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.

AIIMS New Delhi has successfully performed its second dual kidney transplant using organs from a marginal donor. The procedure highlighted a strategy that could help make greater use of kidneys that may otherwise be rejected for transplantation.

The procedure was carried out on July 28 by a multidisciplinary team from the Departments of Surgical Disciplines, Nephrology, Anaesthesia, Transplant Immunology and the Organ Retrieval Banking Organisation (ORBO).

The donor was a 70-year-old woman from Command Hospital, Chandimandir, Chandigarh. Because of her advanced age and the marginal characteristics of the donated kidneys, doctors transplanted both kidneys into a single 56-year-old woman.

The organs were transported from Chandigarh to New Delhi by an Army helicopter. According to AIIMS, despite a cold ischaemia time of 12 hours, both kidneys were functioning immediately after transplantation.

The recipient showed no complications after the transplantation and was discharged after 10 days with normal kidney function.

What Is A Dual Kidney Transplant?

In a conventional kidney transplant, one donated kidney is transplanted into a recipient. Meanwhile, in a dual kidney transplant both kidneys are placed into one patient from the same deceased donor.

The approach is considered when the donor is older or the kidneys have characteristics that suggest that a single kidney may not provide sufficient function.

In simple terms, two kidneys that have lower individual functional capacity may be able to provide adequate overall kidney function when transplanted together.

Research has previously found that dual kidney transplantation can be a viable option for kidneys from older or marginal donors. Transplant teams carefully assess the donor organs and recipient before deciding whether using both kidneys together could provide adequate renal function.

A 2025 analysis comparing single and dual transplantation from marginal donors also highlighted the potential of using kidneys from a deceased donor.

Also read: The Hidden Cost Of Self-Medicating UTIs. How Antibiotic Misuse Is Fueling Resistance

Need Of The Hour

The milestone comes as India faces shortage of transplantable organs. India recorded 20,138 organ transplants in 2025, crossing the 20,000 mark for the first time, but the number of patients needing transplants remains far higher than the available organs.

Recent reports has also highlight the country's mounting transplant needs that still remain unmet despite its position as one of the world's largest transplant centres by volume.

This makes the ability to safely use organs from older or marginal donors particularly important.

“Dual kidney transplantation from carefully selected marginal donors represents an important strategy for increasing the utilization of deceased-donor organs,” AIIMS said in the press release.

AIIMS said the successful transplant demonstrates its efforts to “maximize the utilization of marginal donor organs” and help patients with end-stage kidney disease receive organs at the earliest.

Also read: US HHS Action Against Kentucky Organ Donation Group Raises Questions About Transplant Safety

Encouraging Development

The immediate functioning of both kidneys despite around 12 hours of cold storage is certainly encouraging. However, the patient’s discharge with normal kidney function represents an early outcome.

Longer follow-up will be needed to determine how well the transplanted kidneys perform over the months and years ahead.

The AIIMS team was led by Prof. Asuri Krishna, with support from the nephrology, anaesthesia, transplant immunology, ORBO and organ retrieval teams.

It is a common belief that metabolic dysfunction-associated steatotic liver disease (MASLD)—formerly known as non-alcoholic fatty liver disease (NAFLD)—is primarily associated with diet, sedentary lifestyles, and obesity. However, there are other factors as well affecting this aspect. Post-menopausal women experience a significantly higher incidence and faster progression of fatty liver disease, even when maintaining a stable body weight.

Why Menopause Increases Fatty Liver Risk

In pre-menopausal women, oestrogen plays a central role in metabolism, by promoting healthy fat accumulation in subcutaneous tissue (below the skin) rather than around internal organs, it also increases insulin sensitivity and suppresses liver inflammation.

After menopause when oestrogen levels drop, this protective function is lost, there is redistribution of fat leading to more fat accumulation around internal organs including liver thus leading to increase chances of NAFLD and also increasing insulin resistance, needless to say that with age our metabolic rate also goes down which also plays a role in this.

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Early Detection Is Key

The important part lies not only in understanding above but to go further in early detection and prevention of menopause associated NAFLD. As we know that fatty liver is a silent disease and often does not causes any signs and symptoms till very advanced stage.

First and foremost is to change lifestyle with advancing age, changing both the dietary habits and physical activity. Regular screening and monitoring is warranted with blood tests, routine metabolic panels, keeping a tab on weight, sugar and cholesterol levels and a basic ultrasound of abdomen.

For someone already diagnosed with 2nd or 3rd stage fatty liver, a simple non-invasive. Fibroscan can help monitor and assess the response to treatment.

Also read: How Menopause Changes Heart Health Risks?

Understanding The Impact Of Menopause On Liver Health

Coming to treatment part of NAFLD in post-menopausal women, it being primary a lifestyle disease so the core of management also lies around managing lifestyle. Medicines are available for treating and controlling NAFLD in conjunction with lifestyle management.

