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.

Feeling breathless after climbing several flights of stairs or a session of strenuous exercise is usually considered normal.

But breathlessness that appears suddenly, happens frequently, or occurs during routine activities should never be dismissed as tiredness or lack of fitness.

When Is Breathlessness Concerning?

Breathlessness, clinically known as dyspnoea, can occur due to many reasons. Asthma, allergies, respiratory infections, chronic lung disease, and heart problems are some of the common possibilities. Anxiety, anaemia and obesity could also be driving factors.

In some cases, persistent or unexplained breathing difficulty may also be linked to more serious conditions, including lung cancer. The important thing is to understand when breathlessness needs medical attention.

HealthandMe spoke to lung disease experts - Dr. Sachin Kumar, Director of Pulmonology & Critical Care Medicine, Sakra World Hospital, Bengaluru, Dr. Sanjeev Kumar, Director & Unit Head of GI & HPB Surgical Oncology & Clinical Administrator, Surgical Oncology, Max Super Specialty Hospital, Dwarka, Dr. Ruchi Singh, HOD & Senior Consultant, Radiation Oncology, Asian Institute of Medical Sciences, and Dr. Ashwin Mallya, Uro-Oncologist and Robotic Surgeon, Sir Ganga Ram Hospital.

Dr. Sanjeev Kumar explains that breathlessness that gets worse during routine activities are major red flags. He also says that other symptoms like chronic cough, coughing up blood, tiredness, and others should not be neglected.

He says, "Pay attention if breathlessness is accompanied by chest pain or pressure, dizziness, fainting, unusual sweating, bluish lips or fingertips, or a feeling that you cannot get enough air. A persistent cough, wheezing, recurring chest infections, coughing up blood, unexplained weight loss or prolonged fatigue along with breathlessness also deserves medical assessment. A cough that does not go away or changes in a long-standing smoker’s cough should not be overlooked. Although these symptoms can have several causes, they can occasionally be associated with lung cancer and need appropriate evaluation."

He also said that changes in usual breathing capacity is also a red flag. He said that if you previously walked comfortably for 20–30 minutes but now have to stop frequently because you are breathless, this change should not simply be attributed to age.

Also read: Lung Nodule on CT Scan? Doctors Explain When You Should Worry

Risks Of Delayed Evaluation & Treatment

Dr. Ruchi Singh points to a worrying trend. She said that the initial symptoms of lung cancer are usually dismissed as routine, which leads to delayed evaluation and treatment.

She says, "One of the most concerning things we are tracking is how late many patients present. Because symptoms like persistent cough or breathlessness are so easily mistaken for pollution-related irritation or a lingering infection, people delay getting scanned."

She explains that earlier detection through low-dose CT screening in high-risk groups remains the best tool for improving survival, and awareness needs to catch up with how the patient's profile itself is changing.

Also read: Can Fitness Hide Lung Cancer? Why Even Active People Shouldn't Ignore Symptoms

Importance Of A Multidisciplinary Approach

Talking about how lung cancer could metastasize, Dr Ashwin Mallya explains that along with early evaluation, it is essential to adopt a treatment strategy

Dr Mallya said, "Although primarily a thoracic malignancy, lung cancer frequently extends beyond the chest. Adrenal metastases are among its most common distant manifestations, while renal metastases, though less frequent, are well recognised."

He added, "These patterns underscore the importance of a multidisciplinary approach, often bringing urologists into the care of patients with advanced disease."

Also read: 'I Wish Every Patient Knew This Before Their Lung Cancer Diagnosis'- Lessons From An Oncologist

Lung Cancer Is No Longer A Smoker's Disease

Giving a real-life example of how lung cancer is no longer a smoker's disease, Dr Sachin Kumar said, "A 50-year-old lady went to the clinic seeking a second opinion after being treated for "asthma" for several weeks. She complained of occasional breathlessness and a persistent cough. Despite inhalers, her symptoms continued. A simple chest X-ray revealed something entirely different: a massive pleural effusion (fluid around the lung). Further evaluation confirmed the underlying cause: *lung cancer that had spread to the pleura (the lining surrounding the lungs).

He added, "This case is a reminder that not every cough or episode of breathlessness is asthma. When symptoms persist or do not respond as expected, they deserve a fresh look. Sadly, lung cancer is no longer a disease seen only in older male smokers. In our own practice, we now diagnose around 2–3 new cases of primary lung cancer every three months, and nearly 40% of these patients are either women or people who have never smoked."

Kidney stones are no longer a disease seen only in middle-aged adults. Across urban India, nephrologists are witnessing an increasing number of young professionals developing kidney stones. Sedentary lifestyles, inadequate water intake, unhealthy dietary habits, obesity, and rising temperatures are all contributing to this growing problem.

It is estimated that nearly one in every ten Indians will develop a kidney stone during their lifetime, and almost half of these patients may experience recurrence if preventive measures are not adopted.

Why Are Kidney Stones Becoming More Common?

Kidney stones form when minerals and salts in the urine become highly concentrated and crystallize inside the kidneys.

