Liver Disease

The liver is an organ that sits just under the rib cage on the right side of the abdomen. It can weigh up to 4 pounds (1.8 kilograms). The liver is needed to help digest food, rid the body of waste products and make substances, called clotting factors, that keep the blood flowing well, among other tasks.

Liver disease can be passed through families, called inherited. Anything that damages the liver also can cause liver problems, including viruses, alcohol use and obesity.

Over time, conditions that damage the liver can lead to scarring, called cirrhosis. Cirrhosis can lead to liver failure, a life-threatening condition. But early treatment may give the liver time to heal.


Liver disease doesn’t always cause symptoms that can be seen or felt. If there are symptoms of liver disease, they may include:

  • Yellowing of the skin and the whites of the eyes, called jaundice. Yellowing of the skin might be harder to see on Black or brown skin.
  • Belly pain and swelling.
  • Swelling in the legs and ankles.
  • Itchy skin.
  • Dark urine.
  • Pale stool.
  • Constant tiredness.
  • Nausea or vomiting.
  • Loss of appetite.
  • Bruising easily.

When to see a doctor

Make an appointment with your healthcare professional if you have any lasting symptoms that worry you. Seek medical help right away if you have belly pain that is so bad that you can’t stay still.


Liver disease has many causes.


Parasites and viruses can infect the liver, causing swelling and irritation, called inflammation. Inflammation keeps the liver from working as it should. The viruses that cause liver damage can be spread through blood or semen, bad food or water, or close contact with a person who is infected.

The most common types of liver infection are hepatitis viruses, including:

  • Hepatitis A.
  • Hepatitis B.
  • Hepatitis C.

Immune system condition

Diseases in which the immune system attacks certain parts of the body are called autoimmune diseases. Autoimmune liver diseases include:

  • Autoimmune hepatitis.
  • Primary biliary cholangitis.
  • Primary sclerosing cholangitis.


A changed gene from one or both parents can cause substances to build up in the liver. This can cause liver damage. Genetic liver diseases include:

  • Hemochromatosis.
  • Wilson’s disease.
  • Alpha-1 antitrypsin deficiency.

Cancer and other growths

Examples include:

  • Liver cancer.
  • Bile duct cancer.
  • Liver adenoma.


Other common causes of liver disease include:

  • Long-term alcohol use.
  • Fat that builds up in the liver, called nonalcoholic fatty liver disease or metabolic-associated steatotic liver disease.
  • Certain prescription or other medicines.
  • Certain herbal mixes.
  • Being in contact often with toxic chemicals.

Risk factors

Factors that can increase the risk of liver disease include:

  • Ongoing moderate or heavy alcohol use.
  • Obesity.
  • Type 2 diabetes.
  • Tattoos or body piercings.
  • Shared needles to inject drugs.
  • Blood transfusion before 1992.
  • Contact with other people’s blood and body fluids.
  • Sex without protection.
  • Contact with chemicals or toxins.
  • Family history of liver disease.


Complications of liver disease depend on the cause of the liver problems. Without treatment, liver disease may progress to liver failure. Liver failure can be fatal.


To prevent liver disease:

  • If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.
  • Avoid risky behavior. Use a condom during sex. If you get tattoos or body piercings, pick a shop that’s clean and safe. Seek help if you shoot illicit drugs. Don’t share needles to shoot drugs.
  • Get vaccinated. If you’re at increased risk of getting hepatitis, talk with your healthcare professional about getting the hepatitis A and hepatitis B vaccines. This also is true if you’ve been infected with any form of the hepatitis virus.
  • Be careful when taking medicines. Take prescription and other medicines only when needed. Take only as much as directed. Don’t mix medicines and alcohol. Talk with your healthcare provider before mixing herbal supplements or prescription or other medicines.
  • Stay away from other people’s blood and body fluids. Hepatitis viruses can be spread by accidental needle sticks or poor cleanup of blood or body fluids.
  • Keep your food safe. Wash your hands well before eating or making foods. If traveling in a resource-poor country, use bottled water to drink, wash your hands and brush your teeth.
  • Take care with aerosol sprays. Make sure to use these products in an open area. Wear a mask when spraying insecticides, fungicides, paint and other toxic chemicals. Always follow the maker’s instructions.
  • Protect your skin. When using insecticides and other toxic chemicals, wear gloves, long sleeves, a hat and a mask so that chemicals don’t get on your skin.
  • Maintain a healthy weight. Obesity can cause nonalcoholic fatty liver disease, now called metabolic-associated steatotic liver disease.

Genital herpes

Genital herpes is a common sexually transmitted infection (STI). The herpes simplex virus (HSV) causes genital herpes. Genital herpes can often be spread by skin-to-skin contact during sexual activity.

Some people infected with the virus may have very mild symptoms or no symptoms. They can still able to spread the virus. Other people have pain, itching and sores around the genitals, anus or mouth.

There is no cure for genital herpes. Symptoms often show up again after the first outbreak. Medicine can ease symptoms. It also lowers the risk of infecting others. Condoms can help prevent the spread of a genital herpes infection.


Most people infected with HSV don’t know they have it. They may have no symptoms or have very mild symptoms.

Symptoms start about 2 to 12 days after exposure to the virus. They may include:

  • Pain or itching around the genitals
  • Small bumps or blisters around the genitals, anus or mouth
  • Painful ulcers that form when blisters rupture and ooze or bleed
  • Scabs that form as the ulcers heal
  • Painful urination
  • Discharge from the urethra, the tube that releases urine from the body
  • Discharge from the vagina

During the first outbreak, you may commonly have flu-like symptoms such as:

  • Fever
  • Headache
  • Body aches
  • Swollen lymph nodes in the groin

Differences in symptom location

Sores appear where the infection enters the body. You can spread the infection by touching a sore and then rubbing or scratching another area of your body. That includes your fingers or eyes.

Sore can develop on or in the:

  • Buttocks
  • Thighs
  • Rectum
  • Anus
  • Mouth
  • Urethra
  • Vulva
  • Vagina
  • Cervix
  • Penis
  • Scrotum

Repeat outbreaks

After the first outbreak of genital herpes, symptoms often appear again. These are called recurrent outbreaks or recurrent episodes.

How often recurrent outbreaks happen varies widely. You’ll usually have the most outbreaks the first year after infection. They may appear less often over time. Your symptoms during recurrent outbreaks usually don’t last as long and aren’t as severe as the first.

You may have warning signs a few hours or days before a new outbreak starts. These are called prodromal symptoms. They include:

  • Genital pain
  • Tingling or shooting pain in the legs, hips or buttocks

When to see a doctor

If you suspect you have genital herpes, or any other STI, see your health care provider.


Genital herpes is caused by two types of herpes simplex virus. These types include herpes simplex virus type 2 (HSV-2) and herpes simplex virus type 1 (HSV-1). People with HSV infections can pass along the virus even when they have no visible symptoms.


HSV-2 is the most common cause of genital herpes. The virus can be present:

  • On blisters and ulcers or the fluid from ulcers
  • The moist lining or fluids of the mouth
  • The moist lining or fluids of the vagina or rectum

The virus moves from one person to another during sexual activity.


