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.

Immunotherapy isn’t always better than chemotherapy. Its benefits depend on the cancer type, stage and biomarkers. Similarly, “superfoods” do not cure cancer, health experts said while addressing comedian Rahul Dua’s claims about cancer treatment.

On a recent podcast, Dua opened up about a family member’s four-year cancer battle and his research into alternative treatments.

Dua said his family member began improving after switching from chemotherapy to immunotherapy. He also claimed that low-cost drug combinations, including ivermectin and fenbendazole, could have potential in cancer treatment and questioned whether pharmaceutical profits influence which treatments receive attention.

But what does science say? HealthandMe spoke to oncologist to fact-check these claims and address common cancer-treatment myths.

Immunotherapy Isn’t Always Better Than Chemotherapy

“Immunotherapy is not universally ‘better’ than chemotherapy. Benefit depends on cancer type, stage, and biomarkers such as PD-L1, MSI-H or TMB,” said Dr Shyam Aggarwal, Chairman, Medical Oncology, Sir Ganga Ram Hospital.

“In melanoma, mismatch-repair–deficient tumors and selected lung or kidney cancers, immunotherapy often outperforms or usefully combines with chemotherapy. In many other cancers, chemotherapy remains the backbone,” he added.

Patients should not decide their treatment on their own, the expert told HealthandMe.

Accurate diagnosis, staging and molecular testing require a multidisciplinary team. Shared decision-making with an oncologist is essential, as self-directed treatment choices can delay effective care and cause harm.

Also read: Wegovy & Zepbound Are Not Approved By US FDA For Children Under 12: So Why Are Prescriptions Rising?

‘Superfoods’ Don’t Cure Cancer

Dua also claimed that certain “superfoods” — including a high-protein, high-fat, low-fibre diet — combined with immunotherapy can cure cancer.

“‘Superfoods’ do not treat cancer. A balanced diet supports strength and treatment tolerance, but no food replaces proven therapy. Miracle-food claims lack rigorous evidence,” Dr Shyam said, stressing that patients should consult their oncologist for individualized, evidence-based care.

The Rs 50 Ivermectin-Fenbendazole Claim

Dua also spoke about a combination of ivermectin and fenbendazole, describing it as a “₹50 cancer treatment” that he believed could be more effective and questioned whether pharmaceutical profits were a factor.

“But since it was a 50 rupee cure. There is no profit for pharma in that. There is no profit for pharma in that. Off the record, there is this medicine combination of Ivermectin and Fenbendazole. Fenbendazole is a dog dewormer. It costs 20 rupees. Ivermectin is a horse dewormer. I am very convinced that as soon as my auntie moved from (4 years of) chemo to immunotherapy. (She) Started becoming better,” Dua shared during the podcast.

According to the American Cancer Society, ivermectin is not approved to treat cancer in people or animals, and no clinical guidelines recommend it as a cancer treatment.

"Ivermectin has not undergone the rigorous clinical trials needed to establish whether it is safe and effective as a cancer treatment in humans. Available research is insufficient to determine whether it could work as an anticancer drug," it says.

While ivermectin may be used at recommended doses to treat certain worm infections, large doses can be dangerous, potentially causing seizures, coma and even death. It may also worsen the side effects of standard cancer treatments such as chemotherapy.

Read More: Bill Ackman’s Daughter Gets Experimental Treatment For Vision Loss: When Can Mitochondrial Transplants Help?

Experts Warn Against ‘Miracle Cure’ Claims

Dua’s claims has drawn sharp criticism from oncologists, public health specialists and medical communicators, who warned that unscientific “miracle cure” claims could mislead patients into delaying evidence-based treatment.

“Don’t fall for this. A ₹50 cancer ‘cure’ that pharma is hiding is clickbait, not care. These people never follow it themselves and feel no responsibility when patients delay real treatment just so a video can go viral. Lives are not content,” Dr Rishabh Jain, Medical Oncologist, AIIMS Delhi, said on X.

Dr Arshiet Dhamnaskar, neurosurgeon at Western India Institute of Neurosciences, also said people not “trained in medical science should refrain from commenting upon it. As even one bit of misinformation can be disastrous.”

BBC News presenter Maryam Moshiri has opened up about her experience of living with an incurable blood cancer for the past two years.

Moshiri, 49, was diagnosed with Polycythemia Vera (PV) in November 2024. The condition affects the bone marrow and causes the blood to become thicker than normal.

While undergoing treatment, Moshiri has continued to work and has spoken about the challenges of managing her condition alongside her career.

“I love what I do. I love being where the story is. I don’t want to allow blood cancer to stop me from doing my work,” she told The Times.

Maryam Moshiri Opens Up About Living With Blood Cancer

Moshiri’s treatment involves having blood removed to reduce the concentration of red blood cells, a procedure that can leave her feeling exhausted.

