensibly.
Keep loads reasonably close, avoid unnecessary twisting and get assistance with heavy or awkward objects.

5. Build strength gradually.
Regular appropriate exercise can improve the muscles involved in movement and physical function.

6. Prioritise overall health.
Sleep, nutrition, physical activity, not smoking and healthy weight management can all contribute to general musculoskeletal health.

7. Don't ignore warning signs.
Most back pain improves, but unusual or severe neurological symptoms require proper assessment.

The Bottom Line

Back pain is extremely common and can affect people at virtually any age.

It is also the world's leading cause of disability.

But having back pain does not automatically mean that your spine is damaged.

Around 90% of low back pain is classified as non-specific, meaning a single structural cause cannot be confidently identified.

For many people, remaining appropriately active, exercising, varying positions, improving workplace ergonomics and gradually returning to normal activities are important parts of recovery.

Scans are not automatically necessary, prolonged bed rest is generally unhelpful, and no single posture can guarantee protection against back pain.

Most importantly, learn to distinguish common back pain from symptoms that require medical assessment.

Persistent or concerning pain deserves professional advice, while serious neurological symptoms, major trauma or other emergency warning signs require urgent medical attention.

Medical Disclaimer

This article provides general health information for an international audience and is not a substitute for individual medical advice, diagnosis or treatment. Back pain has many possible causes, and appropriate treatment depends on individual circumstances. If you have severe, persistent or worsening symptoms, consult a qualified healthcare professional. For potentially life-threatening symptoms, seek urgent medical care or contact the emergency medical service where you live.

Sources and Further Reading

World Health Organization — Low back pain

https://www.who.int/news-room/fact-sheets/detail/low-back-pain

World Health Organization — Guideline for non-surgical management of chronic primary low back pain

https://www.who.int/publications/i/item/9789240081789

National Institute of Arthritis and Musculoskeletal and Skin Diseases — Back Pain

https://www.niams.nih.gov/health-topics/back-pain

National Institute of Arthritis and Musculoskeletal and Skin Diseases — Back Pain: Diagnosis, Treatment, and Steps to Take

https://www.niams.nih.gov/health-topics/back-pain/diagnosis-treatment-and-steps-to-take

CDC/NIOSH — Ergonomics and Work-Related Musculoskeletal Disorders

https://www.cdc.gov/niosh/ergonomics/about/index.html

Moringa: Nutrition, Possible Health Benefits and Safety

Moringa: Nutrition, Possible Health Benefits and Safety

Moringa has attracted worldwide attention as a nutritious food and traditional herbal remedy.

Often called the “miracle tree” or “drumstick tree,” Moringa oleifera is grown in many tropical and subtropical regions. Its leaves, pods and other parts have been used as foods in Africa and Asia for generations.

Moringa leaves can provide valuable nutrients, which is one reason the plant has become popular as fresh leaves, dried powder, tea and dietary supplements.

But there is an important distinction:

Moringa can be a nutritious food without being a miracle cure.

Claims that moringa can cure diabetes, cancer, infections, kidney disease, asthma, ulcers and many other illnesses go far beyond what current human evidence can establish.

Here is what we currently know.

What Is Moringa?

Moringa oleifera is a fast-growing tree originally associated with the Indian subcontinent and now cultivated widely across tropical and subtropical regions.

It is known by several names, including:

• moringa,
• drumstick tree,
• horseradish tree, and
• ben oil tree.

Different cultures also have their own local names for the plant.

Several parts of the tree have traditionally been used, including its leaves, pods, seeds and flowers.

However, different parts of a plant do not necessarily have the same nutritional properties or safety profile.

That is particularly important when distinguishing moringa eaten as a normal food from concentrated extracts and supplements.

Is Moringa Nutritious?

Yes.

This is one of the best-supported reasons for including moringa leaves in the diet.

The Food and Agriculture Organization of the United Nations describes moringa as a nutritious food crop. Its leaves contain protein, fibre and micronutrients.

Nutrient composition varies depending on factors such as where the plant was grown, whether the leaves are fresh or dried and how they are prepared.