HSV-1 is a version of the virus that causes cold sores or fever blisters. People may be exposed to HSV-1 as children due to close skin-to-skin contact with someone infected.

A person with HSV-1 in tissues of the mouth can pass the virus to the genitals of a sexual partner during oral sex. The newly caught infection is a genital herpes infection.

Recurrent outbreaks of genital herpes caused by HSV-1 are often less frequent than outbreaks caused by HSV-2.

Neither HSV-1 nor HSV-2 survives well at room temperature. So the virus is not likely to spread through surfaces, such as a faucet handle or a towel. But kissing or sharing a drinking glass or silverware might spread the virus.

Risk factors

A higher risk of getting genital herpes is linked to:

  • Contact with genitals through oral, vaginal or anal sex. Having sexual contact without using a barrier increases your risk of genital herpes. Barriers include condoms and condom-like protectors called dental dams used during oral sex. Women are at higher risk of getting genital herpes. The virus can spread more easily from men to women than from women to men.
  • Having sex with multiple partners. The number of people you have sex with is a strong risk factor. Contact with genitals through sex or sexual activity puts you at higher risk. Most people with genital herpes do not know they have it.
  • Having a partner who has the disease but is not taking medicine to treat it. There is no cure for genital herpes, but medicine can help limit outbreaks.
  • Certain groups within the population. Women, people with a history of sexually transmitted diseases, older people, Black people in in the United States and men who have sex with men diagnosed with genital herpes at a higher than average rate. People in groups at higher risk may choose to talk to a health care provider about their personal risk.


Complications associated with genital herpes may include:

  • Other sexually transmitted infections. Having genital sores raises your risk of giving or getting other STIs, including HIV/AIDS.
  • Newborn infection. A baby can be infected with HSV during delivery. Less often, the virus is passed during pregnancy or by close contact after delivery. Newborns with HSV often have infections of internal organs or the nervous system. Even with treatment, these newborns have a high risk of developmental or physical problems and a risk of death.
  • Internal inflammatory disease. HSV infection can cause swelling and inflammation within the organs associated with sexual activity and urination. These include the ureter, rectum, vagina, cervix and uterus.
  • Finger infection. An HSV infection can spread to a finger through a break in the skin causing discoloration, swelling and sores. The infections are called herpetic whitlow.
  • Eye infection. HSV infection of the eye can cause pain, sores, blurred vision and blindness.
  • Swelling of the brain. Rarely, HSV infection leads to inflammation and swelling of the brain, also called encephalitis.
  • Infection of internal organs. Rarely, HSV in the bloodstream can cause infections of internal organs.


Prevention of genital herpes is the same as preventing other sexually transmitted infections.

  • Have one long-term sexual partner who has been tested for STIs and isn’t infected.
  • Use a condom or dental dam during sexual activity. These reduce the risk of disease, but they don’t prevent all skin-to-skin contact during sex.
  • Don’t have sex when a partner with genital herpes has symptoms.

Pregnancy precautions

If you are pregnant and know you have genital herpes, tell your health care provider. If you think you might have genital herpes, ask your provider if you can be tested for it.

Your provider may recommend that you take herpes antiviral medicines late in pregnancy. This is to try to prevent an outbreak around the time of delivery. If you have an outbreak when you go into labor, your provider may suggest a cesarean section. That is a surgery to remove the baby from your uterus. It lowers the risk of passing the virus to your baby.

Breast cancer

Breast cancer is a kind of cancer that begins as a growth of cells in the breast tissue.

After skin cancer, breast cancer is the most common cancer diagnosed in women in the United States. But breast cancer doesn’t just happen in women. Everyone is born with some breast tissue, so anyone can get breast cancer.

Breast cancer survival rates have been increasing. And the number of people dying of breast cancer is steadily going down. Much of this is due to the widespread support for breast cancer awareness and funding for research.

Advances in breast cancer screening allow healthcare professionals to diagnose breast cancer earlier. Finding the cancer earlier makes it much more likely that the cancer can be cured. Even when breast cancer can’t be cured, many treatments exist to extend life. New discoveries in breast cancer research are helping healthcare professionals choose the most effective treatment plans.


  • Angiosarcoma
  • Ductal carcinoma in situ (DCIS)
  • Inflammatory breast cancer
  • Invasive lobular carcinoma
  • Lobular carcinoma in situ (LCIS)
  • Male breast cancer
  • Paget’s disease of the breast
  • Recurrent breast cancer


Signs and symptoms of breast cancer may include:

  • A breast lump or thickened area of skin that feels different from the surrounding tissue.
  • A nipple that looks flattened or turns inward.
  • Changes in the color of the breast skin. In people with white skin, the breast skin may look pink or red. In people with brown and Black skin, the breast skin may look darker than the other skin on the chest or it may look red or purple.
  • Change in the size, shape or appearance of a breast.
  • Changes to the skin over the breast, such as skin that looks dimpled or looks like an orange peel.
  • Peeling, scaling, crusting or flaking of the skin on the breast.

When to see a doctor

If you find a lump or other change in your breast, make an appointment with a doctor or other healthcare professional. Don’t wait for your next mammogram to see if the change you found is breast cancer. Report any changes in your breasts even if a recent mammogram showed there was no breast cancer.


The exact cause of most breast cancers isn’t known. Researchers have found things that increase the risk of breast cancer. These include hormones, lifestyle choices and things in the environment. But it’s not clear why some people who don’t have any factors get cancer, yet others with risk factors never do. It’s likely that breast cancer happens through a complex interaction of your genetic makeup and the world around you.

Healthcare professionals know that breast cancer starts when something changes the DNA inside cells in the breast tissue. A cell’s DNA holds the instructions that tell a cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions tell the cells to die at a set time. In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to make many more cells quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells.

The cancer cells might form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it’s called metastatic cancer.

The DNA changes that lead to breast cancer most often happen in the cells that line the milk ducts. These ducts are tubes designed to carry milk to the nipple. Breast cancer that starts in the ducts is called invasive ductal carcinoma. Breast cancer also can start in cells in the milk glands. These glands, called lobules, are designed to make breast milk. Cancer that happens in the lobules is called invasive lobular carcinoma. Other cells in the breast can become cancer cells, though this isn’t common.

