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.

From being a macho dude, Bruce Willis’ personality has changed to becoming more ‘tender’ even as the 71-year-old action hero continues to battle dementia, according to his daughter Rumer.

“I’m so grateful I get to go see him,” Rumer, 37, said during a podcast interview. “Even though it’s different now, I’m so grateful.”

“There’s a sweetness. He’s always been this kind of macho dude, and there’s like a — fragile is not the right word, but — just a tenderness that maybe being Bruce Willis might not have allowed him in a certain way,” she added.

Bruce Willis is continuing into his third year living with the condition.

In March 2022, Bruce Willis, the media legend who dominated Hollywood in his prime, was diagnosed with dementia, and since then, his family has been sharing their struggle with his diagnosis and how slowly it has been taking a toll on his health.

The following year, his diagnosis was confirmed as frontotemporal dementia (FTD), which is a degenerative disease that slowly chips away at your motor skills, communication skills, etc. His wife, Emma Heming Willis, noted early signs were subtle changes in his speech, initially mistaken for a resurgence of his childhood stutter.

Rumer is the eldest daughter of Bruce and The Substance star Demi Moore, who were married from 1987 to 2000. The former couple also had Scout Willis, 34, and Tallulah, 32, together.

Although FTD is considered to be one of the rarest forms of dementia, Rumer said the disease is more “prevalent” than she realized.

“It’s wild to me. So many people come up to me now, and they say, ‘My uncle had FTD. My dad had this,” she said.

Bruce Willis Is Alive

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Earlier this year, in March, a hoax news of Bruce Willis’ death circulated. However, his representatives confirmed that the news is fabricated and that the actor is alive.

"He joins the long list of celebrities who have been victimized by this hoax. He's still alive and well. Stop believing what you see on the Internet," his official representative stated.

What Is Frontotemporal Dementia?

Frontotemporal dementia is a less prevalent type of dementia that mainly occurs in the frontal and temporal lobes of the brain. It tends to affect behavior, personality, language, and movement more than memory, particularly in its initial stages.

In contrast to Alzheimer's, which generally strikes older individuals, FTD can hit at an earlier age—sometimes as young as 40. The symptoms can range from changes in personality, emotional flatness, or the inability to show empathy to impulsiveness, so it is especially hard for spouses and children to cope.

Frontotemporal Dementia: Symptoms

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The Mayo Clinic states that the symptoms of FTD vary depending on the most affected part of the brain. The progression is gradual but relentless.

Behavioral symptoms:

• Socially inappropriate behavior.
• Loss of empathy and sensitivity to others.
• Poor judgment and impulsivity.
• Apathy that can be mistaken for depression.
• Compulsive habits such as tapping, clapping, or repetitive lip-smacking.
• Decline in hygiene.
• Odd eating habits – from sudden sugar cravings to chewing on non-food items.

• Trouble understanding and producing speech.
• Difficulty finding the right words.
• Using vague terms like “it” instead of specific words.
• Simplified, telegraphic speech.
• Errors in building sentences.

• Tremors, stiffness, or muscle spasms.
• Difficulty swallowing or weakness.
• Poor balance leading to falls.
• Inappropriate emotional outbursts, such as laughing or crying.
• The “wide-based gait” noted by Dr. Gartner falls into this movement-related cluster, aligning with the suspicion of FTD.

Even as injectable aesthetic procedures are gaining popularity as "cosmetic" treatments in beauty clinics and wellness centers across the country, the Central Drugs Standard Control Organisation (CDSCO) has tightened rules around cosmetic use.

In a new public notice issued this week, the CDSCO stated that cosmetic products that come in injectable form do not fall under the definition of cosmetics under the law. It said that such products are not permitted for use by consumers, professionals, or aesthetic clinics.

"Cosmetic means any article intended to be rubbed, poured, sprinkled or sprayed on, or introduced into, or otherwise applied to, the human body," the notice said.

It added that cosmetics are for "cleansing, beautifying, promoting attractiveness, or altering the appearance."

Thus, "products supplied in the form of injectable preparation do not fall under the definition of cosmetics. No cosmetic is permitted to be used as injection by consumer/professionals/aesthetic clinics," the notice added.

What Can No Longer Be Done

The new rules bar professionals and stakeholders from using or manufacturing any cosmetic product intended for injection or medical purposes.

The move also seeks to curb misleading advertising and unauthorised cosmetic practices by clinics and individuals.

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The regulator also warned against misleading claims and the use of prohibited ingredients in cosmetic products, saying such violations attract action under the Drugs and Cosmetics Act and Cosmetics Rules, 2020.

