For those who have not experienced a migraine, perhaps it would seem just another headache. But for someone like me who has suffered through migraines that will last over a week even with medication, I can definitely tell you that it's much more. The ache is not confined to the head; it's the whole experience. Nausea, sensitivity to light, and throbs so bad it makes simple tasks unbearable. It also comes with an emotional burden—the loneliness and frustration are pretty unbearable. Through the years, realizing how hormones are also implicated in triggering and exacerbating my migraines has helped change the game in my dealing with these episodes.

What are Hormonal Migraines?

Hormonal migraines are caused by fluctuations in estrogen and progesterone, the two main female hormones. These hormones are essential for the reproductive system, regulating menstrual cycles and pregnancy. They also have an effect on brain chemicals, such as serotonin and dopamine, which affect mood and pain perception. When hormone levels fluctuate, such as during menstruation, pregnancy, or menopause, they can destabilize the pathways in the brain, causing migraines.

According to Dr. Shivananda Pai, Consultant Neurology, migraines are more than a neurological disorder. "Migraines represent a complex interplay of genetic, environmental, and hormonal factors. In women, hormonal fluctuations are a critical trigger that amplifies sensitivity to pain," he explains. Hormonal headaches are particularly challenging because they are influenced by multiple life stages, from puberty to post-menopause. Common causes include:

• Menstrual periods: Estrogen levels significantly drop just before menstruation often triggers a migraine.
• Pregnancy: Hormones can act to relieve symptoms or aggravate them during different times of pregnancy.
• Menopause: The hormonal fluctuation during menopause can intensify a migraine, while some women tend to find relief.
• Hormonal therapies: Birth control and HRT tend to level off hormone balances in some individuals but will exacerbate a migraine in others.

Complex Role of Hormones in Women’s Neurological Health

Estrogen and Neurological Health

Estrogen, often called the "hormone of femininity", does more than regulate reproductive functions. It is a powerful influencer of brain health. Estrogen modulates the activity of neurotransmitters like serotonin, which regulates mood and pain perception, and dopamine, associated with reward and pleasure.

During stages of hormonal stability, like in pregnancy's latter months, women may have fewer migraines because of the steady elevation of estrogen. However, a sudden downfall in estrogen destabilizes these chemicals in the brain, sending a heightened sensitivity for migraine triggers.

Menstrual Migraines

The most common form of hormonal migraines is menstrual migraines, which occur in response to the steep decline in estrogen levels just before menstruation. These are typically more intense and less responsive to standard treatment. The timing of these migraines provides clear evidence of the role hormones play in neurological health.

Pregnancy and Hormonal Shifts

Pregnancy is a rollercoaster of hormones. Although many women experience relief from migraines as a result of the constantly elevated levels of estrogen, some women, particularly in the first trimester, worsen. This individual variability is a characteristic of hormonal migraine triggers.

Hormonal Therapies and Management of Migraine

Hormonal treatments, such as oral contraceptives and HRT, have had mixed reviews regarding their use in managing migraine. Some women fare better with the stabilization the treatment provides, whereas others suffer worsening symptoms. This will depend on the nature and dose of the hormones used.

Post-Menopause: Migraine Remission or Continued Struggles?

For most women, menopause brings relief from their migraines. The decline in frequency and severity often accompanies stability in hormone levels. Even so, the susceptibility remains with some towards other forms of triggers including stress and sleep deprivation, not to forget diet-related factors and continues the saga of migraines well after the menopausal stages.

Effect on Neurological Health Due to Hormonal Changes

The relationship of hormones to neurological health goes beyond migraines. Hormonal changes have profound effects on a woman's brain in general.

Mood Disorders: Estrogen helps stabilize mood by regulating serotonin. Its decline at menopause increases the risk of mood swings and depression.

Neurodegenerative Diseases: Estrogen is neuroprotective, stimulating the growth and repair of brain cells. Its absence in post-menopausal women has been associated with an increased risk of Alzheimer's disease and cognitive decline.

Multiple Sclerosis (MS): Hormonal cycles may affect the course of MS, a disease that occurs more frequently in women than in men. Estrogen's anti-inflammatory effects provide transient protection during pregnancy, reducing relapse rates in women with MS.

