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.

Adolescents who use cannabis could face a significantly higher risk of developing psychotic (doubled), bipolar (doubled), depressive and anxiety disorders, a study shows.

Researchers from Kaiser Permanente, the Public Health Institute's Getting it Right from the Start, the University of California, San Francisco and the University of Southern California, who studied 463,396 adolescents ages 13 to 17 through age 26, found that children between these ages were extremely prone to developing mental illnesses.

Lynn Silver, MD, program director of the Getting it Right from the Start, a program of the Public Health Institute, and study co-author noted: "As cannabis becomes more potent and aggressively marketed, this study indicates that adolescent cannabis use is associated with double the risk of incident psychotic and bipolar disorders, two of the most serious mental health conditions.

"The evidence increasingly points to the need for an urgent public health response - one that reduces product potency, prioritizes prevention, limits youth exposure and marketing and treats adolescent cannabis use as a serious health issue, not a benign behavior."

"Even after accounting for prior mental health conditions and other substance use, adolescents who reported cannabis use had a substantially higher risk of developing psychiatric disorders - particularly psychotic and bipolar disorders.

"This study adds to the growing body of evidence that cannabis use during adolescence could have potentially detrimental, long-term health effects. It's imperative that parents and their children have accurate, trusted, and evidence-based information about the risks of adolescent cannabis use," Kelly Young-Wolff, Ph.D., lead author of the study and senior research scientist at the Kaiser Permanente Division of Research, added.

The observational US-focused study also found that cannabis use was more common among adolescents enrolled in Medicaid and those living in more socioeconomically deprived neighborhoods.

How Does Cannabis Usage In Teens Affect Overall Health?

Strong links have also been found between adolescent cannabis use and mental health issues, including increased risk of depression, anxiety, and, in some cases, schizophrenia or other psychotic disorders.

Additionally, smoking cannabis can lead to breathing problems similar to tobacco, such as chronic bronchitis. It can also cause an increased heart rate, and some studies suggest a higher risk of heart attacks.

Early initiation, especially before age 16, increases the risk of developing Cannabis Use Disorder (addiction). High-potency products can lead to rapid onset of withdrawal symptoms, mood changes, and even physical complications like Cannabis Hyperemesis Syndrome (severe nausea/vomiting)

Why Should Early Cannabis Usage Be Discouraged?

Compared to teens who don't use cannabis, those who do are more likely to drop out of high school or not finish a college degree. Using cannabis can cause several immediate and long-term problems for teens:

• Difficulty Thinking
• Memory Issues
• Poor Coordination
• Attention Problems
• School and Social Troubles
• Cannabis use can also lead to more serious issues that affect a teen's overall life.
• Increased Mental Health Risks

Driving under the influence of cannabis is illegal and unsafe, as it severely slows reaction time. Cannabis reduces coordination and concentration, impacting all the skills necessary for responsible and safe driving.

Around 30 percent of cannabis users are also known to develop an addiction (cannabis use disorder). Failing to quit or choosing the drug over family activities are signs. This risk is higher for frequent teen users.

Scientists have created a three-dimensional "heart-on-a-chip" (HOC) model that beats on its own, uses calcium to initiate muscular activity and responds predictably to common drugs in hopes that it will help fight against cardiovascular diseases and heart failure.

This engineered heart is the first to incorporate a dual-sensing platform that provides real-time tracking of activity throughout the heart tissue down to the cellular level, helping scientists measure cellular function, which is critical for preventing heart failure in patients with CVDs.

First author Ali Mousavi, a biomedical engineer at the University of Montreal: "The ability to observe the tissue's response to different compounds in real time represents a major advantage for preclinical development and translational research."

To create their heart-on-chip (HOC) models, researchers collected heart muscle and connective tissue cells from rats. They placed the cells in a gel rich in proteins and nutrients to help them grow, then put them onto tiny, flexible silicon chips.

