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.

After Dussehra festivities, Delhi woke up to an alarming AQI of 300, maybe even more in some parts of the city. On October 21, pollution curbs under GRAP-1 were implemented, which are brought in force when AQI ranges between 201 and 300.

As Delhi's air pollution increases, some people may experience uncommon symptoms like feeling unusually tired, sluggish or unable to concentrate. This is not just a coincidence. Even people without asthma or breathing difficulties can feel fatigue, especially during periods of high air pollution.

Fine particulate matter (PM2.5) can penetrate deep into the lungs and trigger inflammation and physiological stress. Its effects may extend beyond the respiratory system, affecting blood vessels health, cardiovascular function as well as sleep.

HeathandMe spoke to Dr Puneet Khanna, Chairman, Respiratory Medicine and Pulmonology, Manipal Hospital Dwarka, New Delhi, Dr. Puneet Gupta, HOD - Pulmonology, Intervention Pulmonology & Sleep Medicine, Yatharth Super Speciality Hospital, Noida Extension, and Dr Mrinal Sircar, Director, Respiratory and Sleep Medicine, Medanta, Noida, who explained why rising AQI can leave some people feeling exhausted, what can help and when chronic fatigue needs medical attention.

High AQI May Make You Feel Tired Even Without Breathing Problems

Poor air quality does not affect just the lungs. Dr Sircar explains that air pollution can cause symptoms even in people without a pre-existing respiratory condition.

According to Dr Khanna, exposure to PM2.5 can trigger inflammation and oxidative stress, increase the body's workload and affect sleep quality. These changes may contribute to tiredness, headaches, low energy and reduced concentration, even in people with otherwise healthy lungs.

“Exposure to polluted air may also affect sleep quality and increase the body's overall stress response, contributing to symptoms such as tiredness, reduced energy and difficulty concentrating,” he says.

Dr. Gupta delves deeper into the process of PM2.5's attack and how the body responds to it.

He explained, "Your immune system treats fine particles (PM2.5) as intruders and mounts a constant low-grade defence, which burns energy much like a mild infection. At the same time, irritated airways and gases like carbon monoxide can make oxygen delivery slightly less efficient. The most underrated cause is sleep: a dry throat, blocked nose, and mild night-time cough fragment your sleep, so you wake up unrefreshed without knowing why. Fatigue here doesn’t mean your lungs are weak. It means your body is working overtime quietly."

Also read: Sky Turns Orange In Indonesia: How Toxic Smog From Wildfires Can Impact Health

Can PM2.5 Affect The Heart And Blood Vessels Too?

PM2.5 particles are small enough to penetrate deep into the lungs. Some of its components can even enter the bloodstream. Exposure can trigger inflammatory and oxidative stress responses beyond the respiratory system.

Dr Khanna says, “These changes may reduce physical endurance, increase feelings of fatigue, and contribute to symptoms such as brain fog, lethargy, and reduced exercise tolerance, particularly during periods of severe air pollution.”

Dr. Gupta explained PM2.5 can create the same response from body as a common flu does. But the extent of these effects depends on pollution levels, duration of exposure and individual risk.

He said, "PM2.5 is small enough that it, or the inflammatory chemicals it triggers, can enter the bloodstream. Signalling molecules such as IL-6 and CRP then travel through the whole body and produce the same “wiped out” feeling you get with the flu."

He also said that particles also create oxidative stress, which damages mitochondria, the power plants of your cells. Blood vessels become stiffer, blood pressure can rise slightly, and the nervous system’s control of heart rhythm can be disturbed, which may feel like heaviness or palpitations. Inflammation can also reach the brain, causing fog and poor focus.

Also read: Delhi Smog: Can You Really Tackle Pollution Season With An N95 Mask And Air Purifier?

What Can Help?

According to the doctors, the key is to reduce exposure to polluted air. Practical steps include:

• Limit exertion: Avoid strenuous outdoor activity when pollution levels are high, especially during periods of severe pollution.
• Wear a well-fitting N95 respirator: It can reduce exposure to fine particles when outdoors.
• Improve indoor air quality: Keep windows closed when outdoor air quality is poor and use a suitably sized air purifier with a HEPA filter where feasible.
• Maintain basic health routines: Get adequate sleep, stay hydrated and eat regular meals.
• Check AQI levels: Use local air quality updates to plan outdoor activities.

Dr Khanna emphasises that these steps can help reduce exposure but cannot eliminate the effects of ongoing pollution. He also said that severe breathlessness, chest pain, fainting or sudden weakness requires urgent medical attention.

Does Pollution-Induced Fatigue Go Away When AQI Improves?

For many otherwise healthy people, symptoms can improve once air quality improves. Dr Khanna says recovery may occur within a few hours to several days, depending on pollution severity, exposure duration and individual health.

However, there is no fixed recovery timeline. People with underlying respiratory or cardiovascular conditions may take longer to recover, while persistent tiredness may point to another health problem.

Dr Sircar advises seeking medical advice if fatigue continues after air quality improves.

The doctors also advise that if fatigue is chronic, recurrent, worsening or interferes with daily activities, medical evaluation should be sought rather than simply attributing it to air pollution.

Dr Sircar also says that that a doctor may need to investigate other possible causes, including anaemia, thyroid disorders, sleep problems and cardiovascular conditions. Fatigue accompanied by a chronic cough, wheezing, breathlessness, chest problems or reduced exercise tolerance also needs intervention.

A single photograph of someone’s face might carry real clues about their health and how long they’re likely to live, at least according to new AI tools built by researchers at Mass General Brigham in Boston.

What the researchers built

The team trained a large AI foundation model called FAHR-Face, short for Foundation Artificial Intelligence for Health Recognition, on more than 40 million facial images.