Risk factors

Factors that may increase the risk of breast cancer include:

  • A family history of breast cancer. If a parent, sibling or child had breast cancer, your risk of breast cancer is increased. The risk is higher if your family has a history of getting breast cancer at a young age. The risk also is higher if you have multiple family members with breast cancer. Still, most people diagnosed with breast cancer don’t have a family history of the disease.
  • A personal history of breast cancer. If you’ve had cancer in one breast, you have an increased risk of getting cancer in the other breast.
  • A personal history of breast conditions. Certain breast conditions are markers for a higher risk of breast cancer. These conditions include lobular carcinoma in situ, also called LCIS, and atypical hyperplasia of the breast. If you’ve had a breast biopsy that found one of these conditions, you have an increased risk of breast cancer.
  • Beginning your period at a younger age. Beginning your period before age 12 increases your risk of breast cancer.
  • Beginning menopause at an older age. Beginning menopause after age 55 increases the risk of breast cancer.
  • Being female. Women are much more likely than men are to get breast cancer. Everyone is born with some breast tissue, so anyone can get breast cancer.
  • Dense breast tissue. Breast tissue is made up of fatty tissue and dense tissue. Dense tissue is made of milk glands, milk ducts and fibrous tissue. If you have dense breasts, you have more dense tissue than fatty tissue in your breasts. Having dense breasts can make it harder to detect breast cancer on a mammogram. If a mammogram showed that you have dense breasts, your risk of breast cancer is increased. Talk with your healthcare team about other tests you might have in addition to mammograms to look for breast cancer.
  • Drinking alcohol. Drinking alcohol increases the risk of breast cancer.
  • Having your first child at an older age. Giving birth to your first child after age 30 may increase the risk of breast cancer.
  • Having never been pregnant. Having been pregnant one or more times lowers the risk of breast cancer. Never having been pregnant increases the risk.
  • Increasing age. The risk of breast cancer goes up as you get older.
  • Inherited DNA changes that increase cancer risk. Certain DNA changes that increase the risk of breast cancer can be passed from parents to children. The most well-known changes are called BRCA1 and BRCA2. These changes can greatly increase your risk of breast cancer and other cancers, but not everyone with these DNA changes gets cancer.
  • Menopausal hormone therapy. Taking certain hormone therapy medicines to control the symptoms of menopause may increase the risk of breast cancer. The risk is linked to hormone therapy medicines that combine estrogen and progesterone. The risk goes down when you stop taking these medicines.
  • Obesity. People with obesity have an increased risk of breast cancer.
  • Radiation exposure. If you received radiation treatments to your chest as a child or young adult, your risk of breast cancer is higher.


Things you can do to lower your risk of breast cancer

Making changes in your daily life may help lower your risk of breast cancer. Try to:

  • Ask about breast cancer screening. Talk with your doctor or other healthcare professional about when to begin breast cancer screening. Ask about the benefits and risks of screening. Together, you can decide what breast cancer screening tests are right for you.
  • Become familiar with your breasts through breast self-exam for breast awareness. You may choose to become familiar with your breasts by occasionally inspecting them during a breast self-exam for breast awareness. If there is a new change, a lump or something not typical in your breasts, report it to a healthcare professional right away.
    Breast awareness can’t prevent breast cancer. But it may help you to better understand the look and feel of your breasts. This might make it more likely that you’ll notice if something changes.
  • Drink alcohol in moderation, if at all. Limit the amount of alcohol you drink to no more than one drink a day, if you choose to drink. For breast cancer prevention, there is no safe amount of alcohol. So if you’re very concerned about your breast cancer risk, you may choose to not drink alcohol.
  • Exercise most days of the week. Aim for at least 30 minutes of exercise on most days of the week. If you haven’t been active lately, ask a healthcare professional whether it’s OK and start slowly.
  • Limit menopausal hormone therapy. Combination hormone therapy may increase the risk of breast cancer. Talk with a healthcare professional about the benefits and risks of hormone therapy.
    Some people have symptoms during menopause that cause discomfort. These people may decide that the risks of hormone therapy are acceptable in order to get relief. To reduce the risk of breast cancer, use the lowest dose of hormone therapy possible for the shortest amount of time.
  • Maintain a healthy weight. If your weight is healthy, work to maintain that weight. If you need to lose weight, ask a healthcare professional about healthy ways to lower your weight. Eat fewer calories and slowly increase the amount of exercise.

Medicines and operations for those a high risk of breast cancer

If you have a high risk of breast cancer, you might consider other options to lower the risk. You might have a high risk if you have a family history of breast cancer. Your risk also might be higher if you have a history of precancerous cells in the breast tissue. Talk about your risk with your healthcare team. Your team might have options for lowering your risk, such as:

  • Preventive medicines. Using estrogen-blocking medicines can lower the risk of breast cancer in those who have a high risk. Options include medicines called selective estrogen receptor modulators and aromatase inhibitors. These medicines also are used as hormone therapy treatment for breast cancer.
    These medicines carry a risk of side effects. For this reason, they’re only used in those who have a very high risk of breast cancer. Discuss the benefits and risks with your healthcare team.
  • Preventive surgery. If you have a very high risk of breast cancer, you may consider having surgery to lower the risk of breast cancer. One option might be surgery to remove the breasts, called prophylactic mastectomy. Another option is surgery to remove the ovaries, called prophylactic oophorectomy. This operation lowers the risk of breast cancer and ovarian cancer.



What is a migraine? 

A migraine is a headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It’s often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so bad that it interferes with your daily activities.

For some people, a warning symptom known as an aura occurs before or with the headache. An aura can include visual disturbances, such as flashes of light or blind spots, or other disturbances, such as tingling on one side of the face or in an arm or leg and difficulty speaking.

Medications can help prevent some migraines and make them less painful. The right medicines, combined with self-help remedies and lifestyle changes, might help.


Migraines, which affect children and teenagers as well as adults, can progress through four stages: prodrome, aura, attack and post-drome. Not everyone who has migraines goes through all stages.


One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine, including:

  • Constipation.
  • Mood changes, from depression to euphoria.
  • Food cravings.
  • Neck stiffness.
  • Increased urination.
  • Fluid retention.
  • Frequent yawning.


For some people, an aura might occur before or during migraines. Auras are reversible symptoms of the nervous system. They’re usually visual but can also include other disturbances. Each symptom usually begins gradually, builds up over several minutes and can last up to 60 minutes.

Examples of migraine auras include:

  • Visual phenomena, such as seeing various shapes, bright spots or flashes of light.
  • Vision loss.
  • Pins and needles sensations in an arm or leg.
  • Weakness or numbness in the face or one side of the body.
  • Difficulty speaking.


A migraine usually lasts from 4 to 72 hours if untreated. How often migraines occur varies from person to person. Migraines might occur rarely or strike several times a month.

During a migraine, you might have:

  • Pain usually on one side of your head, but often on both sides.
  • Pain that throbs or pulses.
  • Sensitivity to light, sound, and sometimes smell and touch.
  • Nausea and vomiting.


After a migraine attack, you might feel drained, confused and washed out for up to a day. Some people report feeling elated. Sudden head movement might bring on the pain again briefly.

When to see a doctor

Migraines are often undiagnosed and untreated. If you regularly have signs and symptoms of migraine, keep a record of your attacks and how you treated them. Then make an appointment with your health care provider to discuss your headaches.

Even if you have a history of headaches, see your health care provider if the pattern changes or your headaches suddenly feel different.

See your health care provider immediately or go to the emergency room if you have any of the following signs and symptoms, which could indicate a more serious medical problem:

  • An abrupt, severe headache like a thunderclap.
  • Headache with fever, stiff neck, confusion, seizures, double vision, numbness or weakness in any part of the body, which could be a sign of a stroke.
  • Headache after a head injury.
  • A chronic headache that is worse after coughing, exertion, straining or a sudden movement.
  • New headache pain after age 50.


Though migraine causes aren’t fully understood, genetics and environmental factors appear to play a role.

