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.

Malaria is widely known as a mosquito-borne disease that causes fever, chills, and body aches. But what many people don’t realize is that in severe cases, it can also affect the heart.

Malaria is caused by parasites belonging to the Plasmodium genus. It may cause complications beyond the bloodstream. In some cases, this may happen in severe malaria, where either the diagnosis or treatment is late.

How Malaria Infection Affects The Heart

Speaking to HealthandMe, Dr. Ravi Prakash, Senior Consultant Cardiology, PSRI Hospital, Delhi, noted that malaria affects different parts of the body, depending on the severity and the patient's immunity.

"In severe malaria cases, the parasite that causes malaria infects the red blood cells, making them sticky. When these stick together, the cells block the flow of blood in smaller blood vessels, limiting oxygenation of important organs, including the heart," Dr Prakash explained.

The condition may then result in myocarditis, arrhythmias, or heart failure. Although these complications rarely affect the heart, they require prompt medical intervention.

Further, Dr. Rakesh Pandit, Senior Consultant & HOD, Internal Medicine, Aakash Healthcare, highlighted that malaria can put stress on the heart either directly or indirectly.

It can lead to inflammation of the heart and result in chest pains, fatigue, or arrhythmia.

"Patients suffering from severe malaria may develop tachycardia or, in worst-case scenarios, experience heart blockage," Dr. Pandit told HealthandMe.

The Role of Anemia

Furthermore, malaria infection may limit the blood flow to the heart by increasing the stickiness of the blood, thus blocking small blood vessels.

"Anemia associated with malaria can increase the load on the patient's heart," Dr Pandit said.

Fever, dehydration, and hypoxia further increase cardiac stress in malaria patients, who may end up having their pre-existing heart conditions unmasked.

Malaria: Early Signs Of Heart Damage?

Early detection is important. Besides classic malaria symptoms such as fever, sweats, shivers, headaches, and tiredness, any unusual symptoms such as chest pains, difficulty breathing, rapid heartbeats, or excessive weakness must be considered carefully.

"These could be signs of organ damage caused by the disease, which means early diagnosis and treatment are vital. Blood tests will be conducted to identify malaria parasites in your body," Dr. Prakash said.

Malaria And Heart: Who Is At More Risk

Some individuals are more susceptible to contracting malaria, which increases their chances of developing complications from the disease.

These include

• children,
• pregnant women,
• the elderly,
• immunocompromised patients.

"People who have underlying diseases may develop heart-related problems due to the malaria infection," Dr Prakash said.

Moreover, travelers to malaria-endemic areas without adequate protection from the disease are also likely to be affected.

How To Prevent?

The best method to avoid contracting malaria is to take preventive measures.

• Individuals must protect themselves from mosquito bites.
• Applying insect repellents, sleeping under mosquito nets, and covering your arms and legs when you go out are effective ways to shield yourself from being bitten.
• Proper hygiene and sanitation practices are necessary to prevent mosquitoes from reproducing.
• Having a good general health status is another preventive measure. Your immune system must be able to combat invading agents.

Malaria is usually understood as a fever illness, with symptoms such as chills, sweating, body ache, weakness, and in severe cases, anemia or organ complications. But for women, especially in malaria-prone regions, its impact can be more layered.

It can disturb the body’s hormonal rhythm, worsen fatigue, complicate menstrual symptoms, and create confusion between infection-related pain and period-related discomfort. That is why malaria should not be seen only as a seasonal mosquito-borne disease, but also as a health concern that can affect women’s reproductive and menstrual well-being.

India has made strong progress against malaria. According to the Government of India, reported malaria cases fell from 11.6 lakh in 2015 to 2.27 lakh in 2023, a reduction of roughly 80%. Malaria-related deaths also declined from 384 to 83 in the same period, a fall of about 78%. This shows that prevention, testing, surveillance, and treatment have improved significantly.

At the same time, malaria has not disappeared. The risk remains higher in endemic, tribal, forested, and hard-to-reach areas, where mosquito exposure, delayed testing, limited access to care, and anemia can make the illness more difficult to manage.

How Malaria Dents Menstrual Health

The connection begins with the body’s stress response. Malaria infection does not remain limited to the bloodstream. Research on hormones in malaria shows that the infection can affect host metabolism and create hormonal imbalances, with changes influenced by parasite type, disease severity, immune response, age, sex, nutrition, and stage of infection.

The research notes that malaria can dysregulate the hypothalamic-pituitary-adrenal, thyroid, and gonadal axes, which are central to stress, metabolism, and reproductive hormone regulation.

For menstrual health, this matters because periods are not controlled by the uterus alone. They depend on coordination between the brain, ovaries, and hormones such as estrogen and progesterone. When the body is fighting malaria, that rhythm can be disturbed.

Fever, inflammation, poor appetite, weakness, anemia, and high physical stress can make periods late, lighter, heavier, or more exhausting than usual. In some women, premenstrual symptoms such as body ache, fatigue, abdominal discomfort, and mood changes may also feel worse because malaria itself produces overlapping symptoms.

There is also a direct hormonal pathway to consider. Cortisol, often called the stress hormone, is reported to rise in both P. falciparum and P. vivax malaria. High cortisol can affect immune function and may also disturb the wider hormonal balance on which regular ovulation and menstruation depend.

The same research notes that lower estradiol has been reported in severe falciparum malaria, while progesterone levels have also been reported to be lower in patients with P. falciparum malaria.

