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.

When the name misleads, the disease remains misunderstood. Hence, endocrinologists now propose renaming PCOS as Polyendocrine Metabolic Ovarian Syndrome or PMOS.

This is because the term “Polycystic Ovarian Syndrome” is considered a misnomer. The name makes it sound like the condition is only related to the ovaries. However, over 30% of such patients have normal ovaries. The root lies in the hypothalamus, pituitary, adrenals, pancreas, and adipose tissue — truly polyendocrine.

The cysts in the name are actually antral follicles. The real burden is insulin resistance, dyslipidemia, NAFLD, and a 2-fold higher cardiovascular risk by age 50.

Not just reproductive: PCOS is India’s commonest endocrine disorder — 1 in 5 young women. It drives diabetes, hypertension, depression, and infertility.

PMOS, the acronym, expands as:

P — Polyendocrine: HPO axis + adrenal + insulin + leptin dysfunction

M — Metabolic: Insulin Resistance, obesity, fatty liver, CVD risk

O — Ovarian: Anovulation, hyperandrogenic ovarian dysfunction remains key

S — Syndrome: Heterogeneous, lifelong

This aligns with the 2023 International PCOS Guideline that defines it as a “metabolic + reproductive + psychological disorder”. Yet patients are still told, “You just have cysts.” PMOS reminds every physician to check OGTT, lipids, BP, and mental health at age 18, not 45.

The bottom line is that by changing the name, it is possible to change the game. When a 16-year-old hears “Polyendocrine Metabolic Ovarian Syndrome”, she understands it’s not vanity or infertility alone.

India is better prepared to deal with potential Hantavirus outbreaks due to the healthcare infrastructure and quarantine systems established during the COVID-19 pandemic, according to Dr NK Ganguly, former Director General of the Indian Council of Medical Research (ICMR).

In an exclusive interview with HealthandMe, Dr Ganguly said that while isolated cases of Hantavirus have appeared in India in the past, especially in crowded peri-urban and urban settings in Kerala, large-scale outbreaks have largely been reported in countries such as China, Argentina, the UK, and the US.

Dr Ganguly said that India's healthcare system significantly improved after the deadly COVID pandemic.

“India is overprepared in a way that during the COVID-19, our system, even at the district level or in much more rural settings, got established,” he said.

He pointed out that hospitals now have access to ECMO, BPAP systems, ventilators, and oxygen management facilities to curb the spread in case of an outbreak.

Dr Ganguly also mentioned the availability of antiviral drugs and experimental vaccine efforts that could potentially be explored for hantavirus treatment. “There are some crude vaccines which are made here also,” he said.

He added that India’s quarantine systems and public health drills developed during COVID-19 would also help contain future outbreaks.

“I think India will be okay because of the sheer transmission dynamics of this virus,” he said.

Hantavirus is a zoonotic disease that primarily gets transmitted through contact with infected rodents or exposure to their urine, droppings, and saliva, though rare cases of person-to-person transmission have also been reported.

According to the World Health Organization (WHO), 11 cases — including three deaths — have been confirmed so far. However, additional suspected and confirmed cases are likely to emerge across countries.

Also read: Hantavirus Can Linger Indoors, Spread Through Contaminated Dust, Says Infectious Disease Expert

Importance Of One Health

The One Health approach is critical in understanding and containing outbreaks like hantavirus, Dr Ganguly said.

The One Health approach, which integrates human health, animal health, and environmental monitoring, is also crucial to target the emerging infectious diseases, he noted.

Further, the noted microbiologist stressed the importance of strengthening surveillance across humans, animals, and the environment.

He explained that disease surveillance requires collaboration between bird specialists, forest experts, environmental scientists, and mammologists, especially for tracking zoonotic infections such as avian flu and hantavirus.

“In avian flu, birds follow special migration routes, so we needed bird specialists, forest experts, environmental experts, and mammologists,” Dr Ganguly said.

The expert also highlighted the growing challenge posed by shrinking spaces between humans and animals and the role of antimicrobial resistance (AMR) in emerging disease threats.

“Animal health is equally important. We need to maintain them, track their movements, and do surveillance,” he said.