Changes in the brainstem and its interactions with the trigeminal nerve, a major pain pathway, might be involved. So might imbalances in brain chemicals — including serotonin, which helps regulate pain in your nervous system.

Researchers are studying the role of serotonin in migraines. Other neurotransmitters play a role in the pain of migraine, including calcitonin gene-related peptide (CGRP).

Migraine triggers

There are a number of migraine triggers, including:

  • Hormonal changes in women. Fluctuations in estrogen, such as before or during menstrual periods, pregnancy and menopause, seem to trigger headaches in many women.
    Hormonal medications, such as oral contraceptives, also can worsen migraines. Some women, however, find that their migraines occur less often when taking these medications.
  • Drinks. These include alcohol, especially wine, and too much caffeine, such as coffee.
  • Stress. Stress at work or home can cause migraines.
  • Sensory stimuli. Bright or flashing lights can induce migraines, as can loud sounds. Strong smells — such as perfume, paint thinner, secondhand smoke and others — trigger migraines in some people.
  • Sleep changes. Missing sleep or getting too much sleep can trigger migraines in some people.
  • Physical strain. Intense physical exertion, including sexual activity, might provoke migraines.
  • Weather changes. A change of weather or barometric pressure can prompt a migraine.
  • Medications. Oral contraceptives and vasodilators, such as nitroglycerin, can aggravate migraines.
  • Foods. Aged cheeses and salty and processed foods might trigger migraines. So might skipping meals.
  • Food additives. These include the sweetener aspartame and the preservative monosodium glutamate (MSG), found in many foods.

Risk factors

Several factors make you more prone to having migraines, including:

  • Family history. If you have a family member with migraines, then you have a good chance of developing them too.
  • Age. Migraines can begin at any age, though the first often occurs during adolescence. Migraines tend to peak during your 30s, and gradually become less severe and less frequent in the following decades.
  • Sex. Women are three times more likely than men to have migraines.
  • Hormonal changes. For women who have migraines, headaches might begin just before or shortly after onset of menstruation. They might also change during pregnancy or menopause. Migraines generally improve after menopause.


Taking painkillers too often can trigger serious medication-overuse headaches. The risk seems to be highest with aspirin, acetaminophen (Tylenol, others) and caffeine combinations. Overuse headaches may also occur if you take aspirin or ibuprofen (Advil, Motrin IB, others) for more than 14 days a month or triptans, sumatriptan (Imitrex, Tosymra) or rizatriptan (Maxalt) for more than nine days a month.

Medication-overuse headaches occur when medications stop relieving pain and begin to cause headaches. You then use more pain medication, which continues the cycle.

Alcohol use disorder

Alcohol use disorder is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol or continuing to use alcohol even when it causes problems. This disorder also involves having to drink more to get the same effect or having withdrawal symptoms when you rapidly decrease or stop drinking. Alcohol use disorder includes a level of drinking that’s sometimes called alcoholism.

Unhealthy alcohol use includes any alcohol use that puts your health or safety at risk or causes other alcohol-related problems. It also includes binge drinking — a pattern of drinking where a male has five or more drinks within two hours or a female has at least four drinks within two hours. Binge drinking causes significant health and safety risks.

If your pattern of drinking results in repeated significant distress and problems functioning in your daily life, you likely have alcohol use disorder. It can range from mild to severe. However, even a mild disorder can escalate and lead to serious problems, so early treatment is important.


Alcohol use disorder can be mild, moderate or severe, based on the number of symptoms you experience. Signs and symptoms may include:

  • Being unable to limit the amount of alcohol you drink
  • Wanting to cut down on how much you drink or making unsuccessful attempts to do so
  • Spending a lot of time drinking, getting alcohol or recovering from alcohol use
  • Feeling a strong craving or urge to drink alcohol
  • Failing to fulfill major obligations at work, school or home due to repeated alcohol use
  • Continuing to drink alcohol even though you know it’s causing physical, social, work or relationship problems
  • Giving up or reducing social and work activities and hobbies to use alcohol
  • Using alcohol in situations where it’s not safe, such as when driving or swimming
  • Developing a tolerance to alcohol so you need more to feel its effect or you have a reduced effect from the same amount
  • Experiencing withdrawal symptoms — such as nausea, sweating and shaking — when you don’t drink, or drinking to avoid these symptoms

Alcohol use disorder can include periods of being drunk (alcohol intoxication) and symptoms of withdrawal.

  • Alcohol intoxication results as the amount of alcohol in your bloodstream increases. The higher the blood alcohol concentration is, the more likely you are to have bad effects. Alcohol intoxication causes behavior problems and mental changes. These may include inappropriate behavior, unstable moods, poor judgment, slurred speech, problems with attention or memory, and poor coordination. You can also have periods called “blackouts,” where you don’t remember events. Very high blood alcohol levels can lead to coma, permanent brain damage or even death.
  • Alcohol withdrawal can occur when alcohol use has been heavy and prolonged and is then stopped or greatly reduced. It can occur within several hours to 4 to 5 days later. Signs and symptoms include sweating, rapid heartbeat, hand tremors, problems sleeping, nausea and vomiting, hallucinations, restlessness and agitation, anxiety, and occasionally seizures. Symptoms can be severe enough to impair your ability to function at work or in social situations.

What is considered 1 drink?

The National Institute on Alcohol Abuse and Alcoholism defines one standard drink as any one of these:

  • 12 ounces (355 milliliters) of regular beer (about 5% alcohol)
  • 8 to 9 ounces (237 to 266 milliliters) of malt liquor (about 7% alcohol)
  • 5 ounces (148 milliliters) of wine (about 12% alcohol)
  • 1.5 ounces (44 milliliters) of hard liquor or distilled spirits (about 40% alcohol)

When to see a doctor

If you feel that you sometimes drink too much alcohol, or your drinking is causing problems, or if your family is concerned about your drinking, talk with your health care provider. Other ways to get help include talking with a mental health professional or seeking help from a support group such as Alcoholics Anonymous or a similar type of self-help group.

Because denial is common, you may feel like you don’t have a problem with drinking. You might not recognize how much you drink or how many problems in your life are related to alcohol use. Listen to relatives, friends or co-workers when they ask you to examine your drinking habits or to seek help. Consider talking with someone who has had a problem with drinking but has stopped.

If your loved one needs help

Many people with alcohol use disorder hesitate to get treatment because they don’t recognize that they have a problem. An intervention from loved ones can help some people recognize and accept that they need professional help. If you’re concerned about someone who drinks too much, ask a professional experienced in alcohol treatment for advice on how to approach that person.


Genetic, psychological, social and environmental factors can impact how drinking alcohol affects your body and behavior. Theories suggest that for certain people drinking has a different and stronger impact that can lead to alcohol use disorder.

Over time, drinking too much alcohol may change the normal function of the areas of your brain associated with the experience of pleasure, judgment and the ability to exercise control over your behavior. This may result in craving alcohol to try to restore good feelings or reduce negative ones.

Risk factors

Alcohol use may begin in the teens, but alcohol use disorder occurs more frequently in the 20s and 30s, though it can start at any age.

