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.

For most people, the arrival of monsoon brings welcome relief from the scorching summer heat. For physicians, however, it also signals the beginning of a season when managing chronic lifestyle diseases becomes significantly more challenging.

High humidity, fluctuating temperatures and a sharp rise in seasonal infections create conditions that can quietly destabilise diabetes, hypertension and heart disease, even in people whose conditions are otherwise well controlled.

Lifestyle diseases are often thought of as long-term conditions that progress gradually. Yet they are also highly sensitive to environmental changes. During the monsoon, the body works harder to regulate temperature and maintain normal circulation. High humidity reduces the body'sability to cool itself efficiently, increasing the workload on the heart. At the same time, sudden shifts between hot outdoor conditions and cold indoor environments can influence blood vessel function, leading to fluctuations in blood pressure. These physiological changes may seem subtle, but for individuals living with chronic illnesses, they can increase the likelihood of complications.

The season also brings a surge in viral, bacterial and mosquito-borne illnesses. Infections such as influenza, gastroenteritis, dengue, and fungal diseases are becoming more common, placing additional stress on the body. For people living with diabetes, even a relatively minor infection can upset blood sugar control. The body's response to illness triggers the release of stress hormones that increase blood glucose levels. In contrast, changes in appetite and food intake during illness may increase the risk of both hyperglycaemia and hypoglycaemia if medications or insulin are not adjusted appropriately under medical supervision.

Beyond infections, the monsoon often disrupts everyday routines that are essential for effective diabetes management. Reduced physical activity due to persistent rainfall, missed walks, and a greater tendency to indulge in fried, calorie-dense comfort foods can contribute to poor glycaemic control. Prolonged exposure to damp conditions, particularly from wearing wet or closed footwear for extended periods, also increases the risk of fungal infections and delayed wound healing—complications that people with diabetes are already more susceptible to. While these changes may appear routine, together they can make diabetes significantly more difficult to manage during the rainy season.

Seasonal changes equally influence hypertension, although the effects are often less obvious. Variations in temperature and atmospheric pressure can cause blood vessels to constrict or relax, leading to fluctuations in blood pressure. Dietary habits also tend to shift during the rainy season, with increased consumption of salty snacks, pickles, and processed foods, which contribute to sodium overload and fluid retention. Because hypertension frequently remains symptomless, many people assume they are doing well despite missing medicines or delaying routine blood pressure checks. Unfortunately, uncontrolled blood pressure often comes to light only after a serious complication such as a stroke, heart attack, or acute cardiac event.

By Dr. Manjeeta Nath Das, Associate Director – Internal Medicine, PB Health

A cough that lingers for weeks is often dismissed as a stubborn cold, allergy, or lung infection. However, ENT specialists warned that in some cases, the real cause may be acid reflux, a condition that can affect the throat even without the typical symptom of heartburn.

Doctors told HealthandMe that recognizing the signs early can help patients receive the right treatment and prevent long-term complications.

When Does Acid Reflux Trigger a Chronic Cough?

According to Dr. Nishit Shah, ENT/Otorhinolaryngologist at Bombay Hospital, acid reflux, also known as gastroesophageal reflux disease (GERD), does not always present with chest burning.

"Sometimes people with reflux do not feel the usual symptom of heartburn in their chest. Instead, the acid from their stomach goes up into their throat, irritates it, which can cause a dry cough that will not go away, a hoarse voice, or a feeling that something is stuck in their throat," Dr. Shah told HealthandMe.

He advised that if a cough lasts for more than eight weeks and does not improve with usual medicines, acid reflux should be considered as a possible cause.

"It is very important to know what is causing your cough because if you just treat the cough, the acid reflux can still be hurting your throat," Dr. Shah said.

Not Every Throat Symptom Is Acidity

Also read: 'Let's Fix Our Food': India Launches New Policy To Fight Childhood Obesity, Boost Nutrition

However, not every throat symptom should be dismissed as acidity.

Dr. Alok Aggarwal, Chairperson, ENT, Sir Ganga Ram Hospital, said silent reflux often presents as intermittent throat irritation, a sensation of something stuck in the throat, or occasional voice changes.

"These symptoms are often judged as acidity by the common man, and people start self-medicating with antacids and even ayurvedic medicines. Less do they know that this can be a symptom of some underlying ENT disease," he said.

He explained that laryngopharyngeal reflux disease (LPRD) occurs when food or semi-digested food enters the pharynx, irritating its lining.

"It causes symptoms such as throat irritation, burning sensation, pain in throat, nasal irritation, globus sensation and change in voice," Dr. Aggarwal told HealthandMe.

ENT Evaluation Is Essential

Read More: Japanese PM Sanae Takaichi Sleeps 3 Hours A Night: How Much Sleep Do You Really Need?