Need To Track Climate

Dr Ganguly also warned that rising temperatures and shrinking boundaries between humans and animals could increase the risk of future infections.

“It is an environmental infection. With the rise of temperature, more hantavirus infections occur,” he told HealthandMe.

Why India Must Boost Surveillance

Calling surveillance one of the most critical tools in outbreak prevention, he urged India to strengthen monitoring systems for animals, vectors, and humans alike.

“We need to set up a dedicated surveillance for hantavirus in India, and we need to track hantavirus,” he said.

Dr Ganguly explained that to date, hantavirus cases in India have been detected accidentally during testing for respiratory infections or flu-like illnesses using advanced panel-based diagnostic systems.

“Like now these days, what happens is that when you are getting respiratory infection or flu-like symptoms, they put up a test system which is known as bio-fire or a thing like that which identifies 26 panels and gives the CT scoring of that, so from there, hantavirus emerged,” he said.

He added that India should strengthen surveillance tools and continue monitoring infections in animals, vectors, and humans alike.

Prateek Yadav (38), the son of late Samajwadi Party founder Mulayam Singh Yadav, died due to a massive blockage in the blood vessels of the lungs, leading to a collapse of the heart and respiratory system, as revealed in the postmortem examination report.

According to the autopsy findings, the provisional cause of death was recorded as “cardiorespiratory collapse due to massive pulmonary thromboembolism.” In simple terms, doctors said a large blood clot had blocked blood flow to the lungs, causing his heart and breathing to fail.

What Is Pulmonary Thromboembolism?

An embolism is any object (clot, fat, air, tissue) traveling through the bloodstream that becomes stuck, blocking blood flow. A thromboembolism is a specific type of embolism where that travelling object is a piece of a blood clot (thrombus) that has broken off from its original site.

It is a life-threatening condition that happens when a blood vessel in the lungs is blocked by a blood clot.

The common symptoms may include:

• Difficulty in breathing
• Chest pain
• Cough up blood

The blood clot starts in a deep vein in the leg and travels to the lung in most cases. Rarely, the clot forms in a vein in another part of the body, noted Mayo Clinic. When a blood clot forms in one or more of the deep veins in the body, it is called a deep vein thrombosis or DVT.

Other symptoms of pulmonary embolism include:

• irregular heartbeat
• lightheadedness or dizziness
• excessive sweating
• fever
• leg pain or swelling, usually in the back of the lower leg
• clammy or discolored skin

Also read: Your Desk Jobs May Impact Fertility, Not Just Waistlines, Say Experts

Lung Infection Claims Life of Karnataka Minister

Meanwhile, Karnataka's Planning and Statistics Minister, D. Sudhakar (66), passed away after a prolonged battle with a lung infection.

The most common lung infections that people experience are pneumonia, bronchitis, tuberculosis, influenza-related infections, and severe viral illnesses.

Experts noted that these lung infections cause fluid or pus to fill the air sacs, which prevents oxygen from entering the bloodstream.

"What may initially appear as a routine cough, fever, or chest infection can progress to severe pneumonia, respiratory failure, sepsis, or permanent lung damage,” Dr. Vikas Mittal, Director - Pulmonologist, CK Birla Hospital, Delhi, told HealthandMe.

Warning signs include

• worsening breathlessness,
• persistent fever,
• chest pain,
• bluish lips,
• confusion,
• falling oxygen levels should never be ignored.

Dr. Nikhil Rajvanshi, Consultant - Paediatric Pulmonology, Rainbow Hospital, Delhi, told HealthandMe that children may be more at risk of pulmonary infections as they can become dangerous quickly because their lungs and immune systems are still developing.

Common illnesses such as bronchiolitis, pneumonia, influenza, and other viral infections may rapidly lead to breathing difficulty, low oxygen levels, dehydration, and respiratory distress. Infants, premature babies, malnourished children, and those with asthma or congenital disorders are at higher risk of complications.

The experts called for

• early medical evaluation
• timely treatment
• vaccination
• good hygiene practices,
• quit smoking,
• maintaining immunity.