Moringa should therefore be regarded as another nutritious leafy vegetable rather than a food with supernatural properties.

What Nutrients Are Found in Moringa Leaves?

Moringa leaves can provide several nutrients and plant compounds.

Depending on the form and preparation, these may include:

• protein,
• dietary fibre,
• calcium,
• iron,
• carotenoids related to vitamin A,
• vitamin C,
• other vitamins and minerals, and
• various plant compounds.

FAO data demonstrate that moringa leaves can be particularly nutrient-dense. Open Knowledge FAO

However, the amount shown in a laboratory analysis is not necessarily the amount your body absorbs.

Cooking, drying, storage, serving size and other foods eaten at the same meal can all affect the nutritional contribution.

Fresh Moringa vs Moringa Powder

Fresh leaves and dried moringa powder should not be considered nutritionally identical.

Removing water concentrates many nutrients by weight.

That is why 100 grams of dried leaf powder may appear to contain dramatically more nutrients than 100 grams of fresh leaves.

But people usually consume much smaller quantities of powder.

When comparing moringa products, always consider the actual serving size rather than simply comparing nutrients per 100 grams.

How Can Moringa Be Eaten?

Moringa leaves are eaten as vegetables in many parts of the world.

They may be:

• cooked similarly to other leafy vegetables,
• added to soups and stews,
• incorporated into sauces,
• dried and ground into powder, or
• added in small quantities to other foods.

The immature pods are also used as vegetables in some cuisines.

FAO resources describe moringa leaves and pods being prepared and consumed as traditional foods. FAOHome

This long history as a food is different from taking highly concentrated moringa extracts as medicine.

Is Moringa Really a “Miracle Tree”?

“Miracle tree” is a popular nickname, not a medical description.

The name reflects the many traditional uses of the plant, its nutritional value and its ability to grow in difficult environmental conditions.

It should not be interpreted as evidence that moringa can cure diseases.

Calling a food a miracle cure can be particularly misleading when people have serious conditions requiring proven medical treatment.

For KandyWandy, we therefore use the term only to explain the plant's nickname—not as a health claim.

Does Moringa Boost the Immune System?

You may frequently see claims that moringa “boosts immunity.”

This needs more careful wording.

Normal immune function depends on adequate nutrition, and deficiencies in certain nutrients can impair immune function.

Because moringa leaves provide nutrients, they can contribute to an overall nutritious diet.

But there is not sufficient evidence to promise that eating moringa will supercharge the immune system or prevent infections.

No single food creates immunity against every disease.

Moringa should be viewed as part of a varied diet rather than an immune-system medicine.

Can Moringa Treat Diabetes?

Moringa has been studied for possible effects on blood glucose.

Some research is promising, but that does not make moringa a replacement for established diabetes treatment.

Recent systematic reviews have examined clinical trials investigating moringa and blood-glucose control. Some results suggest possible improvements in certain measurements, but researchers have highlighted substantial limitations in the available evidence.

The findings should therefore be considered preliminary rather than proof that moringa treats diabetes.

If you have diabetes, continue taking prescribed medicines and following your healthcare team's advice.

Do not replace diabetes medication with moringa.

Can Moringa Lower Blood Pressure?

Researchers have also investigated whether moringa might affect blood pressure.

Some recent clinical evidence suggests possible blood-pressure effects, but the quality and consistency of available research remain important limitations.

This creates another safety consideration.

If you already take medication that lowers blood pressure, adding concentrated herbal supplements could potentially complicate blood-pressure management.

Never stop prescribed blood-pressure medication because you have started consuming moringa.

Can Moringa Treat Anaemia?

Moringa leaves contain iron, so they can contribute iron to the diet.

But that does not mean moringa should be described as a treatment for all anaemia.

Anaemia has many possible causes.

These include:

• iron deficiency,
• vitamin deficiencies,
• blood loss,
• chronic diseases,
• inherited blood disorders, and
• other medical conditions.

Someone with suspected anaemia should have the cause properly investigated.

