Michał Karol

Purpose: Heavy menstrual bleeding (HMB) is common in reproductive-age women and may be underreported in sport, where fatigue is often attributed to training load, stress, or low energy availability. This narrative review summarizes evidence on HMB coexisting with iron deficiency (ID) and iron-deficiency anemia (IDA) in physically active women and translates it into practical screening, nutrition, and referral guidance. Materials and Methods: FIGO AUB (PALM–COEIN) and NICE guidance were integrated with sports-medicine evidence on exercise-related iron stress and post-exercise hepcidin regulation. Results: HMB can deplete iron stores before anemia is detected on routine blood counts. In athletes, increased iron demand and losses and transient hepcidin elevations may further reduce absorption and functional iron availability; serial ferritin assessment is often more informative than a single test. Conclusions: An integrated pathway - routine screening questions, appropriate laboratory testing, individualized nutrition, monitored supplementation when indicated, and timely gynecology/hematology referral when red features are present - may improve health protection and training continuity.

Night-shift work poses significant challenges to human health, largely through disruption of circadian rhythms and dysregulation of cortisol secretion. Cortisol, a key glucocorticoid, regulates metabolism, immune function, and stress responses, following a distinct diurnal pattern characterized by a morning peak and gradual decline throughout the day. Night-shift work alters this rhythm, often causing blunted cortisol awakening responses, elevated evening cortisol levels, and overall circadian misalignment. These hormonal disturbances contribute to a spectrum of adverse health outcomes, including metabolic dysregulation (insulin resistance, hyperglycemia, obesity), cardiovascular disorders (hypertension, atherosclerosis, increased cardiovascular mortality), impaired cognitive function, and heightened susceptibility to mood disorders such as anxiety and depression. Sleep disruption further exacerbates cortisol dysregulation and associated physiological and psychological effects. Understanding the mechanisms linking night-shift work to cortisol rhythm alterations is crucial for developing interventions aimed at mitigating health risks in shift-working populations. This review synthesizes current evidence on the effects of night-shift work on cortisol dynamics and the broader implications for metabolic, cardiovascular, and mental health.

Introduction. Clinical work is performed under conditions of high cognitive load, time pressure and frequent interruptions. Research on patient safety has traditionally focused on sleep deprivation, fatigue and work organisation, whereas environmental factors are analysed less frequently, despite their chronic and cumulative effects.Aim. The aim of this narrative review is to present the current state of knowledge on the relationship between indoor environmental quality (IEQ) and cognitive performance of healthcare professionals and trainees, and to discuss the implications of these associations for medical education and patient safety.State of knowledge. IEQ encompasses ventilation and air quality, thermal and humidity conditions, lighting, and sensory load, including noise. Experimental and observational evidence suggests that even moderate deviations of environmental parameters may be associated with impairments in vigilance, attention, working memory, reaction time and executive functions, particularly when combined with sleep deficit, multitasking and high distraction. Indirect effects may also arise from exposures typical of hospital environments and from factors increasing respiratory discomfort and communication burden.Conclusions. Framing IEQ within a human factors perspective supports a systems-based approach to quality and safety. Monitoring environmental parameters and implementing low-cost organisational interventions may represent a practical component of strategies aimed at supporting cognitive performance of staff and the effectiveness of medical education.

Sleep hygiene encompasses behavioral and environmental practices that shape sleep quality and circadian stability. Among young adults, lifestyle demands, academic pressures, and widespread digital media use contribute to irregular sleep–wake schedules, shortened sleep duration, and increasing sleep disturbances. This narrative review synthesizes research from sleep medicine, psychology, and public health to examine how sleep hygiene relates to cognitive performance, psychological well-being, and physical functioning in young adults. Evidence indicates that inconsistent sleep timing, evening light exposure, and stimulating pre-sleep activities are linked to impaired attention, reduced learning efficiency, and poorer executive functioning. Poor sleep hygiene is also associated with heightened emotional reactivity, greater risk of anxiety and depressive symptoms, and impaired stress regulation. Physiological consequences include altered neuroendocrine rhythms, reduced recovery capacity, and declines in physical performance. Intervention studies show that adopting regular sleep schedules, minimizing nocturnal screen exposure, and optimizing sleep environments can improve sleep quality, daytime functioning, and mental health. Taken together, sleep hygiene emerges as a modifiable and cost-effective determinant of health in young adults. Integrating sleep-supportive behaviors into preventive medicine, education, and public health initiatives may help protect cognitive, emotional, and physical functioning during this critical developmental period.