From that base model, they built two specialised tools: FAHR-FaceAge, which estimates a person’s biological age from a single photo, and FAHR-FaceSurvival, fine-tuned on 34,389 photos of cancer patients to predict survival risk directly from facial appearance.

“I was pretty surprised to find out that we could pick up signs of mortality risk from just a facial photograph,” corresponding author is Dr. Raymond Mak, a radiation oncologist at Mass General Brigham Cancer Institute told CNN. The study is published in The Lancet Digital Health.

What the two tools actually look at

The two algorithms focus on entirely different parts of the face. “The age estimation algorithm is looking at the area around the temples, the area on the forehead, above the eyes and then what we call the nasolabial fold,” Mak said, while “the mortality risk prediction algorithm is looking at a totally different part of the face... the bridge of the nose and the area under the eyes.”

Also Read: ADHD Linked To 71% Higher Risk Of Death; Suicide And Injuries Among Top Concerns

The results

Among 122 cancer patients flagged by FAHR-FaceSurvival as high-risk, 52.5% died within 90 days, compared with about 2% of the 975 patients in the lowest-risk group. Separately, 21% of patients whose biological age came back more than 20 years older than their actual age died within 90 days, against about 6% of those whose biological age was at least 10 years younger than their chronological age.

The researchers also found that cosmetic changes, including surgery, Botox, or makeup, didn’t throw off the models’ performance, according to the Mass General Brigham release.

An eerie echo of ancient medicine

The facial regions both AI models rely on, the nose, temples, and the area around the eyes, closely match what the Greek physician Hippocrates described around 400 BC in his Book of Prognostics as signs of approaching death: “the nose sharp, the eyes sunken, the temples fallen in.”

Mak told CNN the algorithms had no exposure to Hippocrates’ text and were trained purely on photographs and outcomes data. “Hearing Hippocrates echo over millennia in our algorithms was very eerie,” he said.

Not ready for the clinic yet

Outside experts urged caution. Dr. Wilbur Lam of Emory University, who wasn’t involved in the study, called it “an extremely compelling study” with robust associations, but said its “true clinical utility... will need to be demonstrated prospectively,” and flagged open questions about how well it performs across different facial features, skin tones, and age groups.

Miroslaw Bober of the University of Surrey, also not involved in the study, said the findings shows “convincing evidence” of a statistical link but cautioned that “predicting an outcome is not the same as explaining it.”

He noted the study never tested whether the AI model picks up anything a doctor’s own assessment wouldn’t, since doctors’ general health evaluations weren’t measured for comparison. “This is a promising proof of concept, but it is not ready for clinical use,” Bober said.

An individual's income, education, gender and place of residence can impact their risk of developing chronic diseases, as well as their access to diagnosis and treatment, according to a new World Health Organization (WHO) report.

The report highlights how social and economic inequalities affect the burden of noncommunicable diseases (NCDs) like cancer, cardiovascular diseases, diabetes and chronic respiratory diseases.

Published on October 20, State of Inequality: Noncommunicable Diseases and Their Risk Factors is WHO's first comprehensive global assessment of inequalities in NCDs and their risk factors. The report is based on data sources from nine countries and examines 35 indicators, using national data that collected over the past decade.

NCDs account for about three-quarters of deaths worldwide but their impact is not shared equally across different countries and their populations. The report examines how differences in economic status, education, sex, age, disability, employment, migration status and location influence disease risks and access to healthcare.

“This is the first effort to systematically measure inequalities in NCDs and their risk factors on a global scale,” said Dr Ahmad Reza Hosseinpoor, who leads WHO's health inequality monitoring team. “The findings show which populations are being left behind.”

How Income And Education Influence Chronic Disease Risk

The report found that people with lower levels of education in low and middle income countries tend to have higher rates of hypertension and diabetes.

Education can affect access to credible health information, opportunities to make informed health decisions and the capability to navigate technically complex healthcare services.

Income becomes a key factor that affects whether people's ability to afford nutritious food, preventive care, medicines and routine medical check-ups.

The report found that the poorest and least-educated women were less likely to receive cervical cancer screening. Tobacco use was also higher among men who were less educated than their educated counterparts.

Also read: G155E H1N1 Mutation In US Raises Concerns: Can This Year’s Flu Shot Still Protect You?

Risk Is Also Affected By Gender And Location

Differences in healthcare access and risks were also observed between men and women. Men were more likely to use tobacco and consume alcohol, but men with hypertension were less likely to be diagnosed and treated than women.

Women were less likely to meet recommended physical activity levels, while obesity was more common among women, particularly in low and middle-income countries.

Geography was another key factor as in many underprivileged countries, people living in rural areas had less access to hypertension diagnosis and treatment, as well as cervical cancer screening.

Rural households could also face greater exposure to household air pollution, while urban populations often experienced greater exposure to outdoor air pollution.

People with disabilities and migrants may also face financial, administrative, geographical or language barriers that make prevention, screening and treatment harder to access.

Also read: Lead Poisoning: WHO Warns There Is No Known Safe Level; Flags Risks From Paint, Spices and Cookware

What Needs To Change According To WHO

WHO said countries should use inequality data to identify marginalised populations who face barriers to enable direct prevention and treatment services towards them.

The report recommends expanding interventions to reduce NCD risks, improving access to screening and treatment in weak communities, and collecting data that reveal differences between population groups.

“Inequality data are not simply about documenting differences – they are a tool for action,” said Dr Alain Labrique, director of WHO's Data, Digital Health, Analytics and AI Department. “They help countries better tailor policies and programmes, identify gaps in coverage and track whether progress is reaching all population groups.”