"Use of prohibited ingredients in cosmetic products, misleading claims on label, use of cosmetics for treatment, and application of cosmetics through injection attracts violations of the said Act & Rules," the notice said.

The regulator stated that no person shall alter, obliterate, or deface any inscription made by the manufacturer on the container or label of the product intended for use as a cosmetic.

The notice added that the list of generally not recognised as safe (GNRAS) and restricted ingredients is published by the Bureau of Indian Standards (BIS).

It has also encouraged the public and users to report any instance of misleading claims or violations through email and state licensing authorities.

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Why Injectable Beauty Clinic Therapies Are Under Scanner

The move follows several incidents of sub-standard cosmetic products found to be sold in the market, ranging from Botox parties in upscale salons to glutathione “skin whitening” drips offered in local aesthetic clinics.

Social media trends, celebrity endorsements, and growing demand for “preventive anti-ageing” treatments among younger consumers have driven the market for injectable beauty products, especially Glutathione drips, as well as detoxifying therapies, in the country.

Medical experts have also been raising concerns over their long-term safety and efficacy. As per experts, unregulated injectable procedures carry risks ranging from allergic reactions and infections to liver and kidney complications in extreme cases.

The new norms, thus, are part of the government's plans to strengthen the regulatory mechanism for cosmetics.

The government is also reportedly planning to designate a Central Cosmetics Laboratory to test cosmetic samples and may also designate any laboratory under its control for testing, according to Mint.

In addition, manufacturers will have to keep details and records of each batch and raw materials. Records are to be maintained for three years after the expiry of each batch. Imported cosmetic products shall bear a code number as approved by the State Licensing Authority.

Amid continuing heatwave conditions in northern India, prolonged exposure to extreme temperatures can trigger serious and potentially fatal medical emergencies, particularly among elderly individuals and cardiac patients, according to an expert.

The India Meteorological Department (IMD) has warned of severe temperatures across several states.

"Heat wave to severe heat wave conditions likely to continue to prevail over northwest & central India during the week and over East India during the next 5 days," the IMD said, in its latest update on May 20.

It added that severe heat conditions will persist for at least the next 72 hours across Delhi-NCR, Rajasthan, Uttar Pradesh, Punjab, and Haryana. Temperatures in several cities are expected to touch 47°C to 48°C, with Banda currently emerging as the hottest place in the country.

Dr. Vaibhav Mishra, Senior Director & Head, CTVS, Max Super Speciality Hospital, told HealthandMe that heat-related illnesses are not limited to discomfort or dehydration alone, and can rapidly worsen if early warning signs are ignored.

Heat Exhaustion Vs Heat Stroke

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There are two major heat-related illnesses that people must understand so that timely precautions can be taken — heat exhaustion and heat stroke.

"Heat exhaustion is a milder and more common condition and typically occurs after prolonged exposure to high temperatures or intense physical activity in the outdoors," Dr. Vaibhav said.

Excessive sweating leads to significant loss of water and salts from the body, resulting in:

• dehydration,
• fatigue,
• dizziness,
• muscle cramps,
• weakness,
• headache,
• nausea.

"However, if heat exposure continues and the body’s cooling mechanisms begin to fail, the condition can progress to heat stroke, which is a medical emergency. In heat stroke, body temperature often rises above 104°F," Dr Vaibhav told HealthandMe.

What may initially appear as confusion, disorientation, or irrelevant talking can rapidly worsen into:

• altered consciousness,
• seizures,
• coma,
• death.

How Heat Affects The Heart

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Dr Vaibhav said that to cool the body during extreme heat, the heart has to work harder and beat faster so that more blood can be directed towards the skin for heat dissipation.

"This places additional stress on an already weakened heart. Many cardiac patients are also on medications such as diuretics, which increase fluid loss and dehydration. Certain blood pressure medicines may blunt the body’s normal response to heat and delay warning symptoms," the expert told HealthandMe.

Dehydration further thickens the blood and, combined with increased cardiac workload, can significantly raise the risk of heart attacks, strokes, and dangerous rhythm disturbances.

How To Prevent Heat Stroke

Dr. Vaibhav stressed the critical need for early recognition of symptoms, especially in vulnerable individuals such as elderly people and cardiac patients, who are much more susceptible to heat-related complications.

Simple preventive measures can save lives. These include

• avoiding direct sun exposure during peak afternoon hours,
• maintaining adequate hydration,
• wearing loose cotton clothing,
• avoiding strenuous outdoor activity,
• never ignoring early symptoms such as excessive fatigue, dizziness, or confusion.