Introduction and purpose. Young adults—especially students—are increasingly exposed to the combined impact of a sedentary lifestyle and chronic academic stress. Screen-based learning and computer-mediated work promote prolonged sitting, while high academic demands limit time and energy for recovery and movement. The aim of this narrative review is to summarize current knowledge on links between sedentary behaviour, academic stress and health in young adults, and to indicate implications for health education and prevention at universities. Description of the state of knowledge. Studies show that sedentary behaviour in this age group is associated with musculoskeletal pain, early metabolic disturbances, poorer sleep and reduced psychological well-being, whereas academic stress correlates with anxiety and depressive symptoms, sleep problems, risky health behaviours and burnout. Both factors share biological and psychosocial mechanisms, including dysregulation of the stress axis and consolidation of passive, screen-based coping. The academic environment—through timetables, assessment methods and access to sports infrastructure—shapes students’ movement patterns and stress load. Interventions that combine promotion of everyday physical activity with training in stress self-regulation and sleep hygiene, supported by environmental changes that facilitate movement breaks, appear promising but are still evaluated mainly in cross-sectional or short-term studies. Summary (conclusions). Sedentary lifestyle and academic stress form a mutually reinforcing cluster of risk factors that may contribute to early health problems in young adults, supporting the need for integrated, university-based programmes that address both daily movement patterns and stress management skills.

Introduction and purpose: Orthostatic intolerance is an increasingly recognized disturbance of circulatory regulation in young adults, particularly in academic settings where characteristic lifestyle patterns promote autonomic imbalance. The aim of this narrative review is to synthesize current knowledge on pathophysiological mechanisms, classification, prevalence and management of orthostatic intolerance in young adults, with particular emphasis on the role of dehydration, sleep irregularities, academic stress and low physical activity. Description of the state of knowledge: Available data indicate that early haemodynamic changes after standing, including initial orthostatic hypotension and impaired baroreflex adaptation, are key mechanisms underlying presyncopal symptoms in this age group. In many patients complaints are misinterpreted as manifestations of anxiety or panic, which leads to delayed diagnosis, unnecessary cardiologic and neurologic investigations and failure to implement simple, effective lifestyle interventions. Studies in student populations show that recurrent presyncopal episodes, “brain fog” and exercise intolerance may significantly impair academic performance and quality of life, while remaining largely unreported. Summary (conclusions): Orthostatic intolerance in young adults rarely reflects severe structural disease but rather a mismatch between autonomic compensatory capacity and chronic environmental load. Early recognition, clear explanation of mechanisms and structured non-pharmacologic management focused on hydration, sleep hygiene, nutrition and physical activity usually lead to substantial symptom relief. In academic environments preventive measures and increased awareness among clinicians, students and university staff are essential to limit unnecessary diagnostics and to reduce the long-term functional impact of orthostatic intolerance.

Functional hypothalamic amenorrhea (FHA) is a common cause of amenorrhea among women in reproductive age. The disturbance is often associated with stress and deficiency in energy availability caused by either intensive exercise or improper nutrition. Those factor affect the hypothalamic-pituitary-gonadal axis and further absence of ovulation and normal menstrual cycle. Treatment should be directed to treatment of the etiology, however sometimes it is not enough. For this reason, novel therapies emerged to counteract the consequences of FHA to support restoring that lifestyle changes are not capable of. This review summarizes current knowledge on the leptin and kisspeptin treatment, which recently gained more interest, due to it physiological basis in hypothalamic-pituitary-gonadal axis. Furthermore, paper evaluates clinical data, its limitations and safety consideration, and more importantly, the need for future research.