These findings do not mean every woman with malaria will have menstrual changes, but they do show that malaria can interfere with the hormonal systems linked to reproductive health.

Link Between Malaria And Anemia in Women

Anemia is another important link. Malaria can destroy red blood cells and contribute to severe anemia. Menstruation, especially heavy bleeding, can also lower iron stores. When both happen together, the result can be extreme tiredness, dizziness, breathlessness, paleness, poor concentration, and slower recovery.

This is particularly relevant in India, where anemia among women is already a major public health concern. A woman recovering from malaria who also has heavy periods should not dismiss prolonged weakness as “normal period fatigue.”

Malaria: Delayed Symptoms In Women

One reason diagnosis can be delayed is that malaria symptoms are often nonspecific. WHO lists fever, headache, and chills as common early symptoms, and says early testing is important because symptoms may initially resemble many other fever illnesses. In women, body ache, fatigue, abdominal discomfort, and weakness may be mistaken for PMS, a painful period, viral fever, or early pregnancy unless malaria is actively considered.

The risk is even more serious during pregnancy, including early pregnancy when a woman may not yet know she is pregnant. WHO states that malaria during pregnancy can cause premature delivery or low birth weight, and it is also noted that pregnancy reduces immunity to malaria, increasing the risk of severe anemia and illness.

The practical message is simple: if fever with chills, severe body ache, vomiting, unusual weakness, dizziness, or headache appears around the time of a period, it should not automatically be treated as PMS or “period weakness,” especially after travel to or residence in a malaria-prone area.

A malaria test should be done promptly, and treatment should be taken only under medical supervision.

Malaria can affect menstrual health by placing stress on the body’s blood, hormones, immunity, and energy reserves. For women, recognizing this connection can help prevent delayed diagnosis and support faster recovery.

When it comes to gas, bloating, and "acidity," it is easy to think that these are simply a case of IBS or nervousness about eating. However, gastric cancer is one of the most frequent causes of cancer-related deaths in the world, including in India, where it is a common form of gastrointestinal cancer. In some cases of early gastric cancer, the symptoms are so similar to other digestive troubles that it could prove fatal to ignore the warning signs.

In an interaction with Health and Me, Dr Rakesh Kumar Sharma, Senior Consultant Medical Oncologist at M | O | C Cancer Care & Research Centre, Gurugram, spoke about the symptoms of stomach cancer and how it can often be confused with IBS.

Why is IBS confused with stomach cancer?

IBS is a functional gastrointestinal condition, which means the patient’s gut may seem fine, but it is not functioning properly. Common complaints in IBS include abdominal pain, bloating, diarrhoea, and constipation. Patients may notice a pattern in which their symptoms come and go over several months and may even associate them with food triggers or emotional stress.

However, IBS does not cause ulcers, bleeding, or intestinal damage, and patients have no greater likelihood of developing cancer when evaluated properly. This means that since many symptoms of IBS, inflammation, and cancers can overlap, there is a risk of diagnosing something serious as “just IBS."

What are the symptoms of stomach cancer?

Stomach cancer commonly begins in the inner lining of the stomach and usually presents with non-specific and subtle symptoms in its early stages. Common complaints include continuous indigestion and heartburn that fail to respond to common anti-acidity medication. Early satiety is another common complaint, whereby patients feel full too soon during meals, along with upper abdominal discomfort and heaviness. Other common symptoms include bloating, nausea, and gradual loss of appetite over weeks.

It is important to differentiate early-stage gastric cancer from simple acidity and IBS, since the latter conditions usually show periodic improvement and respond to common medications. However, if the above symptoms persist for two to three weeks without relief despite basic management, further evaluation may be required, especially in middle-aged and older patients.

Stomach cancer symptoms to never miss

There are certain symptoms that should never be overlooked and are regarded as red flags requiring prompt investigation for possible stomach cancer:

1. Sudden weight loss and poor appetite
2. Concurrent vomiting and regurgitation
3. Dysphagia or difficulty swallowing
4. Melena or hematochezia
5. Anaemia (reduced haemoglobin level), tiredness, and weakness due to chronic blood loss
6. Ongoing or progressive upper abdominal pain or a lump in the upper part of the abdomen

Any of these require immediate attention, regardless of an IBS diagnosis.

Who is at an increased risk?

Persistent infection by the bacterium Helicobacter pylori is the most well-established risk factor for the development of stomach cancer, primarily lower stomach cancers. H. pylori infections affect about half the global population and may lead to chronic inflammation, ulcers, and eventually precancerous changes in the stomach lining. High dietary consumption of salt, pickled or smoked foods, and processed meats increases the risk, especially when there is an existing H. pylori infection.

Smoking and alcohol abuse independently contribute to an increased risk of gastric cancer, along with obesity and specific genetic or familial risk factors. There are higher rates of gastric cancer in some parts of India, with the majority of cases being detected at later stages of the disease. This emphasises the importance of early detection and evaluation in populations with a high burden of gastric cancer.

When should you be alarmed?

You do not have to worry about every episode of acid reflux, but you should never dismiss anything unusual that occurs in your body. You need to consult your doctor if your indigestion, epigastric pain, early satiety, and bloating persist for two to three weeks even after conventional treatment. You experience alarming symptoms such as weight loss, vomiting, dysphagia, black stools, and anaemia