"The intricate interplay between hormones and neurological health underscores the need for gender-specific treatment approaches," says Dr. Pai.

Managing Hormonal Migraines: Practical Strategies

While hormonal changes are inevitable, several strategies can help manage migraines effectively:

1. Tracking Your Cycle

Understanding your menstrual cycle can help identify patterns and predict when migraines might occur. This knowledge allows for preventive measures, such as scheduling medications or adjusting lifestyle habits.

2. Consulting Specialists

Working with a neurologist or gynecologist can help develop a personalized treatment plan. Options might include hormonal therapies, triptans, or preventive medications tailored to your specific needs.

3. Adopting a Healthy Lifestyle

A well-balanced diet, regular exercise, and stress management are all integral parts of managing migraines. For instance, magnesium-rich foods and hydration can help reduce the frequency and severity of attacks.

4. Exploring Preventive Therapies

For people with severe or frequent migraines, preventive medications, such as beta-blockers or CGRP inhibitors, may be prescribed. These medications stabilize brain activity and therefore reduce the chances of migraine during hormonal fluctuations.

5. Mind-Body Techniques

Techniques like yoga, meditation, and biofeedback can enhance wellness and reduce the debilitating effects of stress-one of the most common migraine triggers.

Research that was once in its embryonic stage continues to shed more light on the role of hormones in migraines and other neurological conditions. Further breakthroughs in genetic testing might enable doctors to predict, at least in a way, how an individual would react to hormonal therapies. The importance of gender-specific approaches is gradually being realized, which involves differentiating between the plight of women with migraines from others.

As Dr. Pai puts it, "Empowering women with knowledge about the hormonal underpinnings of migraines can lead to better, more personalized care. With the right strategies, migraines can be effectively managed, allowing women to lead fuller, healthier lives.

Migraines are not headaches; they are a complex neurological condition that deeply impacts the lives of millions of women. Understanding the role of hormones in triggering and exacerbating migraines is a vital step toward better management and relief.

Awareness, proactive care, and advances in medical research can help women regain their lives from the grip of hormonal migraines. Whether tracking cycles, adopting healthier habits, or seeking tailored medical care, every step taken toward understanding and managing migraines is a step toward empowerment.

Dr Shivananda Pai is a Consultant Neurology at KMC Hospital Dr B R Ambedkar Circle in Mangalore, India.

Brandes JL. The Influence of Estrogen on Migraine: A Systematic Review. JAMA. 2006;295(15):1824–1830. doi:10.1001/jama.295.15.1824

Sacco S, Ricci S, Degan D, Carolei A. Migraine in women: the role of hormones and their impact on vascular diseases. J Headache Pain. 2012 Apr;13(3):177-89. doi: 10.1007/s10194-012-0424-y. Epub 2012 Feb 26. PMID: 22367631; PMCID: PMC3311830.

A two-year-old boy from Bristol, UK has died from a rare heart disease, known to mostly affect children with only flu-like symptoms, on January 8.

Hudson Martin had been diagnosed with Kawasaki disease when he was seven months old and was placed on lifelong medication including aspirin and blood thinners to reduce the risk of clots. Since then, he had been living a normal and happy life, according to father Damien Martin.

He told Bristol Live: "You’d never know anything was wrong from pictures or videos. He bounced off everything. He loved climbing, dancing, music, he was a proper daredevil."

But days before his third birthday, he suddenly collapsed while playing at home. Despite being given CPR by paramedics for an hour, his heart did not restart and he passed away.

“They did absolutely everything they could,” Damien said. "His heart just wouldn't come back."

What Is Kawasaki Disease?

Also known as mucocutaneous lymph node syndrome, Kawasaki disease causes inflammation in the walls of small to medium-sized blood vessels that carry blood throughout the body which can damage to the heart and blood vessels, mostly in children younger than five years old.

When this happens, the heart doesn't work as well to pump blood to the body and could burst (coronary artery dilation and aneurysms). It also causes swelling in the lymph nodes and mucous membranes inside the mouth, nose, eyes and throat.

