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.

Delhi-NCR is witnessing a sharp increase in seasonal influenza, with 1,777 confirmed H1N1 (swine flu) cases reported out of 2,392 total Influenza A cases.

According to data from the National Centre for Disease Control (NCDC), the corresponding period last year recorded just 229 H1N1 cases.

Several hospitals in the national capital have reported a significant increase in cases. However, so far there have been no reports of patients requiring ICU care or ventilator support.

“Delhi is fully prepared to deal with the present health situation. There is no shortage of beds, doctors, medicines or essential medical equipment, and every patient will receive timely and appropriate treatment,” health authorities said.

Is The H1N1 Surge Due To A New Strain?

The Indian Council of Medical Research (ICMR) has confirmed that the current surge is not due to a new strain of H1N1 and has advised people to follow precautions rather than panic, PTI reported.

According to the apex research body, the Influenza A (H1N1) viruses currently circulating in India belong to the A/Missouri/11/2025 (H1N1)pdm09-like virus strain.

“These viruses belong to clade 6B.1A.5a2a, subclade D.3.1.1, and have been in circulation since 2025,” the ICMR said. “Seasonal influenza, including H1N1, is mostly self-limiting,” it added.

Is The Current H1N1 Strain Covered By The Flu Vaccine?

The ICMR said the influenza strains currently circulating in India are well matched with the vaccine strains recommended for the Northern Hemisphere.

For both egg-based vaccines and cell culture-, recombinant protein- or nucleic acid-based vaccines, the World Health Organization (WHO) recommends an A/Missouri/11/2025 (H1N1)pdm09-like virus.

HealthandMe spoke to experts to understand whether people should consider getting a flu vaccine amid the current rise in H1N1 cases and who should prioritise vaccination.

Doctors stressed that annual influenza vaccination remains an important tool to reduce the risk of severe illness, complications and hospitalization, particularly among people at higher risk.

“Since the 2009 H1N1 pandemic, H1N1 is no longer given as a separate standalone vaccine. The H1N1 strain is included in the regular seasonal influenza vaccine, whether trivalent or quadrivalent. Therefore, getting the recommended annual flu vaccine also protects against H1N1,” Dr Tushar Tayal, Associate Director, Internal Medicine, CK Birla Hospital, Gurugram, told HealthandMe.

Who Should Prioritize Flu Vaccination?

The seasonal influenza vaccine is recommended every year for everyone aged six months and above. Doctors say vaccination is particularly important for:

• Pregnant women
• Older adults
• Young children
• Healthcare workers
• People with diabetes
• People with asthma
• People with heart disease

The Indian Medical Association (IMA) advises that the inactivated influenza vaccine can be given to the above high-risk groups.

“The live attenuated influenza vaccine (intranasal spray) can be given only to persons aged 2-49 years (not to pregnant females),” as per the IMA.

“The H1N1 flu vaccine is typically administered annually before flu season, around October, as a single intramuscular dose at clinics, pharmacies or hospitals,” Dr Atul Gogia, Head, Infectious Diseases, Sir Ganga Ram Hospital, New Delhi, told HealthandMe.

For most adults and children aged over nine years, one dose each year is sufficient. However, children aged six months to eight years who are receiving the flu vaccine for the first time may require two doses at least four weeks apart. After the initial vaccination, one annual dose is generally sufficient.

Should You Get The Flu Vaccine Now?

In India, influenza vaccination is ideally taken ahead of periods when flu activity tends to increase, particularly during the monsoon and winter months. The vaccine is available through hospitals, clinics and vaccination centers.

With H1N1 cases currently rising in Delhi-NCR, people who fall into high-risk groups may particularly benefit from discussing vaccination with their doctor.

Can The Flu Vaccine Prevent H1N1 Completely?

“While the shot drastically reduces hospitalizations and complications, its primary limitation is that it does not offer 100% protection against infection, nor does it cover non-influenza viruses. However, even if contracted, vaccination significantly softens the disease’s severity,” Dr Atul said.

Dr Tayal also explained that vaccine effectiveness can vary from season to season, depending on how well the vaccine strains match the influenza viruses circulating at the time.

Why Is Annual Flu Vaccination Needed?