She has also opened up about the challenges of continuing to work while experiencing fatigue related to her cancer treatment.

“I was working 14-hour days, constantly on air, constantly having to think on my feet, and holding it together, despite the fact that I had this chronic tiredness and fatigue,” she was quoted as saying.

“When you’re doing live news, you have this rush of adrenaline, and you just have to get on with it.”

Moshiri, who is a mother of three children aged 13, 11 and 9, also highlighted how she has struggled with constant fatigue while managing family life.

What Is Polycythemia Vera?

Polycythemia vera is a disorder in which the bone marrow produces excessive amounts of blood cells. In PV, the major problem is an overproduction of red blood cells.

An increased number of red blood cells means a higher proportion of cells are circulating in the blood. This can make the blood thicker and increase the risk of blood clots, stroke and heart attack.

Doctors therefore pay close attention to a patient's hematocrit, which represents the proportion of blood made up of red blood cells.

One of the major treatment goals is to keep hematocrit below 45%, which helps reduce cardiovascular risks.

How Is Polycythemia Vera Treated?

One of the traditional ways of controlling PV is removing some blood. The procedure, called phlebotomy, involves taking blood from a vein to reduce the number of circulating red blood cells and bring the hematocrit level down.

For some patients, this can become a recurring procedure. They may need repeated blood draws even while receiving standard treatment. This treatment burden is one reason a new drug for PV has attracted attention.

FDA Approves Drug for Polycythemia Vera

Late last month, the US Food and Drug Administration (FDA) approved Mimrylo (rusfertide) for adults with polycythemia vera (PV).

The drug is the first approved treatment for PV that mimics hepcidin, a naturally occurring hormone that regulates iron in the body.

The approval is particularly significant for patients whose disease remains inadequately controlled despite existing treatment and who need frequent blood-removal procedures.

“People living with polycythemia vera have long faced the challenge of managing a chronic blood disorder with frequent blood draws,” said Tanya Wroblewski, Director of the Division of Nonmalignant Hematology at the FDA's Center for Drug Evaluation and Research.

The FDA granted priority review and approved the drug to Takeda Pharmaceuticals America.

Air pollution has now become an inevitable aspect in many Indian cities, whether it is vehicular emissions, dust from construction activities, industrial pollutants, or smoke from burning crops. Some of the worst pollutants from the health point of view are those comprising PM2.5 (particulate matter 2.5).

Particulate matter 2.5 means the fine particulate matter measuring 2.5 microns in diameter or smaller, which is roughly 30 times smaller than the diameter of a human hair.

Due to their microscopic size, these particles can enter deep inside the lungs and even the blood stream. The WHO and the IARC have labeled outdoor air pollution and particulate matter as a carcinogen, which implies that it can lead to increased risk of cancer.

How does PM2.5 increase cancer risk?

Long-term exposure to PM2.5 is responsible for causing inflammation and oxidative stress within the body. Inflammation and oxidative stress will eventually result in DNA damage leading to an abnormal growth of cells.

The link between exposure to PM2.5 and cancer is well-documented, with lung cancer being the most established one, while others are still under investigation. According to WHO guidelines, long-term exposure to PM2.5 is linked to higher lung cancer mortality rates, even at lower concentrations.

This is highly relevant to India because air pollution in many Indian cities exceeds WHO recommendations.

Also read: Exposure To Air Pollution May Harm Male And Female Fertility, Expert Reveals

Practical ways to reduce your exposure

Even though individual measures may not solve the problem of air pollution completely, they do help to minimize personal exposure.

1. Keep an eye on the daily air quality

Monitor the AQI index before engaging in any outdoor physical activity and on polluted days, try to reduce the amount of time you spend outdoors.

2. Avoid pollution peaks

Early morning and late evening are typically times when pollution level is high. Plan your outdoor activities on less polluted days.

3. Use an N95 mask

When going out, especially commuting, during the days of high pollution use an N95 mask that helps to filter fine particles.

4. Improve indoor air quality

Close windows during heavy air pollution and install a HEPA filter air purifier if needed, especially for kids, elderly people and those who suffer from lungs diseases.

5. Reduce indoor pollution sources

Do not smoke indoors; use less incense and mosquito coil indoors, and make sure there is a good ventilation system in the kitchen when you cook.

6. Take care of general lung health

Never smoke, keep physically active during the days of decent air quality, and eat nutritious food with lots of fruit and veggies.

The bigger picture

Protecting yourself from the health risks of PM2.5 can be done by both individual means and also collective efforts. More sustainable modes of transport, better emission control policies, improved waste disposal facilities, and sound urban planning practices will become necessary eventually. In the meantime, we only have our knowledge and preventive steps to safeguard our health.

By Dr. Reshma Puranik, Cancer Physician, MOC Pune