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.

Seeing your child suddenly screaming at night, with wide eyes and thrashing limbs, can be deeply unsettling. However, remaining calm and focusing on safety is crucial for parents during the sleep terror episodes, said health experts.

Sleep terrors, also known as night terrors, are episodes of sudden fear, screaming, or intense distress that occur during sleep.

The condition is more common in children, especially between the ages of 3 and 8 years, as their sleep patterns are still maturing.

Unlike nightmares, which usually happen during dreaming (REM sleep) and are often remembered, sleep terrors occur during deep non-REM sleep.

Dr Preeti Singh, Senior Consultant, Clinical Psychology, Max Super Speciality Hospital, Dwarka told HealthandMe, that while it may be frightening to witness, especially for parents, sleep terrors themselves are usually not harmful.

Although most kids outgrow this naturally, if the episodes are violent or very frequent, consult a specialist, added Dr Sudhir Kumar, a neurologist at Apollo Hospitals, Hyderabad.

What Are Sleep Terrors

During sleep terror, the child may sit up abruptly, shout, appear frightened, sweat, breathe rapidly, and be difficult to console. In most cases, they do not recall the episode the next morning.

Sleep terrors typically occur in the first third of the night, during deep sleep (slow-wave sleep). They are considered a type of parasomnia, meaning an unusual behavior during sleep.

Dr Kumar, in a post on social media platform X, explained that unlike a bad dream, a sleep terror happens in deep sleep (Stage N3).

It is characterized by abrupt sitting up/screaming, with physical signs that include a fast heart rate, sweating, and dilated pupils.

"It is 11 PM. Your child suddenly sits up, screams at the top of their lungs, and looks terrified. They are not responding to you, and they seem to be looking right through you. This is likely a sleep terror (night terror), a common NREM sleep parasomnia in children aged 3-12,” said Dr Kumar, popularly known as the Hyderabad doctor, on X.

The expert noted that the children are unlikely to recognize the parents and be "consoled" during the episodes.

What Factors Trigger Sleep Terrors

• Sleep deprivation or irregular sleep schedules
• Fever or illness
• Emotional stress or anxiety
• Major life changes or trauma
• Family history of parasomnias
• Certain medications

For children, sleep terrors are often developmental and tend to reduce as the nervous system matures, Dr Singh told HealthanMe.

How Can Parents Respond?

Parents often feel alarmed during a sleep terror episode, but the key is to remain calm, the experts said. They said during an episode:

• Do not try to fully wake the child, as this may increase confusion and agitation.
• Gently ensure the child is safe and cannot injure themselves.
• Speak softly and reassuringly, even if they do not respond.
• Wait for the episode to pass, which usually happens within a few minutes.

Other preventive measures include:

• Maintaining a consistent bedtime routine
• Ensuring the child gets adequate sleep
• Reducing screen time before bed
• Managing stress during the day
• Creating a calm and secure sleep environment

How To Manage

Most children do not require medical treatment, as sleep terrors usually resolve on their own with age. Treatment is considered when episodes are frequent, severe, cause injury, or significantly disrupt family life.

However, addressing sleep deprivation, treating any underlying medical conditions (e.g., sleep apnea), counseling or stress management strategies can help.

Hypertension or high blood pressure, a major risk for stroke, is preventable and treatable. Yet it accounts for about 14 per cent of cases of stroke among young adults aged below 45 years.

High blood pressure can be defined as the increasing pressure in blood vessels marked as 140/90 mmHg or higher.

Uncontrolled hypertension can burst or block arteries that supply blood and oxygen to the brain, causing a stroke.

A recent study by the Indian Council of Medical Research (ICMR) found that hypertension (74.5 percent) was the most common risk factor for stroke and related deaths (27.8 percent) and significant disability (about 30 per cent) across India.

“Blood vessel walls can be damaged through uncontrolled high blood pressure, making them prone to blockage or rupture. The good news is that hypertension is preventable through regular monitoring, reduced intake of salt, exercise stress control, and medication when required,” Dr. Rajul Aggarwal, Director - Neurology, Sri Balaji Action Medical Institute, Delhi, told HealthandMe.

How Does Hypertension Increase The Risk Of Stroke?

Chronic high pressure forces the brain to compensate, leading to vessel remodeling, narrowing, and eventually rupture or clotting.

The ICMR study reported that ischemic stroke accounted for 60 percent of cases.

The experts explained that in the case of ischemic stroke, high blood pressure damages artery walls, fostering plaque buildup (atherosclerosis) or allowing clots to form and block blood flow to the brain.

On the other hand, with hemorrhagic Stroke, constant strain caused by high blood pressure weakens artery walls, causing them to burst or leak blood into the brain. This can result in severe damage or life-threatening emergencies.

“When blood pressure stays high for years, it slowly strains the blood vessels -- nothing dramatic at first, which is why people ignore it. The arteries become stiff and fragile, sometimes narrowing, sometimes tearing,” Dr. Gunjan Shah, Interventional Cardiologist, Narayana Hospital, Ahmedabad, told HealthandMe.