Apart from a 102.2 degrees Fahrenheit (39 degrees Celsius) fever that can last for five days, children with Kawasaki may also experience some or all of the following symptoms:

• Rash on the main part of the body or in the genital area
• Swelling and redness of their hands and feet
• Irritation and redness of the whites of their eyes
• Swollen lymph glands in the neck
• Irritation and inflammation of the mouth, lips, and throat

It remains unknown what causes Kawasaki disease in children and if it affects adults.

Diagnosis involves ruling out other diseases that cause the same symptoms which include:

• Scarlet fever
• Juvenile rheumatoid arthritis
• Stevens-Johnson syndrome (a disorder of the mucous membranes)
• Toxic shock syndrome
• Measles
• Some illnesses caused by ticks, such as Rocky Mountain spotted fever

Is It Curable?

While this non-contagious disease can be treated with a mixture of antibodies given through the veins (intravenous immunoglobulin) and aspirin, it remains uncurable. Doctors may also advice steroids if intravenous immunoglobulin is not effective.

After receiving treatment for Kawasaki disease, most children recover fully and long-term follow-up care remains unnecessary. However, children who have suffered through aneurysms or other complications related to the disease will need lifelong monitoring with a cardiologist.

Cases of scabies, a highly contagious skin condition caused by microscopic mites, continue to remain higher than normal across England this winter, according to the latest surveillance data. Recent findings from the Royal College of General Practitioners’ Research and Surveillance Centre indicate that scabies has been spreading more widely than expected over the past few months, with infections steadily increasing through autumn and winter.

Overall, reported cases have stayed above the usual five-year average, with the sharpest rise recorded during the final four months of last year, particularly across northern regions of the country. With scabies infections continuing to climb, concerns are growing around which treatments are safe to use, especially when it comes to children.

What Is Scabies?

Scabies is caused by a microscopic parasite known as Sarcoptes scabiei. This mite burrows into the top layer of the skin to lay its eggs, triggering severe itching and a red, spotty rash that often becomes more intense at night. Although the mites are too small to be seen easily, measuring less than half a millimetre, the body reacts to their saliva, eggs, and waste, leading to an allergic response.

Scabies spreads through prolonged skin-to-skin contact and can affect people of all ages. According to the NHS, it is most commonly transmitted through close household contact, including between partners, family members, people living together, and during sexual activity.

How Is Scabies Spreading In The UK?

UK Health Security Agency surveillance data shows that scabies cases reported through sexual health services remained relatively stable before the COVID-19 pandemic, but numbers began rising sharply from 2022 onwards. Diagnoses increased from 3,393 cases in 2023 to 4,872 cases in 2024, marking a 44 per cent rise.

• London accounted for roughly one-third of all cases recorded in 2024.
• The steepest percentage increase was seen in the North East, where reported cases nearly doubled.
• Young adults aged 20 to 24 made up 41 per cent of diagnoses, while those aged 25 to 34 accounted for 31 per cent.

Scabies UK: What's Behind The Surge In Cases?

Both the UKHSA and the British Association for Sexual Health and HIV (BASHH) suggest several reasons could be driving the surge:

• Increased social interaction and physical contact following the pandemic, after years of reduced mixing.
• Greater awareness of scabies and more testing taking place at sexual health clinics.
• Overcrowded housing and the ongoing cost of living crisis, which may delay access to prompt treatment.

Experts also caution that the actual number of cases is likely much higher, as the available data only reflects diagnoses made in sexual health settings.

Scabies UK: Can Ivermectin Treat Scabies In Children Safely?

Ivermectin is an oral antiparasitic medicine used to treat scabies by paralysing the mites. It offers a systemic alternative to topical creams and is often considered in cases that are widespread, severe, or involve institutional outbreaks. Because the drug does not kill scabies eggs, a second dose is usually required after seven to fourteen days to target newly hatched mites.

According to the Centres for Disease Control and Prevention, ivermectin is generally well tolerated, improves treatment compliance compared to creams, and has been widely used in mass drug administration programmes, though repeat dosing is important due to its limited effect on mite eggs.

Despite its broad use in programmes targeting conditions such as river blindness, intestinal worms, and scabies, ivermectin has traditionally not been recommended for children weighing under 15 kilograms, largely due to limited safety data. However, researchers revisited this concern following a systematic review and meta-analysis that suggested the drug could be safe even in children weighing as little as 11 pounds.