Risk factors for alcohol use disorder include:

  • Steady drinking over time. Drinking too much on a regular basis for an extended period or binge drinking on a regular basis can lead to alcohol-related problems or alcohol use disorder.
  • Starting at an early age. People who begin drinking — especially binge drinking — at an early age are at a higher risk of alcohol use disorder.
  • Family history. The risk of alcohol use disorder is higher for people who have a parent or other close relative who has problems with alcohol. This may be influenced by genetic factors.
  • Depression and other mental health problems. It’s common for people with a mental health disorder such as anxiety, depression, schizophrenia or bipolar disorder to have problems with alcohol or other substances.
  • History of trauma. People with a history of emotional trauma or other trauma are at increased risk of alcohol use disorder.
  • Having bariatric surgery. Some research studies indicate that having bariatric surgery may increase the risk of developing alcohol use disorder or of relapsing after recovering from alcohol use disorder.
  • Social and cultural factors. Having friends or a close partner who drinks regularly could increase your risk of alcohol use disorder. The glamorous way that drinking is sometimes portrayed in the media also may send the message that it’s OK to drink too much. For young people, the influence of parents, peers and other role models can impact risk.


Alcohol depresses your central nervous system. In some people, the initial reaction may feel like an increase in energy. But as you continue to drink, you become drowsy and have less control over your actions.

Too much alcohol affects your speech, muscle coordination and vital centers of your brain. A heavy drinking binge may even cause a life-threatening coma or death. This is of particular concern when you’re taking certain medications that also depress the brain’s function.

Impact on your safety

Excessive drinking can reduce your judgment skills and lower inhibitions, leading to poor choices and dangerous situations or behaviors, including:

  • Motor vehicle accidents and other types of accidental injury, such as drowning
  • Relationship problems
  • Poor performance at work or school
  • Increased likelihood of committing violent crimes or being the victim of a crime
  • Legal problems or problems with employment or finances
  • Problems with other substance use
  • Engaging in risky, unprotected sex, or experiencing sexual abuse or date rape
  • Increased risk of attempted or completed suicide

Impact on your health

Drinking too much alcohol on a single occasion or over time can cause health problems, including:

  • Liver disease. Heavy drinking can cause increased fat in the liver (hepatic steatosis) and inflammation of the liver (alcoholic hepatitis). Over time, heavy drinking can cause irreversible destruction and scarring of liver tissue (cirrhosis).
  • Digestive problems. Heavy drinking can result in inflammation of the stomach lining (gastritis), as well as stomach and esophageal ulcers. It can also interfere with your body’s ability to get enough B vitamins and other nutrients. Heavy drinking can damage your pancreas or lead to inflammation of the pancreas (pancreatitis).
  • Heart problems. Excessive drinking can lead to high blood pressure and increases your risk of an enlarged heart, heart failure or stroke. Even a single binge can cause serious irregular heartbeats (arrhythmia) called atrial fibrillation.
  • Diabetes complications. Alcohol interferes with the release of glucose from your liver and can increase the risk of low blood sugar (hypoglycemia). This is dangerous if you have diabetes and are already taking insulin or some other diabetes medications to lower your blood sugar level.
  • Issues with sexual function and periods. Heavy drinking can cause men to have difficulty maintaining an erection (erectile dysfunction). In women, heavy drinking can interrupt menstrual periods.
  • Eye problems. Over time, heavy drinking can cause involuntary rapid eye movement (nystagmus) as well as weakness and paralysis of your eye muscles due to a deficiency of vitamin B-1 (thiamin). A thiamin deficiency can result in other brain changes, such as irreversible dementia, if not promptly treated.
  • Birth defects. Alcohol use during pregnancy may cause miscarriage. It may also cause fetal alcohol spectrum disorders (FASDs). FASDs can cause a child to be born with physical and developmental problems that last a lifetime.
  • Bone damage. Alcohol may interfere with making new bone. Bone loss can lead to thinning bones (osteoporosis) and an increased risk of fractures. Alcohol can also damage bone marrow, which makes blood cells. This can cause a low platelet count, which may result in bruising and bleeding.
  • Neurological complications. Excessive drinking can affect your nervous system, causing numbness and pain in your hands and feet, disordered thinking, dementia, and short-term memory loss.
  • Weakened immune system. Excessive alcohol use can make it harder for your body to resist disease, increasing your risk of various illnesses, especially pneumonia.
  • Increased risk of cancer. Long-term, excessive alcohol use has been linked to a higher risk of many cancers, including mouth, throat, liver, esophagus, colon and breast cancers. Even moderate drinking can increase the risk of breast cancer.
  • Medication and alcohol interactions. Some medications interact with alcohol, increasing its toxic effects. Drinking while taking these medications can either increase or decrease their effectiveness, or make them dangerous.


Early intervention can prevent alcohol-related problems in teens. If you have a teenager, be alert to signs and symptoms that may indicate a problem with alcohol:

  • Loss of interest in activities and hobbies and in personal appearance
  • Red eyes, slurred speech, problems with coordination and memory lapses
  • Difficulties or changes in relationships with friends, such as joining a new crowd
  • Declining grades and problems in school
  • Frequent mood changes and defensive behavior

You can help prevent teenage alcohol use:

  • Set a good example with your own alcohol use.
  • Talk openly with your child, spend quality time together and become actively involved in your child’s life.
  • Let your child know what behavior you expect — and what the consequences will be for not following the rules.

Acute kidney failure

Acute kidney failure occurs when your kidneys suddenly become unable to filter waste products from your blood. When your kidneys lose their filtering ability, dangerous levels of wastes may accumulate, and your blood’s chemical makeup may get out of balance.

Acute kidney failure — also called acute renal failure or acute kidney injury — develops rapidly, usually in less than a few days. Acute kidney failure is most common in people who are already hospitalized, particularly in critically ill people who need intensive care.

Acute kidney failure can be fatal and requires intensive treatment. However, acute kidney failure may be reversible. If you’re otherwise in good health, you may recover normal or nearly normal kidney function.


Signs and symptoms of acute kidney failure may include:

  • Decreased urine output, although occasionally urine output remains normal
  • Fluid retention, causing swelling in your legs, ankles or feet
  • Shortness of breath
  • Fatigue
  • Confusion
  • Nausea
  • Weakness
  • Irregular heartbeat
  • Chest pain or pressure
  • Seizures or coma in severe cases

Sometimes acute kidney failure causes no signs or symptoms and is detected through lab tests done for another reason.

When to see a doctor

See your doctor immediately or seek emergency care if you have signs or symptoms of acute kidney failure.