While LPRD is commonly diagnosed, Dr. Aggarwal cautioned that similar symptoms may also be caused by allergic rhino-pharyngitis, chronic rhino-sinusitis, vocal nodules or polyps, laryngeal leukoplakia, and candida infection.

"Though this comes as the most common diagnosis in clinical practice, it often overshadows some very serious conditions which mimic the symptoms, and only after a thorough ENT examination can the exact diagnosis be made," he said.

He added that these conditions can be effectively diagnosed through thorough history-taking, clinical examination, and endoscopic examination.

"As doctors, we need to educate our patients regarding the disease physiology and the differentials it carries before establishing any diagnosis. A timely and adequate intervention with planned treatment can effectively cure the patient in most cases," Dr. Aggarwal said.

Lifestyle Changes May Help Control Symptoms

Dr. Shah recommended avoiding heavy meals, especially at night, limiting fatty foods, maintaining a healthy weight, and sleeping with the head elevated to help manage acid reflux.

"If people know that acid reflux can cause a cough, they can get a diagnosis sooner, get the right treatment and finally feel better," he added.

Dr. Aggarwal stressed the importance of timely medical evaluation.

"Early diagnosis and treatment can avoid unnecessary medications and avoid missing out on serious complications. A stitch in time saves nine," he said.

Japanese Prime Minister Sanae Takaichi has sparked debate after revealing that she gets very little sleep since taking office.

In a post on X, Takaichi wrote that she had managed to get "five full hours of sleep for the first time in ages"—an improvement from her usual "zero to three hours" a night since becoming prime minister.'.

"On weekdays, by the time I get back to the residence, I'm maxed out on private time just handling bath cleaning, bathing, dinner, washing up afterward, laundry, and some light tidying," she wrote.

"So the late-night hours after that get consumed until dawn with reading materials brought back from the Prime Minister's Office or prepping for … question time."

Takaichi added that whatever free time remained was spent ironing handkerchiefs, catching up on laundry, and repairing clothes.

While the disclosure offered a rare glimpse into the pressures of Japan's highest office, it also sparked a nationwide debate about the health risks of chronic sleep deprivation.

"I think she should rest more," Democratic Party for the People leader Yuichiro Tamaki said at a news conference.

"Why doesn't her entourage provide more support to create an environment in which she can make important decisions with a fresh mind?"

However, some of Takaichi's colleagues defended her.

"Each person has their own various circumstances and behind-the-scenes stories, and on the premise of fulfilling responsibilities in public duties, I would be grateful if you could understand," Deputy Foreign Affairs Minister Ayano Kunimitsu wrote on X.

Also read: Could Poor Sleep Be One of the Earliest Signs of Alzheimer's Disease? Study Says Yes

How Much Sleep Do You Really Need?

Dr. Nitin Dange, Comprehensive Stroke and Endovascular Neurosurgeon at Lilavati Hospital and Research Centre, Mumbai, told HealthandMe that regularly missing sleep can increase the risk of neurological problems over time.

"Currently, due to hectic schedules, people are now sacrificing sleep to meet work deadlines, study longer, or spend more time on screens. Missing a few hours of sleep once in 2-3 months is harmless.

However, chronic sleep deprivation can not only cause irritation and weight gain but also neurological issues. During sleep, the brain processes memories, repairs nerve cells, regulates emotions, and clears waste products that accumulate throughout the day," Dr. Dange said.

A recent research, published in the journal Alzheimer's & Dementia, suggests that disruptions in rapid eye movement (REM) sleep, during which we dream, consolidate memory, and process emotions, could be among the earliest biological signs of Alzheimer's disease.

Dr. Priyam Bordoloi, an Internal Medicine Resident from Assam, also highlighted the dangers of sleeping less than six hours a night.

"When you hit deep sleep, your brain's glymphatic system activates. Think of it as a plumbing system that actively flushes out metabolic waste and neurotoxic proteins (like beta-amyloid) accumulated during the day. When you consistently sleep less than 6 hours, you cut this vital cleaning cycle short. The toxins build up. If you do not fix this, you are actively fast-tracking your risk for Alzheimer's, Parkinson's, stroke etc. It's a bad habit we all need to fix," he wrote on X.

Tips To Sleep Better

Experts recommend getting 7-9 hours of sleep every night for optimal brain health.

• Maintain a consistent sleep and wake-up schedule.
• Avoid screens, caffeine, and heavy meals before bedtime.
• Exercise regularly, but avoid intense workouts late at night.
• Keep your bedroom quiet, cool, and dark.
• Consult a doctor if you snore loudly, stop breathing during sleep, or feel excessively sleepy during the day.