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.

We often hear of dementia as an adult, or older people's disease, but, a father from Glasgow shares how his four-year-old daughter was diagnosed with the condition. Childhood Dementia news of Darren Scott's daughter was delivered to him like a "complete thunderbolt", he tells Sky News. She was diagnosed with the condition before she turned four. Five doctors were waiting, when Sophia Scott, who had just turned four, were summoned to a Glasgow hospital room. Then came the worst news. Scott was told that his daughter could not live beyond the age of 16. "We were told... there was nothing they could do. It was a moment that broke us, shattered our lives. We have never recovered," he says.

What Is Childhood Dementia?

As per Dementia Australia, childhood dementia is a rare brain condition that affects one in every 2,900 babies globally. Childhood dementia is a group of serious brain conditions that interfere with a child’s memory, behavior, emotions and ability to communicate. It isn’t caused by lifestyle or ageing. Instead, it stems from more than 100 rare genetic disorders that children are born with. These include conditions such as Niemann-Pick type C, Batten disease and Sanfilippo syndrome.

No two children experience childhood dementia in the same way. The illness progresses differently for each child, but one thing remains constant: there is currently no cure. Like adult dementia, childhood dementia is progressive, meaning symptoms worsen over time. Heartbreakingly, around half of all affected children do not survive beyond the age of 10.

What causes childhood dementia?

Childhood dementia is genetic. Globally, about one in every 2,900 babies is born with a condition that can lead to childhood dementia. In Australia alone, an estimated 1,394 children were living with dementia in 2021.

The conditions that cause childhood dementia fall into several categories, including inborn errors of metabolism, lysosomal disorders, mitochondrial disorders, mucopolysaccharidoses, leukodystrophy, neurodegeneration with brain iron accumulation (NBIA), and peroxisomal diseases.

Signs and symptoms to look out for

Symptoms can begin in early childhood or appear much later, sometimes not showing up until the teenage years. The progression may be rapid or unfold slowly over several years, deeply affecting both the child and their family.

Much like adults with dementia, children may struggle with memory loss, confusion, changes in personality, anxiety or fear, and severe sleep disturbances. They may also find it difficult to concentrate, learn, communicate or understand things, and some experience behavioral challenges such as hyperactivity.

In addition, childhood dementia can affect the body beyond the brain. Children may develop problems with their bones or joints, experience issues with the heart, lungs or digestive system, lose their ability to move, see or hear, or have seizures.

As the condition advances, children gradually lose skills they once had — talking, walking, reading, writing and playing. Eventually, the body itself begins to shut down. Without major medical breakthroughs and more research, most children with childhood dementia will continue to face a shortened life, often not surviving beyond their teenage years.

India is staring at a sharp rise in lung cancer cases over the next few years, with experts warning that the disease is no longer confined to smokers alone. A recent study published in the Indian Journal of Medical Research projects a significant increase in lung cancer incidence by 2030, with certain regions, particularly the North-East, expected to bear a disproportionate burden. Alarmingly, women are showing one of the fastest rises in new cases.

At a time when the country is on the brink of what researchers describe as a “tsunami” of lung cancer cases, doctors stress that public awareness, early detection, and breaking long-held myths are more important than ever.

Lung Cancer Is No Longer Just a Smoker’s Disease

Lung cancer has long been associated almost exclusively with smoking, but experts say that narrative is outdated. Speaking to The Times of India (TOI), Dr Arun Kumar Goel, Chairman – Surgical Oncology at Andromeda Cancer Hospital, Sonipat, explained that while smoking remains the biggest risk factor, non-smokers are increasingly being diagnosed with the disease.

“Air pollution, indoor cooking smoke, passive smoking, radon gas exposure, occupational hazards like asbestos, and even family history can contribute to lung cancer,” Dr Goel explined. He added that adenocarcinoma, a subtype of lung cancer, is particularly common among non-smokers and appears to be linked more to environmental and genetic factors than tobacco use.

Early Symptoms Are Easy to Miss

One of the biggest challenges with lung cancer is that its early symptoms are often vague and easily mistaken for common respiratory problems. Dr Goel told TOI that persistent cough, changes in cough pattern, coughing up blood or mucus, unexplained chest pain, breathlessness, fatigue, and sudden weight loss are warning signs that should not be ignored.