Acute kidney failure can occur when:

  • You have a condition that slows blood flow to your kidneys
  • You experience direct damage to your kidneys
  • Your kidneys’ urine drainage tubes (ureters) become blocked and wastes can’t leave your body through your urine

Impaired blood flow to the kidneys

Diseases and conditions that may slow blood flow to the kidneys and lead to kidney injury include:

  • Blood or fluid loss
  • Blood pressure medications
  • Heart attack
  • Heart disease
  • Infection
  • Liver failure
  • Use of aspirin, ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, others) or related drugs
  • Severe allergic reaction (anaphylaxis)
  • Severe burns
  • Severe dehydration

Damage to the kidneys

These diseases, conditions and agents may damage the kidneys and lead to acute kidney failure:

  • Blood clots in the veins and arteries in and around the kidneys
  • Cholesterol deposits that block blood flow in the kidneys
  • Glomerulonephritis (gloe-mer-u-loe-nuh-FRY-tis), inflammation of the tiny filters in the kidneys (glomeruli)
  • Hemolytic uremic syndrome, a condition that results from premature destruction of red blood cells
  • Infection, such as with the virus that causes coronavirus disease 2019 (COVID-19)
  • Lupus, an immune system disorder causing glomerulonephritis
  • Medications, such as certain chemotherapy drugs, antibiotics and dyes used during imaging tests
  • Scleroderma, a group of rare diseases affecting the skin and connective tissues
  • Thrombotic thrombocytopenic purpura, a rare blood disorder
  • Toxins, such as alcohol, heavy metals and cocaine
  • Muscle tissue breakdown (rhabdomyolysis) that leads to kidney damage caused by toxins from muscle tissue destruction
  • Breakdown of tumor cells (tumor lysis syndrome), which leads to the release of toxins that can cause kidney injury

Urine blockage in the kidneys

Diseases and conditions that block the passage of urine out of the body (urinary obstructions) and can lead to acute kidney injury include:

  • Bladder cancer
  • Blood clots in the urinary tract
  • Cervical cancer
  • Colon cancer
  • Enlarged prostate
  • Kidney stones
  • Nerve damage involving the nerves that control the bladder
  • Prostate cancer

Risk factors

Acute kidney failure almost always occurs in connection with another medical condition or event. Conditions that can increase your risk of acute kidney failure include:

  • Being hospitalized, especially for a serious condition that requires intensive care
  • Advanced age
  • Blockages in the blood vessels in your arms or legs (peripheral artery disease)
  • Diabetes
  • High blood pressure
  • Heart failure
  • Kidney diseases
  • Liver diseases
  • Certain cancers and their treatments


Potential complications of acute kidney failure include:

  • Fluid buildup. Acute kidney failure may lead to a buildup of fluid in your lungs, which can cause shortness of breath.
  • Chest pain. If the lining that covers your heart (pericardium) becomes inflamed, you may experience chest pain.
  • Muscle weakness. When your body’s fluids and electrolytes — your body’s blood chemistry — are out of balance, muscle weakness can result.
  • Permanent kidney damage. Occasionally, acute kidney failure causes permanent loss of kidney function, or end-stage renal disease. People with end-stage renal disease require either permanent dialysis — a mechanical filtration process used to remove toxins and wastes from the body — or a kidney transplant to survive.
  • Death. Acute kidney failure can lead to loss of kidney function and, ultimately, death.


Acute kidney failure is often difficult to predict or prevent. But you may reduce your risk by taking care of your kidneys. Try to:

  • Pay attention to labels when taking over-the-counter (OTC) pain medications. Follow the instructions for OTC pain medications, such as aspirin, acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve, others). Taking too much of these medications may increase your risk of kidney injury. This is especially true if you have pre-existing kidney disease, diabetes or high blood pressure.
  • Work with your doctor to manage kidney and other chronic conditions. If you have kidney disease or another condition that increases your risk of acute kidney failure, such as diabetes or high blood pressure, stay on track with treatment goals and follow your doctor’s recommendations to manage your condition.
  • Make a healthy lifestyle a priority. Be active; eat a sensible, balanced diet; and drink alcohol only in moderation — if at all.

Sleep Disorder

Sleep disorders are conditions that result in changes in the way that you sleep.

A sleep disorder can affect your overall health, safety and quality of life. Sleep deprivation can affect your ability to drive safely and increase your risk of other health problems.

Some of the signs and symptoms of sleep disorders include excessive daytime sleepiness, irregular breathing or increased movement during sleep. Other signs and symptoms include an irregular sleep and wake cycle and difficulty falling asleep.

There are many different types of sleep disorders. They’re often grouped into categories that explain why they happen or how they affect you. Sleep disorders can also be grouped according to behaviors, problems with your natural sleep-wake cycles, breathing problems, difficulty sleeping or how sleepy you feel during the day.

Some common types of sleep disorders include:

  • Insomnia, in which you have difficulty falling asleep or staying asleep throughout the night.
  • Sleep apnea, in which you experience abnormal patterns in breathing while you are asleep. There are several types of sleep apnea.
  • Restless legs syndrome (RLS), a type of sleep movement disorder. Restless legs syndrome, also called Willis-Ekbom disease, causes an uncomfortable sensation and an urge to move the legs while you try to fall asleep.
  • Narcolepsy, a condition characterized by extreme sleepiness during the day and falling asleep suddenly during the day.

There are many ways to help diagnose sleep disorders. Doctors can usually treat most sleep disorders effectively once they’re correctly diagnosed.


Symptoms of sleep disorders include being very sleepy during the daytime and having trouble falling asleep at night. Some people may fall asleep at inappropriate times, such as while driving. Other symptoms include breathing in an unusual pattern or feeling an uncomfortable urge to move while you are trying to fall asleep. Unusual or bothersome movements or experiences during sleep are also possible. Having an irregular sleep and wake cycle is another symptom of sleep disorders.

Sleep terrors (night terrors)

Sleep terrors are times of screaming or crying, intense fear, and sometimes waving arms and legs when not fully awake. Also known as night terrors, sleep terrors may lead to sleepwalking. Like sleepwalking, sleep terrors are a type of parasomnia. Parasomnias are disturbing or strange behaviors or experiences during sleep. A sleep terror usually lasts from seconds to a few minutes, but it may last longer.

Sleep terrors may happen in children between the ages of 1 and 12 years. They happen much less often in adults. Although sleep terrors can be frightening to those around the person with sleep terrors, they aren’t usually a cause for concern. Most children outgrow sleep terrors by their teenage years.

Sleep terrors may need treatment if they cause problems with getting enough sleep or cause a safety risk.


Sleep terrors differ from nightmares. A nightmare is a bad dream. The person who has a nightmare wakes up from the dream and may remember details. A person who has a sleep terror remains asleep. Children usually don’t remember anything about their sleep terrors in the morning. Adults may recall part of a dream they had during the sleep terrors.

Sleep terrors generally happen in the first part of sleep time, and rarely during naps. A sleep terror may lead to sleepwalking.

During a sleep terror, a person may:

  • Start by screaming, shouting or crying.
  • Sit up in bed and look scared.
  • Stare wide-eyed.
  • Sweat, breathe heavily, and have a racing pulse, flushed face and enlarged pupils.
  • Kick and thrash.
  • Be hard to wake up and be confused if awakened.
  • Not be comforted or soothed.
  • Have no or little memory of the event the next morning.
  • Possibly, get out of bed and run around the house or have aggressive behavior if blocked or held back.

When to see a doctor

Occasional sleep terrors aren’t usually a cause for concern. If your child has sleep terrors, you can simply mention them at a routine well-child exam. But if you have concerns for you or your child, talk to your doctor or other healthcare professional sooner, especially if sleep terrors:

  • Happen more often.
  • Regularly disrupt the sleep of the person with sleep terrors or other family members.
  • Lead to safety concerns or injury.
  • Result in daytime symptoms of extreme sleepiness or problems with daily activities.
  • Continue beyond the teen years or start as an adult.