"This makes clots or bleeding in the brain more likely, leading to ischemic or hemorrhagic stroke, even in people who otherwise feel perfectly fit and busy with daily life," Dr. Shah added.

Importance of the ‘Golden Hour’ In Stroke Care

In stroke-related cases, the golden hour -- referred to as the critical first 60 minutes after symptom onset -- is very much critical. Early medical treatment during the window can prevent death risk as well as boost health outcomes.

However, the ICMR study, published in the International Journal of Stroke, showed that just 20 percent of patients arrived in the hospital after 24 hours of the onset of symptoms.

Dr. Aggarwal said treatment within the first 60 minutes can significantly reduce the brain damage and improve survival as well.

“In a stroke, time moves very differently. Brain cells begin getting damaged within minutes when blood flow stops. If someone reaches the hospital quickly -- within the golden hour -- we have a real chance to restore circulation and limit disability. Recognising symptoms early and not waiting at home can truly change how well a person recovers,” added Dr Shah.

How Can Hypertension And Stroke Be Prevented?

Hypertension is a modifiable disease, and the risks can be reduced by:

• Cutting down and managing stress
• Checking blood pressure regularly
• Treating high blood pressure
• Eating less salt
• Staying active
• Managing stress
• Sleeping properly
• Avoiding tobacco

Dr Shah said that many young patients delay care because they feel fine, but taking medicines on time and correcting lifestyle early can prevent serious problems later.

Living in the mountains has long been linked with a surprising health advantage. People who reside at high elevations appear less likely to develop diabetes than those living at sea level. For years, researchers observed this pattern but could not clearly explain why it happens.

Now, scientists say they finally have an answer. According to inputs and direct quotes shared with news agency ANI, low oxygen conditions trigger a unique change inside red blood cells that helps lower blood sugar levels.

How thin air changes the body

At high altitude, oxygen levels are lower than usual. To cope with this shortage, the human body adapts in several ways, including producing more red blood cells.

Researchers at the Gladstone Institutes found that these red blood cells do far more than simply transport oxygen. In low oxygen environments, they begin absorbing unusually large amounts of glucose from the bloodstream.

In simple terms, the cells start behaving like sugar sponges. By pulling glucose out of circulation, they naturally reduce blood sugar levels, which may explain why diabetes occurs less frequently in people living at higher elevations.

Senior author Isha Jain explained the significance of the finding in comments to ANI: “Red blood cells represent a hidden compartment of glucose metabolism that has not been appreciated until now. This discovery could open up entirely new ways to think about controlling blood sugar.”

The surprising glucose sink

The discovery emerged from experiments on mice exposed to hypoxia, the scientific term for reduced oxygen levels in the blood. The animals showed a rapid drop in blood glucose after eating, something usually associated with a lower risk of diabetes.

But scientists initially could not find where the sugar was going. They examined major organs such as the liver, brain and muscles but none accounted for the sudden disappearance of glucose.

First author Yolanda Marti Mateos told ANI: “When we gave sugar to the mice in hypoxia, it disappeared from their bloodstream almost instantly. We looked at muscle, brain, liver, all the usual suspects, but nothing in these organs could explain what was happening.”

Using advanced imaging techniques, the team discovered the missing destination. Red blood cells themselves were absorbing and using the glucose.

This was unexpected because red blood cells have traditionally been viewed as passive oxygen carriers rather than active metabolic regulators.

Further experiments showed that not only did the body produce more red blood cells in low oxygen conditions, but each individual cell also consumed more glucose than normal.

Research collaborator Angelo D’Alessandro said, “Red blood cells are usually thought of as passive oxygen carriers. Yet, we found that they can account for a substantial fraction of whole body glucose consumption, especially under hypoxia.”

Why this helps survival in low oxygen

The glucose absorbed by red blood cells is not wasted. Instead, it helps generate molecules that improve oxygen delivery to tissues.

This adaptation becomes crucial when oxygen is scarce. The body simultaneously improves oxygen distribution and reduces circulating sugar levels, a combination that may protect against diabetes.

A possible future treatment

The team also tested a new experimental drug called HypoxyStat that recreates the effects of low oxygen exposure. The pill works by making hemoglobin hold onto oxygen more tightly, mimicking high altitude conditions inside the body.

In diabetic mice, the treatment reversed high blood sugar and performed better than existing therapies.

Jain told ANI, “It opens the door to thinking about diabetes treatment in a fundamentally different way by recruiting red blood cells as glucose sinks.”

Researchers also noted the benefits lasted weeks after animals returned to normal oxygen conditions.

What this could mean beyond diabetes

Scientists believe the findings could influence other fields such as exercise science and trauma medicine, where oxygen supply and energy use are closely linked.

For now, the study provides a long sought explanation for the protective effect seen in mountain populations and suggests that future therapies may not target insulin or organs alone but the blood itself.

As Jain concluded in remarks shared with ANI, “This is just the beginning. There’s still so much to learn about how the whole body adapts to changes in oxygen and how we could leverage these mechanisms to treat a range of conditions.”