Exercise-induced rhabdomyolysis is a potentially serious complication of high-intensity physical activity, increasingly observed in young adults, particularly in the context of high-intensity training, abrupt return to exercise after a longer break, and the widespread use of multi-ingredient pre-workout supplements. Early symptoms are often dismissed as “bad muscle soreness”, which may delay diagnosis and treatment and, in consequence, promote the development of acute kidney injury. The aim of this paper is to present a case of exercise-induced rhabdomyolysis in a young, previously healthy man after a resistance-circuit training session performed following a prolonged period of inactivity, and to discuss current knowledge on the etiology, clinical presentation, diagnostics, treatment and prevention of exercise-induced rhabdomyolysis in young adults. We describe the clinical course, laboratory findings and management, and then relate them to available data, with particular emphasis on environmental factors, dehydration and the use of pre-workout preparations. The case illustrates that early recognition based on simple tests – creatine kinase activity, assessment of kidney function and urinalysis – and prompt initiation of intensive fluid therapy often make it possible to avoid renal replacement therapy. From the perspective of sports medicine and primary care, education of young adults, gradual introduction of training loads, and cautious, informed use of supplements – especially in hot environments and with limited fluid intake – are crucial.

Introduction: Sauna bathing, traditionally associated with relaxation in Nordic countries, is increasingly regarded as a tool supporting cardiovascular prevention and post-exercise recovery. As its use becomes more widespread, questions arise about the safety of this form of heat exposure, the mechanisms by which it affects the cardiovascular system and autonomic regulation, and how it can be integrated into training programmes for athletes and physically active individuals.Aim: The aim of this narrative review is to organize current knowledge on the acute and chronic effects of sauna bathing on haemodynamic parameters, sympathetic–parasympathetic balance and post-exercise recovery, with particular emphasis on potential benefits, risks, contraindications and practical aspects of dosing the thermal stimulus.State of knowledge: Available studies indicate that a single sauna session induces predictable circulatory changes – peripheral vasodilation, an increase in heart rate and cardiac output with a moderate reduction in arterial blood pressure, and transient hypovolaemia. Regular sauna bathing has been associated in long-term observations with a more favourable cardiovascular profile, improvement in selected indices of sinus rhythm variability, better subjective well-being and improved exercise tolerance. In athletic populations, sauna may support the perception of recovery, promote muscle relaxation and facilitate glycogen resynthesis, provided that it is used with adequate attention to hydration and appropriate dosing of heat stress.Conclusions: Sauna appears to be a valuable and relatively simple adjunct to cardiovascular prevention strategies and recovery programmes, but it does not replace physical activity or causal treatment. Further interventional studies are needed to refine optimal protocols of sauna bathing in the general population and in elite sport, and to better define groups in whom the benefits outweigh the risks.

Dietary supplements and various nutritional strategies have become an integral part of young adults' lives in recent years, a trend observed in an increasing proportion of the population. The popularity of supplementation has been rising, driven by the easy availability of preparations, the influence of social media, and the belief that health and physical performance should be supported with additional substances. However, growing attention is being paid to the inadequate regulation of the dietary supplement market and the fact that some of the preparations available online contain ingredients that do not match the manufacturer's declaration. At the same time, there has been a marked increase in the interest in restrictive dietary strategies, such as the ketogenic diet, high-protein diet, plant-based diets, and intermittent fasting. Although these approaches may offer metabolic and performance-related benefits, they can also adversely affect the health of young adults if used improperly. The aim of this study was to present current evidence on the efficacy and safety of the most commonly used supplements and dietary strategies in the young adult population. Reports from clinical trials, observational studies and systematic reviews published between 2014 and 2024 were analyzed, with particular focus on health risks such as hepatotoxicity, electrolyte disturbances, interactions between active ingredients, and the risk of deficiencies associated with inadequately balanced diets. The available data indicate that although some supplements have a favorable safety profile, their unsupervised and combined use increases the risk of adverse effects. Similarly, many dietary patterns can be effective but require appropriate planning and, in some cases, professional supervision. These findings highlight the need for targeted health education, routine clinical assessment of supplement and diet use, and stricter regulation of the dietary supplement market.