Sleep terrors are a type of parasomnia. A parasomnia is a disturbing or strange behavior or experience during sleep. People who have sleep terrors don’t completely wake up from sleep during the episodes. Their appearance may suggest they are awake, but they remain partially asleep.

Several issues can contribute to sleep terrors, such as:

  • Serious lack of sleep and extreme tiredness.
  • Stress.
  • Sleep schedule changes, travel or sleep interruptions.
  • Fever.

Sleep terrors sometimes can be triggered by conditions that interfere with sleep, such as:

  • Sleep-disordered breathing — a group of disorders that include breathing patterns that are not typical during sleep. The most common type of sleep-disordered breathing is obstructive sleep apnea.
  • Restless legs syndrome.
  • Some medicines.
  • Mood disorders, such as depression and anxiety.
  • Alcohol use.

Risk factors

Sleep terrors are more common if family members have a history of sleep terrors or sleepwalking.


Some complications that may result from sleep terrors include:

  • Being too sleepy during the day, which can lead to problems at school or work or with everyday tasks.
  • Disturbed sleep.
  • Embarrassment about the sleep terrors or problems with relationships.
  • Injury to the person having a sleep terror or, rarely, to someone nearby.



Insomnia is a common sleep disorder that can make it hard to fall asleep or stay asleep. It also can cause you to wake up too early and not be able to get back to sleep. You may still feel tired when you wake up. Insomnia can drain your energy level and affect your mood. It also can affect your health, work performance and quality of life.

How much sleep is enough varies from person to person. But most adults need 7 to 9 hours a night.

At some point, many adults have short-term insomnia. This can last for days or weeks. Short-term insomnia is usually due to stress or a distressing event. But some people have long-term insomnia, also called chronic insomnia. This lasts for three months or more. Insomnia may be the main problem, or it may be related to other medical conditions or medicines.

You do not have to put up with sleepless nights. Simple changes in your daily habits often can help.


Insomnia symptoms may include:

  • Having a hard time falling asleep at night.
  • Waking up during the night.
  • Waking up too early.
  • Feeling tired or sleepy during the day.
  • Feeling cranky, depressed or anxious.
  • Having a hard time paying attention, focusing on tasks or remembering.
  • Making more errors or having more accidents.
  • Having ongoing worries about sleep.

When to see a doctor

If insomnia makes it hard for you to do daily activities, see your doctor or another primary care professional. Your doctor will search for the cause of your sleep problem and help treat it. If it’s thought that you could have a sleep disorder, your doctor might suggest going to a sleep center for special testing.


Insomnia may be the main problem or it may be related to other conditions.

Long-term insomnia is usually due to stress, life events or habits that disrupt sleep. While treating the cause of your sleep problem may stop your insomnia, sometimes it can last for years.

Common causes of long-term insomnia include:

  • Stress. Concerns about work, school, health, money or family can keep your mind active at night, making it hard to sleep. Stressful life events, such as the death or illness of a loved one, divorce, or a job loss, also may lead to insomnia.
  • Travel or work schedule. Your body’s “internal clock,” known as circadian rhythms, guides things such as your sleep-wake cycle, metabolism and body temperature. Disrupting these rhythms can lead to insomnia. Causes include feeling jet lag from traveling across multiple time zones, working a late or early shift, or changing shifts often.
  • Poor sleep habits. Poor sleep habits include going to bed and waking up at different times each day, taking naps, being too active before bedtime and having a sleep area that is not comfortable. Other poor sleep habits include working, eating or watching TV while in bed. Using computers or smartphones, playing video games, or watching TV just before bed can disrupt your sleep cycle.
  • Eating too much late in the evening. Having a light snack before bedtime is OK. But eating too much may cause you to feel uncomfortable while lying down. Many people also have heartburn. This is when stomach acid backs up into the tube that carries food from your mouth to your stomach. This tube is called the esophagus. Heartburn may keep you awake.
  • Mental health disorders. Anxiety disorders, such as post-traumatic stress disorder, may disrupt your sleep. Waking up too early can be a sign of depression. Insomnia often occurs with other mental health conditions.
  • Medicines. Many prescription drugs can interfere with sleep, such as certain antidepressants and medicines for asthma or blood pressure. Many medicines available without a prescription, such as some pain medicines, allergy and cold medicines, and weight-loss products, contain caffeine and other stimulants that can disrupt sleep.
  • Medical conditions. Examples of conditions linked with insomnia include ongoing pain, cancer, diabetes, heart disease, asthma, gastroesophageal reflux disease (GERD), overactive thyroid, Parkinson’s disease and Alzheimer’s disease.
  • Sleep-related disorders. Sleep apnea causes you to stop breathing at times during the night, disrupting your sleep. Restless legs syndrome causes a strong uncomfortable urge to move your legs when trying to fall asleep. This may keep you from falling asleep or getting back to sleep.
  • Caffeine, nicotine and alcohol. Coffee, tea, cola and other drinks that have caffeine are stimulants. Drinking them in the late afternoon or evening can keep you from falling asleep at night. Nicotine in tobacco products is another stimulant that can disrupt sleep. Alcohol may help you fall asleep, but it prevents deeper stages of sleep and often results in waking up in the middle of the night.

Insomnia and aging

Insomnia becomes more common with age. As you get older, you may:

  • Change your sleep patterns. Sleep often becomes less restful as you age, so noise or other changes in your surroundings are more likely to wake you. With age, your internal clock often moves forward in time, so you get tired earlier in the evening and wake up earlier in the morning. But older people typically still need the same amount of sleep as younger people.
  • Change your level of activity. You may be less physically or socially active. A lack of activity can disrupt a good night’s sleep. Also, the less active you are, the more likely you may be to take a daily nap. Napping can disrupt sleep at night.
  • Have changes in your health. Ongoing pain from conditions such as arthritis or back problems, as well as depression or anxiety, can disrupt sleep. Issues that make it more likely that you’ll need to urinate during the night, such as prostate or bladder problems, can disrupt sleep. Sleep apnea and restless legs syndrome become more common with age.
  • Take more medicines. Older people typically use more prescription drugs than younger people do. This raises the chance of insomnia related to medicines.

Insomnia in children and teens

Sleep problems may be a concern for children and teenagers too. But some children and teens simply have trouble getting to sleep or resist a regular bedtime because their internal clocks are more delayed. They want to go to bed later and sleep later in the morning.

Risk factors

Nearly everyone has an occasional sleepless night. But you’re more likely to have insomnia if:

  • You’re a woman. Changes in hormones during the menstrual cycle and in menopause may play a role. During menopause, night sweats and hot flashes often disrupt sleep. Insomnia also is common during pregnancy.
  • You’re over 60. Because of changes in sleep patterns and health, it’s more likely you’ll have insomnia as you get older.
  • You have a mental health or physical health condition. Many issues that affect your mental or physical health can disrupt sleep.
  • You’re under a lot of stress. Being stressed can cause short-term insomnia. Major or long-lasting stress can lead to long-term insomnia.
  • You do not have a regular schedule. For example, changing shifts at work or traveling can disrupt your sleep-wake cycle.


