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 very common medical condition globally, sleep apnea is a disorder that interrupts breathing during sleep. Several factors can cause it, though the risk rises sharply with obesity because extra fat in the neck, known as pharyngeal fat, can narrow the airway. Health professionals usually advise lifestyle changes such as diet and exercise to ease symptoms, but if these steps do not help enough, weight-loss injections may be recommended.

Australia’s Therapeutic Goods Administration (TGA) has now approved the weight-loss drug Mounjaro as a treatment option for sleep apnea, a condition where a person repeatedly stops and starts breathing through the night. The TGA states that Mounjaro may be used for adults with moderate to severe obstructive sleep apnea who also meet the criteria for obesity with a body-mass index of 30 or more.

The United States Food and Drug Administration cleared the same drug for this purpose last year. This raises an important question. How could a medicine known mainly for weight management and type 2 diabetes support people struggling with sleep apnea?

What Is Sleep Apnea?

Obstructive sleep apnea affects close to a billion people worldwide. It causes repeated pauses in breathing that disrupt sleep and reduce oxygen levels. Many people notice loud snoring, choking or gasping, and heavy daytime fatigue. The main forms are obstructive sleep apnea (OSA), caused by a blocked airway, and central sleep apnea (CSA), which occurs when the brain does not send the right signals to the breathing muscles. If ignored, it can raise the risk of high blood pressure, heart disease and stroke, according to the Mayo Clinic.

How Does Obesity Trigger Sleep Apnea?

Obesity is one of the strongest contributors to obstructive sleep apnea. Roughly 80% of people diagnosed with the condition also live with obesity. The link runs in both directions. Extra fat around the neck can make the airway narrower and disturb breathing.

At the same time, sleep apnea can interfere with hunger and satiety hormones such as ghrelin and leptin, which can encourage overeating. Persistent tiredness makes it harder to stay active or maintain healthy habits, creating a cycle in which both problems feed into each other.

How Can Mounjaro Help With Sleep Apnea?

Mounjaro is the brand name for tirzepatide, also sold elsewhere under names like Zepbound. It works by activating receptors for two gut hormones known as GLP-1 and GIP. These hormones help control appetite, food intake and blood sugar. They are normally released when we eat, but tirzepatide mimics their action so people feel satisfied with smaller portions. Eating less overall can lead to gradual weight loss, which may improve sleep apnea symptoms in those whose condition is tied to obesity.

Mounjaro Side Effects

Although Mounjaro may be useful for some adults with sleep apnea, digestive side effects are fairly common. People may experience nausea, vomiting, diarrhoea, constipation or a drop in appetite. These issues often lessen as the body adjusts. Some users have also noted gallbladder-related concerns.

Even with these drawbacks, interest in Mounjaro as a sleep apnea therapy is growing because it offers a drug-based option for a condition long treated mainly with devices such as CPAP machines. Still, the medication is meant for people with obesity, and not everyone with sleep apnea falls into that category.

It is always best to speak with a healthcare provider before beginning or stopping any prescribed treatment.

A three-year-old boy from California has stunned doctors with his rapid progress after receiving a world-first gene therapy for Hunter syndrome, a rare inherited condition that causes progressive damage to the body and brain. The treatment was carried out at the Royal Manchester Children’s Hospital and offers new hope for families who have long lived with the devastating effects of the disease.

What Is Hunter Syndrome?

Hunter syndrome is caused by a faulty gene that prevents patients from producing an enzyme needed to clear certain molecules from cells. Children appear healthy at birth but start showing symptoms around age two. The condition affects the heart, liver, bones and brain and is often described as a form of childhood dementia. Most severely affected patients rarely live beyond their teenage years.

How Doctors Tried to Halt the Disease

Before treatment, Oliver Chu could not produce the crucial enzyme, reports BBC. Conventional therapy required weekly infusions that only slowed physical decline and could not protect the brain. Doctors in Manchester decided to attempt a one-time gene therapy, something never tried before for this condition.

Stem cells were collected from Oliver’s blood in December 2024 and sent to a specialist laboratory at Great Ormond Street Hospital in London. Scientists inserted a working copy of the missing gene into a harmless virus. The virus delivered the corrected gene into Oliver’s stem cells, allowing them to produce the missing enzyme once infused back into his body. Researchers also modified the gene to help the enzyme travel more easily into the brain, a major challenge in previous treatments.

The First Infusion

In February 2025, Oliver returned to Manchester for the infusion. His corrected stem cells, about 125 million of them, arrived frozen in a cryopreservation tank. After several safety checks, nurses slowly injected two doses into a catheter in his chest. The entire process took minutes, but the hope behind it was enormous. Once the infusion was complete, Oliver and his mother returned to California to wait for results.