Several lifestyle factors increase this risk:

• Drinking too little water

• Excessive salt intake

• Frequent consumption of processed foods and sugary beverages

• High intake of animal protein

• Obesity and sedentary lifestyle

• Diabetes and hypertension

• Prolonged exposure to hot weather causing dehydration

• Busy work schedules, air-conditioned offices, frequent travel, and ignoring the urge to drink water have become common contributors in urban populations

Also read: Adult Kidney Transplant Recipients Who Took COVID-19 Drug Remdesivir At Lower Risk Of Transplant Failure

Warning Signs

The symptoms depend upon the size and location of the stone. Small stones may pass unnoticed, while larger stones can produce severe pain. Common symptoms include:

• Sudden severe pain in the back, side, or lower abdomen

• Pain radiating towards the groin

• Burning during urination

• Blood in urine

• Increased frequency or urgency of urination

• Nausea and vomiting

• Fever with chills, especially if infection develops

• Persistent pain, fever, or difficulty passing urine should never be ignored, as these may indicate obstruction or infection requiring urgent medical attention

Also read: Why Dialysis Patients Should Check Their Fistula Every Day

Can Kidney Stones Be Prevented?

The answer is yes. Most kidney stones can be prevented through simple lifestyle modifications. The most important preventive measure is adequate hydration. Adults should drink enough fluids to produce at least 2–2.5 litres of urine daily, which generally requires about 2.5–3 litres of water per day, depending on climate and physical activity.

Other preventive measures include:

• Reduce salt intake

• Limit processed and packaged foods

• Moderate consumption of red meat

• Avoid excessive sugary drinks

• Maintain a healthy body weight

• Exercise regularly

• Control diabetes and high blood pressure

Contrary to popular belief, dietary calcium should not be avoided unless specifically advised by a doctor. In fact, normal calcium intake helps reduce oxalate absorption and lowers the risk of stone formation.

Modern Treatment Has Changed the Outlook

Fortunately, advances in technology have made kidney stone treatment highly effective and minimally invasive.

Small stones often pass with increased fluid intake, pain relief, and medications that relax the urinary tract. However, larger or obstructing stones require specialist treatment.

Current treatment options include:

• Extracorporeal Shock Wave Lithotripsy (ESWL): Non-invasive shock waves break stones into smaller fragments

• Ureteroscopy (URS): A thin endoscope is passed through the urinary tract to remove or fragment stones

• Retrograde Intrarenal Surgery (RIRS): Flexible laser technology allows treatment of stones inside the kidney without any external incision

• Percutaneous Nephrolithotomy (PCNL): Recommended for large or complex kidney stones through a small skin incision

• Compared with conventional open surgery, these procedures offer higher success rates, less pain, shorter hospital stays, and faster recovery

The Take-Home Message

Kidney stones are becoming increasingly common but are largely preventable. Adequate hydration, healthy dietary habits, regular exercise, and timely medical evaluation can significantly reduce the risk. Those who have already developed one stone should undergo metabolic evaluation and follow preventive advice, as recurrence is common.

Early diagnosis and timely treatment not only relieve pain but also protect kidney function and improve long-term health.

Many people assume that if they exercise regularly, eat healthy, and stay active, they are naturally protected from serious illnesses like lung cancer. It is a comforting belief but unfortunately, it is not entirely true. While a healthy lifestyle lowers the risk of many diseases and improves overall well-being, it does not make anyone completely immune to lung cancer.

This misconception often leads to another problem: delayed diagnosis. When someone who has never smoked or is physically fit develops a persistent cough, unusual tiredness, or breathlessness, they may dismiss these symptoms as a lingering cold, seasonal allergies, or simply overexertion after a workout. Family members may do the same, assuming that someone who looks healthy couldn't possibly have a serious lung condition. As a result, valuable time may be lost before medical help is sought.

Being Fit Doesn't Eliminate Lung Cancer Risk

Some forms of lung cancer, especially adenocarcinoma, develop in the outer parts of the lungs, where they may grow silently for months before causing noticeable symptoms.

Also read: The 'Safer Than Smoking' Myth? Doctors Warn Vaping May Carry Its Own Lung Cancer Risks

Warning Signs That Should Never Be Ignored

One of the challenges is that active individuals often have better lung capacity and stamina, allowing their bodies to compensate for early changes. This can make the warning signs subtler in the beginning.

A persistent cough, breathlessness during activities that once felt easy, unexplained fatigue, chest discomfort, hoarseness of voice, recurrent chest infections, coughing up blood, or unexplained weight loss should never be ignored, especially if these symptoms last for more than two to three weeks.

Also read: Bryan Johnson's New 2.6M Women's Health Project Centers on Girlfriend's Menstrual Blood

Early Detection Can Save Lives

The encouraging news is that early detection can make a significant difference. Recognizing persistent symptoms and seeking medical evaluation promptly can lead to earlier diagnosis, when treatment is often more effective. Depending on an individual's symptoms and risk factors, a doctor may recommend investigations such as a chest X-ray or CT scan.

Staying physically active remains one of the best decisions a person can make for their health. Exercise strengthens the heart, improves lung function, and reduces the risk of several chronic diseases.

But fitness should never create a false sense of security. The body has its own way of asking for attention, and listening to those signals no matter how healthy a person feels can sometimes be the most important step toward protecting long-term health.

By Dr. Jayesh Prajapati, Senior Consultant Surgical Oncology, Sterling Hospital, Ahmedabad