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.

Scoliosis is a fairly common spinal condition that is most often detected during adolescence. Each year, nearly 3 million new cases are diagnosed in the United States, and most of these fall under idiopathic scoliosis, a form that typically develops during the teenage years without a clear cause. In many cases, structural changes in the spine go unnoticed by parents until they begin to show outward physical signs. Scoliosis and kyphosis are among the most frequently seen spinal disorders, both involving abnormal curvature of the spine.

Scoliosis refers to a sideways curve of the spine and is most commonly seen in children and teenagers, though it can affect people at any age. Congenital scoliosis, in particular, may not be visible at birth. It can remain hidden for years and often becomes noticeable during periods of rapid growth. What begins as a minor internal change can gradually turn into a clearly visible curve as a child enters puberty.

To understand this condition better, we spoke with Dr Saraswati Viswanathan, Consultant – Orthopaedics at Manipal Hospital, Kanakapura Road, who shared her insights.

What Is Scoliosis?

Scoliosis is a condition in which the spine curves from side to side, unlike the spine’s normal front-to-back shape. In many cases, the curve is mild and may not cause noticeable symptoms, but it can sometimes lead to back discomfort and changes in posture. The condition is most commonly diagnosed during adolescence. According to the Cleveland Clinic, treatment options may include physical therapy, the use of braces, or surgery, depending on the severity.

Symptoms Of Scoliosis

As noted by the Cleveland Clinic, scoliosis often does not cause obvious symptoms. However, when symptoms do appear, they may include:

• Back pain.
• Trouble standing straight.
• Weakness in the core muscles.
• Pain in the legs, or sensations such as numbness or weakness.

What Are The Types Of Scoliosis?

There are three main types of scoliosis:

• Idiopathic scoliosis: This is the most common form. The term “idiopathic” means that the exact cause is unknown. Research suggests it can run in families and may have a genetic connection.
• Congenital scoliosis: This is a rare condition caused by abnormal spinal development before birth. It occurs when the vertebrae do not form properly during early embryonic growth.
• Neuromuscular scoliosis: This type is linked to conditions that affect the muscles and nerves supporting the spine. It is often seen alongside neurological or muscular disorders such as cerebral palsy, spina bifida, muscular dystrophy, or after certain injuries.

How Can We Identify This Condition Early?

According to Dr Viswanathan, while a visible S-shaped or C-shaped curve is a well-known sign of scoliosis, one of the earliest indicators parents can look for at home is uneven shoulder height. If one shoulder consistently appears lower than the other, it may suggest an underlying spinal curve. Other signs to watch for include a noticeable hump on the back, uneven rib or chest appearance, or hips that look tilted or asymmetrical when the child is standing straight.

If you notice any of these changes, there is no need to panic, but it is important to take action. One simple screening method is Adam’s Forward Bend Test. Ask your child to bend forward at the waist and look for any unevenness in the shoulders or a raised area on one side of the back. Early screening and timely care can make a significant difference in managing spinal health and preventing the condition from worsening. Scheduling a visit with a pediatrician or orthopaedic specialist for proper physical and clinical evaluation can help rule out structural issues and ensure your child gets the right support as they grow into adulthood.

Last week, the Royal Pharmaceutical Society (RPS) advised the public to not use nasal decongestant for more than seven days. The guidelines said that it contains xylometazoline or oxymetazoline. Prolonged use of which could cause 'rebound congestion' or increase dependency on these sprays to breathe easily.

Recently, with the flu cases rising, flu-like symptoms, including nose congestion too have gone up. It is because of this reason, many are using nasal spray continuously, which could cause rebound congestion.

To understand this better, Health and Me spoke to Dr Pranita Bauskar, ENT, Apollo Spectra, Pune.

What Did The Doctor Say About Nasal Spray Usage?

Nasal sprays are widely used by many people to relieve a blocked or stuffy nose caused by colds or allergies. Dr Bauskar explained, "These nasal sprays are known to provide immediate relief. Using decongestant nasal sprays for more than 5 to 7 days could worsen the congestion and steal the piece of mind."

Read: Nasal Spray Warning Over 'Rebound Congestion'; Experts Say It Should Not Be Used For More Than 7 Days

What Does Rebound Congestion Mean?

Doctor says that as the nose becomes more blocked once the medication wears off, this creates a cycle of dependency. "Hence, it is necessary to limit the use of decongestant sprays to a few days only."