Signs of Improvement

By May, the effects were becoming clear. Oliver’s speech had improved, his mobility had increased, and his parents described him as “brighter” and “healthier.” Most significantly, he no longer needed the expensive weekly enzyme infusions. His body had begun producing the enzyme on its own.

His older brother Skyler, who also has Hunter syndrome, accompanied the family to Manchester during this follow-up visit. Their parents now hope Skyler may also qualify for the therapy one day.

A Year That Changed Everything

By late August, nine months after treatment, doctors confirmed that Oliver was producing far above normal levels of the missing enzyme. He was gaining new words, moving more easily and showing continued cognitive progress. Professor Simon Jones, who co-leads the trial, praised Oliver’s development but noted that researchers still need long-term data.

Five boys from the United States, Europe and Australia are enrolled in the ongoing trial. No UK patients qualified because most were diagnosed too late. Participants will be monitored for at least two years to assess effectiveness and safety.

A Trial That Nearly Collapsed

The gene therapy almost never reached patients. Researchers at the University of Manchester had spent over 15 years developing it but nearly lost funding when their biotech partner withdrew. A last-minute contribution of 2.5 million pounds from the medical charity LifeArc saved the trial and allowed children like Oliver to join.

His parents say they are “eternally grateful” and feel his life has been “reset.” For them, the treatment represents not just medical progress but a future filled with possibilities.

For decades, cardiologists have noticed a clear seasonal trend. Heart attacks tend to rise during the winter months. Patients who already have heart conditions often see their health decline in the cold season, requiring more frequent and longer hospital stays. As winter approaches, pollution levels spike dramatically, making breathing more difficult, and for good reason.

Multiple factors combine to create this seasonal risk. We spoke to Dr. Vikash Goyal, Senior Cardiologist at Paras Health, Gurugram, to understand why chest pain becomes more common in winters.

Why Does Winter Trigger More Heart Risks?

Traditionally, this increase in heart-related issues has been linked to the body’s response to cold temperatures. Winter causes blood vessels to constrict and can lead to higher blood pressure, while reduced sweating may cause salt to build up in the body.

Less physical activity, along with a tendency to eat heavier, richer foods, adds to weight gain and raises blood sugar and cholesterol. Together, these factors increase the workload on the cardiovascular system, contributing to the rise in cardiac events during the winter months.

How Does Winter Pollution Trigger Chest Pain?

One constant in North Indian winters is a sharp rise in air pollution that comes alongside dropping temperatures. As the air cools and circulation slows, a thick layer of smog lingers over many cities. This pollution is a mix of vehicle emissions, construction dust, industrial smoke, and seasonal crop stubble burning. The simultaneous rise of air pollution and winter cardiac hospitalizations is too pronounced to ignore.

Dr. Vikash Goyal explained that air pollution has a significant but often overlooked effect on heart health. The heart relies on clear blood flow to support all major organs. When polluted air enters the lungs, tiny particles enter the bloodstream, triggering inflammation throughout the body. This narrows and stiffens blood vessels, forcing the heart to work harder while reducing oxygen supply to vital organs like the brain and kidneys.

He said, “This can lead to headaches, fatigue, dizziness, or worsening kidney function. During winter, the combination of cold temperatures and trapped smog thickens the blood and raises blood pressure, putting extra strain on the heart.” This explains why chest pain, breathlessness, and other cardiac issues increase during winter pollution season. Protecting yourself from polluted air isn’t just about lungs—it’s about safeguarding your whole cardiovascular system.

How Do PM2.5 Particles Harm The Cardiovascular System?

According to the World Health Organization, PM2.5 particles entering the bloodstream can cause multiple harmful effects on the heart. They trigger inflammation, destabilize cholesterol plaques, and increase the risk of plaque rupture, a common cause of heart attacks. They also create oxidative stress, producing free radicals that damage blood vessels and speed up atherosclerosis. Additionally, PM2.5 thickens the blood and makes platelets stickier, raising the chance of clots forming in blood vessels.

How To Protect Your Heart During Winter Pollution?

To reduce the impact of winter pollution on your heart, limit outdoor exposure on high-pollution days, wear N95 or N99 masks when going out, and use air purifiers and humidifiers indoors. Stay hydrated, eat foods rich in antioxidants, and keep an eye on your health.

If you notice persistent chest pain, tightness, or other concerning symptoms, seek medical help immediately.