According to Dr Tayal, annual vaccination can reduce the risk of severe influenza, complications, hospitalization and flu-related deaths. However, it does not provide complete protection against every respiratory infection.

The flu vaccine protects against influenza viruses, including H1N1, but does not prevent illnesses caused by other viruses or bacteria.

Along with annual vaccination, experts advised people to:

• Maintain good hand hygiene
• Follow respiratory etiquette, including covering the mouth and nose when coughing or sneezing
• Stay home when unwell
• Avoid close contact with others when experiencing flu-like symptoms

Higher education has changed far more than we often acknowledge. Universities are no longer simply places where students earn degrees. They are where young adults spend some of the most formative years of their lives, away from familiar support systems, making independent decisions, navigating uncertainty and, for many, encountering the first signs of a mental health condition. That quiet shift has expanded the role of educational institutions in ways that were never envisaged a decade ago.

The conversation around student wellbeing has evolved alongside this change. Mental health is no longer viewed as a subject to be discussed only after a crisis. Students are speaking more openly, parents are asking different questions, faculty members are becoming more aware and institutions are recognising that emotional wellbeing is closely linked to learning, participation and long term outcomes. This change deserves to be welcomed because it has helped move mental health from the margins of campus life to the centre of institutional responsibility.

Why A Counsellor Alone Is Not Enough?

Yet one assumption continues to shape much of this conversation. The presence of a counsellor is often seen as evidence that a campus is equipped to support student mental health. Counsellors remain indispensable and, for many students, they provide exactly the support that is needed. The challenge arises when counselling is expected to fulfil every role within a mental healthcare system.

Every effective healthcare system is built on layers of expertise. A physician does not replace a surgeon. A laboratory does not replace a diagnosis. Emergency care does not replace rehabilitation. Mental healthcare should be viewed no differently. Counselling is often the first point of contact, but the needs of students do not end there.

Some require structured therapy, others psychiatric evaluation, some ongoing clinical monitoring, and a few immediate crisis intervention. A mature campus mental healthcare system should be equipped to respond across this entire spectrum. The conversation should therefore move beyond whether campuses have counsellors to whether they have a system capable of supporting every stage of care.

Also read: Why People With Mental Health Conditions Are More Likely To Struggle With Tobacco Addiction

Building A Comprehensive Campus Mental Healthcare System

Encouragingly, public policy is beginning to recognise this changing reality. The University Grants Commission’s draft guidelines on mental health and wellbeing for higher educational institutions, with recommendations on counsellor ratios, dedicated wellbeing centres, round the clock helplines and mechanisms for early identification of distress, mark an important step in strengthening institutional support. More importantly, they open the door to a broader conversation on what comprehensive mental healthcare within higher education should look like over the coming years.

Building such a system requires looking beyond individual appointments. One of the most valuable lessons from developing healthcare services is that outcomes are rarely determined by the first consultation alone. They depend on how seamlessly care continues afterwards. If a counsellor recognises that a student needs specialised assessment, how quickly can that happen?

Also read: Lindsay Clancy Trial: What Postpartum Psychosis Really Looks Like, From A Survivor

If medication becomes necessary, is psychiatric care available without delay? If a student experiences a crisis outside campus hours, is there a clearly defined pathway to immediate support? If treatment begins, who ensures continuity during semester breaks or after the student returns home? These are not administrative questions. They are questions that shape recovery.

A comprehensive campus mental healthcare ecosystem should therefore bring together different levels of expertise rather than rely on one profession alone. Counsellors, clinical psychologists, psychiatrists, experienced mental health specialists and emergency support services each play a distinct role. Their contribution becomes most effective when they work as part of an integrated network with clear referral pathways, shared clinical responsibility and continuity of care that extends beyond the physical boundaries of the campus.

Prevention And Early Intervention Matter Too

Also read: Sugar Rationing In First 1,000 Days Linked To Lower Depression, Cancer Risk In Adulthood

Equally important is recognising that mental healthcare should not begin only after a student seeks help. Institutions have long understood the value of preventive healthcare through regular physical health assessments, vaccination drives and awareness programmes. Mental health deserves the same thoughtful approach.

Periodic, voluntary mental health check ins, appropriate screening, trained faculty and peer support networks, backed by specialist expertise, can help identify concerns early while respecting privacy, dignity and informed consent. Early recognition is not about labelling students. It is about ensuring that support reaches them before distress becomes disabling.