Hormone replacement therapy (HRT), when initiated early in post-menopausal women for symptomatic relief may offer secondary benefits by maintaining metabolic health. However HRT should always be initiated after proper evaluation and expert guidance.

NAFLD is a silent epidemic and primarily a life style disease, knowing about it and knowing triggering and precipitating factors helps understanding and prevention better.

Menopause being a natural biological phenomenon in every female’s life, it becomes essential for us to know how it affects our liver health and overall health as well.

By Mr. Ankur Garg, Group Director Liver Transplant & GI Surgery, Paras Health, Gurgaon

Every year, as the monsoon rolls in, hospitals and clinics across India see a familiar pattern: a sharp uptick in children and elderly patients presenting with vomiting, diarrhoea, and dehydration.

Doctors attribute this seasonal surge to a combination of contaminated water supplies, deteriorating food hygiene, and warm, humid conditions that favour the spread of viruses like rotavirus and norovirus.

Why Monsoon Fuels Gut Infections

Heavy rains and flooding routinely compromise municipal water lines, allowing sewage to mix with drinking water. Street food and produce are more prone to contamination during this period, and the humidity itself accelerates bacterial and viral growth.

Acute gastroenteritis, an inflammation of the stomach and intestines, is consistently one of the fastest rising monsoon health conditions, with rotavirus being a leading cause in children and norovirus a common culprit across age groups.

Understanding Rotavirus

Rotavirus is a highly contagious, wheel shaped virus and remains the leading cause of severe diarrhoeal illness and death in children under five worldwide. It spreads through the faecal oral route via contaminated water, food, surfaces, or close contact with an infected person, and can cause several days of intense vomiting and watery diarrhoea, putting young children at real risk of rapid dehydration.

The good news: Rotavirus vaccines, given orally in a series of doses before 8 months of age, are highly effective at preventing severe disease and are recommended as part of national immunisation programmes.

Also read: Climate Change And Progressive Urbanization Call For An Integrated Approach To Infectious Disease Surveillance

Expert Recommended Prevention Measures

1. Water safety first

Boil or filter all drinking water during the monsoon months. Avoid ice and beverages of uncertain origin, especially from street vendors.

2. Food hygiene

Steer clear of cut fruits, chaat, and other street food that has been sitting exposed. Cook food thoroughly and eat it hot. Avoid reheated leftovers stored without refrigeration.

Also read: Dengue & Guillain-Barré Syndrome: Can A Common Monsoon Illness Trigger A Serious Nerve Disorder?

3. Hand hygiene

Frequent handwashing with soap before eating, after using the toilet, and after changing diapers remains one of the single most effective, low cost interventions against faecal oral transmission.

4. Vaccination

Ensure infants complete their full rotavirus vaccine schedule on time. Vaccination substantially reduces hospitalisations and severe outcomes, even though it does not eliminate all seasonal transmission.

5. Isolate and disinfect

Because these viruses spread easily within households and childcare settings, keep infected individuals' utensils and linens separate, and disinfect surfaces regularly during an active infection.

Recognising The Warning Signs

Most cases of viral gastroenteritis are self limiting, but caregivers should watch for signs of dehydration that require urgent medical attention:

• Sunken eyes, dry mouth, or reduced tears when crying (in infants)
• Little or no urination for 6+ hours
• Lethargy or unusual drowsiness
• Persistent vomiting that prevents fluid intake
• High fever or blood in the stool

Also read: Beware! Common Mistakes New Parents Make During Their Baby’s First Monsoon

Treatment: What Actually Helps

Oral Rehydration Solution (ORS) is the cornerstone of management.

A simple homemade version consists of 1 litre of boiled and cooled water, 6 teaspoons of sugar, and half a teaspoon of salt. It can be lifesaving when commercial ORS packets are not available, though pre mixed WHO formula ORS is preferable when accessible.

Zinc supplementation (around 20 mg daily for 10 to 14 days) is recommended for children under five, as it has been shown to reduce the duration and severity of diarrhoeal episodes.

Antibiotics are not effective against viral gastroenteritis and should only be used if a bacterial cause, such as cholera, is confirmed by a doctor. Inappropriate antibiotic use can do more harm than good.

Continue feeding. For breastfed infants, continue breastfeeding throughout the illness. For older children and adults, small, frequent sips of fluids and bland, easily digestible food are better tolerated than large meals.

When to See a Doctor

Seek medical care promptly if there is persistent high fever, visible blood in the stool or vomit, signs of moderate to severe dehydration, or if symptoms do not improve within 2 to 3 days, particularly in infants, the elderly, or anyone with underlying health conditions.

By Dr. Geeta Malkan Billa, Director of Gastroenterology & Hepatology at Dr. L. H. Hiranandani Hospital