If iron deficiency is confirmed, the amount of iron required for treatment may be considerably different from what someone obtains from an ordinary serving of moringa.

Does Moringa Reduce Inflammation?

Moringa contains several biologically active plant compounds, and laboratory and animal studies have investigated possible anti-inflammatory effects.

That research is scientifically interesting.

But results from cells or animals cannot automatically be assumed to produce the same effects in humans.

More high-quality clinical research is needed before moringa can be recommended as a treatment for inflammatory diseases.

Can Moringa Treat Arthritis?

The old version of this article stated that moringa helps reduce inflammation and arthritis.

That is too strong.

Arthritis includes many different conditions with different causes and treatments.

Laboratory evidence concerning anti-inflammatory plant compounds does not prove that eating moringa treats arthritis in people.

Someone with persistent painful, swollen or stiff joints should seek appropriate medical assessment rather than relying on moringa supplements.

Can Moringa Treat Infections?

Moringa should not be presented as an alternative to appropriate treatment for bacterial, viral, fungal or parasitic infections.

Laboratory studies have investigated antimicrobial properties of compounds found in moringa.

However, showing that a substance affects microorganisms in a laboratory is very different from proving that eating moringa safely cures an infection in a human being.

Serious infections may require specific medical treatment.

Do not delay appropriate healthcare while experimenting with herbal remedies.

Can Moringa Treat Stomach Ulcers?

Claims that moringa treats stomach or intestinal ulcers are not supported strongly enough by human clinical evidence to recommend it as ulcer treatment.

Stomach ulcers can be associated with Helicobacter pylori infection and medicines such as non-steroidal anti-inflammatory drugs.

Effective medical treatments are available.

Persistent stomach pain, vomiting blood or passing black, sticky stools requires medical attention.

Can Moringa Treat Asthma?

There is not enough good-quality clinical evidence to recommend moringa as a replacement for established asthma treatment.

Asthma can cause serious breathing difficulties.

Anyone prescribed an inhaler should continue using it according to professional advice.

Do not replace asthma medication with moringa tea, powder or supplements.

Can Moringa Treat Epilepsy?

No reliable evidence establishes moringa as a substitute for anti-seizure medicines.

Stopping epilepsy medication suddenly can be dangerous.

Someone with epilepsy should never discontinue or change prescribed medication because of claims made about a herbal product without discussing it with their healthcare professional.

Can Moringa Treat Kidney Stones?

The old article also listed kidney stones among conditions supposedly treated by moringa.

This should be removed as a treatment claim.

Kidney stones vary in composition and cause, and prevention and treatment depend partly on the type of stone and the person's individual circumstances.

People with kidney disease or recurrent kidney stones should be particularly cautious about using concentrated supplements without professional advice.

Moringa Is Not a Treatment for Snakebite

This point is particularly important.

Do not attempt to treat a snakebite with moringa or another herbal remedy.

Snakebite can be a medical emergency.

Someone who may have been bitten by a venomous snake needs urgent medical assessment and, where appropriate, specific treatment such as antivenom.

Traditional use of a plant does not establish it as a safe substitute for emergency treatment.

Can Moringa Increase Breast Milk?

Moringa has traditionally been used as a galactagogue—a substance intended to increase breast-milk production.

This is an area where newer research is more interesting than many of the plant's other claimed uses.

The U.S. National Library of Medicine's LactMed database, updated in July 2026, reports that a recent meta-analysis of 14 studies involving 865 participants found increases in measures including milk volume and prolactin.

However, LactMed also stresses an important point:

Herbal galactagogues should not replace proper evaluation and counselling about factors affecting milk production. NCBI

Long-term effects on breastfed infants also require further study.

Someone concerned about milk supply should speak with a midwife, health visitor, breastfeeding specialist or other qualified healthcare professional rather than relying solely on supplements.

What About Moringa Supplements?

Eating moringa leaves as part of a normal diet is different from taking capsules, extracts or concentrated powders marketed for medicinal purposes.

Supplements can vary substantially in:

• dose,
• concentration,
• ingredients,
• manufacturing quality and
• purity.