In a double-blind clinical trial, researchers assessed the safety, effectiveness, and pharmacokinetics of ivermectin in young children with scabies. A total of 240 children weighing between 11 pounds and under 33 pounds in The Gambia, Kenya, and Brazil were randomly assigned to receive ivermectin at doses of 200, 400, or 800 micrograms per kilogram alongside a placebo cream, or placebo tablets alongside permethrin cream. Blood samples were collected on days 0, 3, 7, 10, and 14 to monitor biochemical markers, drug levels, and blood health.

Ivermectin: Only One Serious Adverse Event

The findings showed that ivermectin was effective in treating scabies, with just one serious adverse event reported. This involved a temporary increase in liver enzymes, which returned to normal levels within 32 days. All other side effects possibly linked to the treatment were mild, resolved on their own, and were similar to those seen in children weighing more than 33 pounds.

“Outcomes from the Ivermectin Safety in Small Children trial will hopefully provide greater reassurance that ivermectin can be safely used in children weighing less than 15 kilograms,” said lead study author Kevin Kobylinski, PhD, an honorary visiting research fellow at the University of Oxford with the Mahidol Oxford Tropical Medicine Research Unit in Bangkok, in an ASTMH press release.

England is recording higher-than-normal scabies infections this winter. Health authorities have cautioned that the condition, caused by microscopic mites known as Sarcoptes scabiei that tunnel into the skin, spreads quickly through close physical contact and often leads to severe itching and irritation. Data from the Royal College of General Practitioners’ Research and Surveillance Centre shows scabies is circulating more widely than usual in England, with cases increasing through the autumn and winter months.

Also Read: Doctor Explains Why Weight Loss Drugs Like Ozempic Are Truly A Medical Breakthrough

Scabies UK: What Is Scabies?

Scabies is caused by the Sarcoptes scabiei mite. These tiny parasites burrow beneath the skin where they survive, feed and lay eggs. The presence of the mites triggers an allergic reaction in the skin, resulting in an itchy rash. Scabies passes easily from one person to another, particularly among people living in close quarters.

If one member of a household is infected, doctors usually advise checking and treating other family members and close contacts at the same time, according to the Cleveland Clinic.

Scabies UK: What Are The Early Symptoms Of Scabies?

Early signs of scabies include intense itching, which is often worse at night, along with a pimple-like rash, small blisters, and thin, irregular lines on the skin known as burrows. These symptoms commonly appear between the fingers, on the wrists, elbows, armpits, waist and genitals. According to the National Health Service, these reactions occur due to the body’s response to the mites and their eggs beneath the skin.

Symptoms do not usually appear straight away and may take three to six weeks after the initial infection to develop. However, people who have had scabies before may notice symptoms within a few days. Typical signs include severe night-time itching and small bumps, blisters or burrow-like tracks on areas such as the hands, wrists, elbows, nipples, genitals and waist.

In more severe cases, the skin may become thickened, rough and scaly. Among children and older adults, scabies can also affect the scalp, face or the soles of the feet.

Scabies UK: Are There Different Types Of Scabies?

Yes, scabies exists in several forms beyond the classic type. These include:

• Crusted (Norwegian): This form is more likely to affect people with weakened immune systems. It causes thick crusts over large areas of skin and can involve millions of mites, compared with the 10 to 15 mites typically found in classic scabies.
• Nodular: More commonly seen in children, this type affects areas such as the genitals, groin or armpits. Firm, raised lumps may persist even after the mites have been eliminated.

Scabies UK: How Is Scabies Treated?

Scabies is usually treated successfully with prescribed medicated creams and lotions called scabicides, along with careful hygiene measures. To avoid reinfection, clothes, bedding and towels should be washed at high temperatures and tumble-dried or ironed. Items that cannot be washed should be sealed in a bag for at least three days, as the mites cannot survive without contact with human skin.

Professor Michael Marks, a professor of medicine at the London School of Hygiene and Tropical Medicine and former chair of the International Alliance for the Control of Scabies, said the rise in cases may be linked to delays in accessing medical care and gaps in identifying and treating close contacts, which can allow the infection to continue spreading.