Technology can strengthen this ecosystem, but it cannot replace it. Digital consultations, secure follow up, coordinated records and access to specialists across locations can make care more continuous, particularly for students studying away from home. Their real value lies in connecting different parts of the system rather than functioning as isolated solutions.

Mental Healthcare As Part Of The Institutional Foundation

The quality of a university has traditionally been measured through its academic standards, faculty and research. Increasingly, it will also be measured by how well it supports the people who make learning possible. Mental healthcare deserves to be seen as part of that institutional foundation, not as an additional welfare service that sits alongside education.

The conversation has already moved beyond whether student mental health matters. The next step is to recognise that no single professional, however skilled, can meet every need that students may bring with them. Every campus needs more than a counsellor because every student deserves access to a mental healthcare system that is prepared not only to listen, but also to respond, support and care through every stage of that journey.

By Dr. Jothi Neeraja, Founder, Chairwoman and Managing Director, Maarga Mindcare

Anxiety and depression are major concerns in adulthood, but could nutrition during the earliest stages of life influence health decades later? Two new studies suggest that lower sugar exposure during the first 1,000 days of life may be associated with lower risks of anxiety, depression and even several cancers later in life.

The findings, from studies published in Translational Psychiatry and PNAS point to the potential long-term effects of early-life nutrition. However, the findings do not mean that restricting sugar in infancy directly prevents these diseases.

Sugar Rationing And Mental Health

A 2026 study led by researchers from the University of Surrey, UK, analyzed 46,448 people born between October 1951 and March 1956.

Participants were grouped according to how long they were exposed to sugar rationing: from in utero only to 24 months. People conceived after food rationing had ended served as the main comparison group.

Researchers also analyzed brain MRI data from 5,990 participants.

Lower Risk Of Anxiety And Depression

Compared with people conceived after rationing ended, those exposed to sugar rationing for the three longest periods had significantly lower hazards of both anxiety and depression.

• Shorter-exposure groups did not show significant differences.
• The associations were stronger in women.
• Adult sugar intake was broadly similar across groups, at about 58–59 g/day of free sugar and 122–124 g/day of total sugar.

When later-life sugar intake was considered, the association with anxiety persisted among those exposed throughout pregnancy and the first two years of life, while the association with depression weakened and was no longer statistically significant.

Further, MRI analysis found differences across rationing groups in 80 of 139 gray matter regions. Analysis identified 11 regions that differed from participants conceived immediately after rationing ended, including the brainstem, occipital fusiform gyrus and several cerebellar regions.

Sugar And Cancer Risk

A separate study published in PNAS examined whether sugar exposure during the first 1,000 days could influence cancer risk later in life.

Researchers from China Agricultural University and the University of Cambridge used the abrupt end of UK sugar rationing in September 1953 as a natural experiment. The analysis included 64,761 UK Biobank participants born between 1951 and 1956.

Compared with those whose first 1,000 days were not affected by rationing, participants exposed to rationing showed lower incidence of several cancers:

• Liver/intrahepatic bile duct cancer: 69% lower
• Prostate cancer: 52% lower
• Lung cancer: 41% lower
• Rectal cancer: 40% lower
• Breast cancer: 36% lower

The researchers identified two possible pathways behind the association.

How Could Early Sugar Exposure Matter?

• Long-term dietary habits: People exposed to rationing consumed less sugar, ate smaller quantities and had healthier, more diverse diets even five decades later, suggesting that early-life exposure may influence lasting food preferences.

• Biological ageing: The rationed groups had longer leukocyte telomeres, equivalent to about 2.2 fewer years of biological ageing, along with lower levels of Granzyme B, a marker linked to chronic immune activation.

Sugar's Link With Mental Health And Cancer

Sugar is an important source of energy for the brain, and very low blood glucose can impair brain function. However, excess sugar intake has also been associated with metabolic problems that can affect long-term health.

When it comes to cancer, sugar does not directly cause cancer, and cutting out all sugar does not “starve” cancer cells. Both healthy and cancer cells use glucose for energy.

However, consistently consuming excessive amounts of added sugar can contribute to weight gain and obesity, which are established risk factors for several cancers.