“In India, lung cancer symptoms often overlap with illnesses like tuberculosis, which leads to delays in diagnosis,” he said. As a result, many patients only seek medical help when the disease has already progressed to an advanced stage.

What a Diagnosis Changes Overnight

A lung cancer diagnosis can be life-altering, both physically and emotionally. According to Dr Goel, patients are suddenly faced with difficult treatment decisions, ranging from surgery and chemotherapy to radiation or targeted therapy. Physical symptoms such as breathlessness and exhaustion can significantly affect daily life.

Emotionally, patients may experience shock, anxiety, fear about the future, concerns for their families, and a loss of independence. “Support from medical teams, counselling services, and loved ones plays a crucial role during this period,” he said.

The Biggest Myth That Delays Care

The most damaging myth, experts say, is the belief that lung cancer only affects smokers. Dr Goel warned that this misconception often results in non-smokers dismissing symptoms or doctors delaying screening. “Anyone can develop lung cancer, regardless of smoking history,” he said.

Early Detection Can Save Lives

If there is one message the public should remember, Dr Goel said, it is that early detection can dramatically improve outcomes. Persistent cough lasting several weeks, unexplained breathing difficulties, or ongoing chest discomfort should prompt immediate medical attention.

“Recognizing symptoms early and seeking help can change the course of treatment and significantly improve quality of life,” he said.

Face masks are not adequate when it comes to protection against flu-like illnesses, including COVID, said the World Health Organization (WHO) guidelines. As the number of flu cases rise in the US and the UK, this WHO guideline, may be of use. The guidelines noted that the surgical masks worn by doctors and nurses, when they are face to face with a patients are no longer providing the protection, and must be replaced with respirators.

The guidelines noted in a letter to the WHO chief Dr Tedros Adhanom Ghebreyesus, noted there is “no rational justification remaining for prioritizing or using” the surgical masks that are ubiquitous in hospitals and clinics globally, given their “inadequate protection against airborne pathogens”. “There is even less justification for allowing healthcare workers to wear no face covering at all,” the letter read.

When COVID was at its peak, an estimated of 129 billion disposable face masks were being used around the world every month. These were used by the healthcare workers as well as general public. These surgical masks were most widely available and recommended by most health authorities during that time. However, respirators were then designed to filter tiny particles. Then came the masks FFP2/3 standards in the UK or the N95 in the US. Evidence also supported that many countries are switching to these masks and that they are more effective. This resulted in fewer infections in patients and health professionals, as well as reducing the rate of sickness, and burnout of the healthcare professionals.

What Is The Key Difference Between Respirator and Surgical Mask?

Face masks are loose in fitting and are designed for one-way protection. It protects others from coughs and sneezes. WHO recommends a three-layer mask when people cannot socially distance. However, not all face masks have a safety rating.

The respirators on the other hand has a tight fitting, which creates a facial seal and filters both inflow and outflow of air. It tightly covers the nose and the mouth. It also removes 94% of all particles that are 0.3 microns in diameter or larger. It is also designed to protect the wear up to the safety rating of the mask.

COVID - Airborne or Not?

The WHO has faced criticism for its delayed acknowledgment of Covid-19’s airborne transmission. The letter urges the agency to reassess its earlier position and clearly communicate to the public that the virus spreads through airborne respiratory particles.

Professor Trisha Greenhalgh of the University of Oxford, a signatory to the letter whose research is widely cited in it, said that infection occurs only when germs enter the body. She explained that respirators, which seal tightly against the face, force air to pass through high-grade filters that block airborne pathogens. In contrast, she noted, medical masks fit loosely and allow significant air leakage.

Supporters of the letter include members of the World Health Network, leading US epidemiologist Eric Feigl-Ding, and Guardian columnist George Monbiot.

Responding to the letter, a WHO spokesperson said it would undergo “careful review.” The spokesperson added that the organization consults experts across diverse health and economic settings when developing guidance on personal protective equipment for healthcare workers, and that its Infection Prevention and Control guidelines for epidemic- and pandemic-prone respiratory infections are currently under review in light of the latest scientific evidence.