Sleep is as important to your health as a healthy diet and regular physical activity. Whatever is keeping you from sleeping, insomnia can affect you mentally and physically. People with insomnia report a lower quality of life compared with people who sleep well.

Complications of insomnia may include:

  • Lower performance on the job or at school.
  • Slowed reaction time while driving and a higher risk of accidents.
  • Mental health conditions, such as depression, anxiety or substance misuse.
  • Higher risk or worsening of long-term diseases or conditions, such as high blood pressure and heart disease.


Good sleep habits like these can help prevent insomnia:

  • Keep the time you go to bed and the time you wake up the same every day, including weekends.
  • Stay active. Regular activity can lead to a good night’s sleep.
  • Limit naps or do not nap at all.
  • Limit or do not use caffeine, alcohol and nicotine.
  • Do not eat large meals or drink a lot of fluids before bed.
  • Make your bedroom comfortable for sleep and only use it for sex or sleep.
  • Create a relaxing bedtime ritual, such as taking a warm bath, reading or listening to soft music.

Prostate Cancer

Prostate cancer

Prostate cancer is cancer that occurs in the prostate. The prostate is a small walnut-shaped gland in males that produces the seminal fluid that nourishes and transports sperm.

Prostate cancer is one of the most common types of cancer. Many prostate cancers grow slowly and are confined to the prostate gland, where they may not cause serious harm. However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly.

Prostate cancer that’s detected early — when it’s still confined to the prostate gland — has the best chance for successful treatment.


Prostate cancer may cause no signs or symptoms in its early stages.

Prostate cancer that’s more advanced may cause signs and symptoms such as:

  • Trouble urinating
  • Decreased force in the stream of urine
  • Blood in the urine
  • Blood in the semen
  • Bone pain
  • Losing weight without trying
  • Erectile dysfunction

When to see a doctor

Make an appointment with your doctor if you have any persistent signs or symptoms that worry you.


It’s not clear what causes prostate cancer.

Doctors know that prostate cancer begins when cells in the prostate develop changes in their DNA. A cell’s DNA contains the instructions that tell a cell what to do. The changes tell the cells to grow and divide more rapidly than normal cells do. The abnormal cells continue living, when other cells would die.

The accumulating abnormal cells form a tumor that can grow to invade nearby tissue. In time, some abnormal cells can break away and spread (metastasize) to other parts of the body.

Risk factors

Factors that can increase your risk of prostate cancer include:

  • Older age. Your risk of prostate cancer increases as you age. It’s most common after age 50.
  • Race. For reasons not yet determined, Black people have a greater risk of prostate cancer than do people of other races. In Black people, prostate cancer is also more likely to be aggressive or advanced.
  • Family history. If a blood relative, such as a parent, sibling or child, has been diagnosed with prostate cancer, your risk may be increased. Also, if you have a family history of genes that increase the risk of breast cancer (BRCA1 or BRCA2) or a very strong family history of breast cancer, your risk of prostate cancer may be higher.
  • Obesity. People who are obese may have a higher risk of prostate cancer compared with people considered to have a healthy weight, though studies have had mixed results. In obese people, the cancer is more likely to be more aggressive and more likely to return after initial treatment.


Complications of prostate cancer and its treatments include:

  • Cancer that spreads (metastasizes). Prostate cancer can spread to nearby organs, such as your bladder, or travel through your bloodstream or lymphatic system to your bones or other organs. Prostate cancer that spreads to the bones can cause pain and broken bones. Once prostate cancer has spread to other areas of the body, it may still respond to treatment and may be controlled, but it’s unlikely to be cured.
  • Incontinence. Both prostate cancer and its treatment can cause urinary incontinence. Treatment for incontinence depends on the type you have, how severe it is and the likelihood it will improve over time. Treatment options may include medications, catheters and surgery.
  • Erectile dysfunction. Erectile dysfunction can result from prostate cancer or its treatment, including surgery, radiation or hormone treatments. Medications, vacuum devices that assist in achieving erection and surgery are available to treat erectile dysfunction.


You can reduce your risk of prostate cancer if you:

  • Choose a healthy diet full of fruits and vegetables. Eat a variety of fruits, vegetables and whole grains. Fruits and vegetables contain many vitamins and nutrients that can contribute to your health.
    Whether you can prevent prostate cancer through diet has yet to be conclusively proved. But eating a healthy diet with a variety of fruits and vegetables can improve your overall health.
  • Choose healthy foods over supplements. No studies have shown that supplements play a role in reducing your risk of prostate cancer. Instead, choose foods that are rich in vitamins and minerals so that you can maintain healthy levels of vitamins in your body.
  • Exercise most days of the week. Exercise improves your overall health, helps you maintain your weight and improves your mood. Try to exercise most days of the week. If you’re new to exercise, start slow and work your way up to more exercise time each day.
  • Maintain a healthy weight. If your current weight is healthy, work to maintain it by choosing a healthy diet and exercising most days of the week. If you need to lose weight, add more exercise and reduce the number of calories you eat each day. Ask your doctor for help creating a plan for healthy weight loss.
  • Talk to your doctor about increased risk of prostate cancer. If you have a very high risk of prostate cancer, you and your doctor may consider medications or other treatments to reduce the risk. Some studies suggest that taking 5-alpha reductase inhibitors, including finasteride (Propecia, Proscar) and dutasteride (Avodart), may reduce the overall risk of developing prostate cancer. These drugs are used to control prostate gland enlargement and hair loss.
    However, some evidence indicates that people taking these medications may have an increased risk of getting a more serious form of prostate cancer (high-grade prostate cancer). If you’re concerned about your risk of developing prostate cancer, talk with your doctor.

10 tips to stay healthy

Staying healthy involves a combination of medical care and a good diet. Here are some tips:

1)Regular Check-ups: Schedule routine check-ups with your healthcare provider to monitor your health and catch any issues early.

2)Stay Active: Engage in regular physical activity to maintain a healthy weight, improve cardiovascular health, and boost mood.

3)Eat a Balanced Diet: Consume a variety of fruits, vegetables, lean proteins, whole grains, and healthy fats. Limit processed foods, sugar, and sodium.

4)Stay Hydrated: Drink plenty of water throughout the day to stay hydrated and support bodily functions.

5)Get Adequate Sleep: Aim for 7-9 hours of quality sleep each night to support overall health and well-being.

6)Manage Stress: Practice stress-reducing techniques such as meditation, deep breathing, or hobbies you enjoy.

7)Limit Alcohol and Avoid Tobacco: Drink alcohol in moderation, if at all, and avoid smoking or using tobacco products.

8)Practice Good Hygiene: Wash your hands frequently, brush and floss your teeth regularly, and maintain good hygiene habits to prevent illness and infection.

9)Stay Informed: Stay informed about health recommendations and guidelines from reliable sources such as healthcare professionals or reputable organizations.

10)Listen to Your Body: Pay attention to your body’s signals and seek medical attention if you experience any concerning symptoms or changes in health.