What Can Be Used Instead?

Dr Bauskar says, "you can try safer alternatives such as saline nasal sprays or rinses to keep nasal passages moist." Furthermore, the doctor suggests to not to forget to take steam "at least two times a day". "Doing so will help to ease congestion. Ensure to take warm showers, and you will feel better," noted Dr Bauskar.

It is imperative to have allergy medications like antihistamines if allergies persist, as prescribed by the doctor, noted the doctor.

"Everyone is also advised to stay hydrated by drinking enough water and liquids. Try to use a humidifier at home. If a person has congestion for over a week and is unable to breathe ,then don’t rely on nasal sprays and consult the doctor to rule out infections or other underlying problems," said Dr Bauskar.

Is Rebound Congestion Preventable?

It is a preventable condition, and is scientifically known as rhinitis medicamentosa, which causes the symptoms to worsen. Patients become depended on the sprays to breathe more easily.

RPS survey of 300 pharmacists found that 59% think the public is not aware of the risks, while 75% said packaging should be clearer about the seven-day limit. 63% said they had intervened in cases of suspected overuse.

Professor Amira Guirguis, chief scientist at RPS told the ITV News, "Nasal decongestant sprays can be helpful for short-term relief, but using them for longer than seven days can make your congestion significantly worse. Our research shows that many people are unaware of this risk, which means they may continue using these sprays without realizing they could be prolonging their symptoms. We'd like to see clearer warnings on the packaging which you can't miss and greater awareness of the seven-day limit. If your congestion lasts more than a week, speak to your pharmacist. There are safe and effective alternative options to help you manage your symptoms."

Another survey by ITV News suggests that more than a fifth of adults have used the products for longer than seven days. This means 5.5 million people in the UK may have risked developing a dependency.

A one-year-old baby from Uzbekistan rom suffering from a rare genetic liver disorder and was saved by his father who donated a part of his liver. The child was suffering with Alagille syndrome. The timely intervention of the doctors as well as father stepping in saved the child from a life-threatening disease.

What Happened to The Child?

Right after birth the child got jaundice, while it is common for newborns, and appears two to three days after birth, it often resolves in one to two weeks. However, this was not the case with him. The baby required neonatal intensive care. When he was of just two months, he was diagnosed with biliary atresia, a condition that blocks the normal flow of bile from liver. The baby underwent a Kasai procedure, which is a surgery performed in infancy to help restore bile flow.

Also Read: The Great Healthcare Plan Explained: What Is In President Trump's Health Care Proposal?

However, his condition continued to worsen. The baby suffered from persistent jaundice, severe itching, poor weight gain, delayed growth and pale stools. All of these symptoms indicated progressive liver failure.

This is when the family sought help from specialized liver care in India. Upon a careful assessment, a serious heart ailment too was detected in the baby. The investigation confirmed that the baby had Alagille syndrome.

What Happens In Alagille Syndrome?

As per the National Institute of Health, Alagille syndrome is a multisystem autosomal dominant disorder with a wide variety of clinical manifestation. Johns Hopkins Medicine says it is an inherited condition in which bile builds up in the liver because there are too few bile ducts to drain the bile. This causes liver damage.

This is caused by JAG1 gene mutation and could be passed from parent to child. If the child has one parent with Alagille syndrome, the child has 50% chance of developing the condition. Its rarity makes it appear in one out of 70,000 babies.

Upon the case review, it was identified that only a liver transplant could save the child's life, this is when his father stepped in.

What Does The Expert Say?

Dr Ajitabh Srivastava, Director HPB Surgery and Liver Transplant, Max Super Speciality Hospital, Patparganj, whose team led the transplant said, "“Infants with prolonged jaundice are commonly evaluated for biliary atresia, for which the Kasai procedure is an early surgical treatment aimed at restoring bile flow and delaying the need for liver transplantation." However, he noted, rare conditions like Alagille syndrome could also mimic biliary atresia in early infancy.

"In such cases, the Kasai procedure may not provide lasting benefit because the underlying problem is genetic rather than structural and in fact the wrong procedure (Kasai) worsens the condition of the child. As the liver disease progressed despite early surgery, a timely living donor liver transplant became the only life-saving option," the doctor explains.

The transplant has been successful, noted Dr Srivastava, and the child is on a "steady path to recovery". The doctor especially pointed out how early diagnoses could save lives even from the rarest of the rare diseases.