Herbal products can also potentially interact with medicines.

Do not assume that a supplement is safe simply because its ingredients come from a plant.

Is Moringa Safe?

Moringa has a long history of use as food.

The U.S. National Library of Medicine's LiverTox resource describes moringa as generally well tolerated but also reports a recent case in which it was implicated in acute liver injury.

This appears to be rare, but it illustrates why concentrated herbal products should not automatically be assumed harmless. NCBI

Safety can also depend on which part of the plant is being consumed and how it has been prepared.

Food and Herbal Medicine Are Not the Same Thing

This distinction is worth repeating.

A serving of cooked moringa leaves in a soup is not equivalent to swallowing a concentrated herbal extract every day.

Traditional food consumption gives useful information about how a plant has historically been used, but it does not prove that high-dose supplements are safe or effective as medicines.

The greater the concentration and medicinal claim, the more important good-quality clinical evidence becomes.

Who Should Be Particularly Careful?

Speak with a healthcare professional before using concentrated moringa supplements if you:

• take regular prescription medicines,
• take medicines for diabetes,
• take blood-pressure medicines,
• have liver disease,
• have kidney disease,
• are pregnant,
• are breastfeeding and considering high-dose supplements, or
• are considering moringa to treat an existing medical condition.

Do not discontinue prescribed treatment in favour of moringa.

How to Use Moringa Sensibly

For most people interested in moringa primarily as food, a sensible approach is straightforward.

Use the leaves as one of many vegetables in a varied diet.

You can add cooked moringa leaves to soups, stews and sauces or use modest amounts of leaf powder in food.

But don't build your entire diet around one plant.

Healthy eating depends on variety.

Include vegetables and fruit, wholegrain or higher-fibre carbohydrates, suitable sources of protein, and other foods that provide the nutrients your body needs.

What Moringa Cannot Reliably Be Claimed to Cure

Based on current evidence, KandyWandy should not tell readers that moringa cures:

• diabetes,
• high blood pressure,
• anaemia,
• bacterial or viral infections,
• kidney stones,
• stomach ulcers,
• asthma,
• epilepsy,
• arthritis,
• parasitic infections,
• fungal infections, or
• snakebite.

Some of these areas are subjects of laboratory, animal or preliminary human research.

That is not the same as having an established medical treatment.

The Bottom Line

Moringa deserves attention—but primarily because it is a nutritious and versatile food, not because it is a miracle medicine.

Its leaves contain protein, fibre, vitamins, minerals and various plant compounds. Moringa can therefore make a useful contribution to a varied diet.

Scientists are investigating possible effects on blood glucose, blood pressure, inflammation, breast-milk production and other areas.

Some results are promising.

But promising research should not be converted into claims that moringa cures dozens of diseases.

Enjoy moringa as food if it is part of your diet, but maintain realistic expectations about its medicinal properties.

And if you have a medical condition, use evidence-based treatment recommended by qualified healthcare professionals rather than replacing treatment with moringa supplements.

Medical Disclaimer

This article provides general nutrition and health information and is not a substitute for individual medical advice, diagnosis or treatment. Do not stop or change prescribed medication because you are using moringa. Speak with an appropriate healthcare professional before using concentrated moringa supplements if you have a medical condition, take regular medicines, are pregnant or are breastfeeding.

Sources and Further Reading

Food and Agriculture Organization of the United Nations — Compendium of Forgotten Foods

https://openknowledge.fao.org/3/cc5044en/cc5044en.pdf

FAO — Food-based nutrition strategies in Bangladesh

https://www.fao.org/4/ag126e/AG126E10.htm

U.S. National Library of Medicine — LiverTox: Moringa

https://www.ncbi.nlm.nih.gov/books/NBK605172/

U.S. National Library of Medicine — LactMed: Moringa

https://www.ncbi.nlm.nih.gov/books/NBK501899/

PubMed — Effects of Moringa oleifera Supplementation on Cardiometabolic Outcomes: Meta-Analysis of Randomized Controlled Trials

https://pubmed.ncbi.nlm.nih.gov/41305552/