To measure how the tissue worked, they used two types of sensors. First, they attached the engineered heart tissue between two small elastic pillars. Each time the tissue beat, the pillars bent slightly, and this bending showed how strong the heartbeat was.

Then they placed tiny, soft gel-based sensors inside the tissue. These very small droplets—about 50 micrometers wide—changed shape as the cells contracted. This allowed the researchers to measure mechanical stress at the level of individual cells.

Talking about this development, senior author Houman Savoji, a mechanical and biomedical engineer at the University of Montreal said: "This breakthrough brings us even closer to true precision health by giving us the ability to identify the most effective medication for each person before treatment is even administered."

The Rising Heart Attack Crisis

During a heart attack, a lack of blood flow causes the cells and tissue in the heart muscle to die, leading to irreversible damage that can result in serious complications like arrhythmias, heart failure, cardiogenic shock, or cardiac arrest.

It is one of the leading causes of death in the country. Four Indians experience a heart attack every minute, with one in four dying of the cause. Experts have also noticed a rising trend of nearly 50 percent of heart attack patients being under the age of 40, with half of all heart attacks in Indian men occurring under 50.

Coronary Artery Disease: The Silent KillerCoronary artery disease (CAD) is one of the most common illnesses that can cause a heart attack in people. It develops over years and has no clear signs and symptoms apart from a heart attack.

The illness begins due to a buildup of fats, cholesterol and other substances known as plaque in and on the artery walls.

Over time, this can cause narrowing or blockage of the coronary arteries and block the supply of oxygen-rich blood to the heart which can lead to chest pain (angina), shortness of breath and ultimately, heart attacks.

READ MORE: How This Chinese Medicine Can Improve Blood Flow In Angina Patients

Typically, those above the age of 45, having a biological family member with heart disease, lack of sleep, smoking, consuming saturated fats along with other autoimmune diseases such as lupus and rheumatoid arthritis, can increase the risk of developing CAD.

Nearly one in 10 Indian adults suffer from CAD and about two million people die from the disease annually. Apart from this, about 18 to 20 million American adults aged 20 and older are also affected about the disease.

How Much You Should Exercise To Prevent CAD?

Moreover, regular exercise can also reduce the risk of Type 2 diabetes, high blood pressure, dementia and Alzheimer’s as well as several types of cancer. It can also help improve sleep, cognition, including memory, attention and processing speed.

Dr Hayes recommends opting for a cardiac evaluation such as an electrocardiogram, or EKG; a stress test; a cardiac MRI or CT scan to generate images of your heart if you notice changes in your ability to exercise or cannot perform consistent levels of exercise.

Long-term exposure to tiny air pollution particles can significantly increase your risk of developing Alzheimer's disease-caused dementia.

Researchers from Emory University, US have found that constant exposure to PM2.5 can affect the brain more directly than scientists have assumed.

They noted: "Alzheimer's disease is the most common form of dementia and a growing public health challenge, especially in aging populations. Our findings suggest that PM2.5 exposure was associated with increased Alzheimer's disease risk, primarily through direct rather than comorbidity-mediated pathways."

The scientists also discovered that those who had suffered a stroke were at a slightly higher risk of developing Alzheimer's disease, suggesting that strokes may make the brain more vulnerable to air pollution.

"The observed effect modification by stroke may reflect an underlying biological vulnerability in cerebrovascular pathways. Stroke-related neurovascular damage can compromise the blood–brain barrier, facilitating the translocation of PM2.5 particles or their associated inflammatory mediators into the brain."

The observational study was released in PLOS Magazine.

When Does The Risk Increase?

A new IIT Delhi study suggests the air quality may be worse than what conventional surface monitoring stations capture.

During a post-winter-haze day in March 2021, the researchers measured the vertical distribution of fine particulate matter at 20-metre intervals from the surface up to 100 meters through drones.

At 100 meters, PM2.5 concentrations were around 160 micrograms per cubic meter which is about 60 percent higher than surface readings on the same days. They also found that humidity levels were also higher by 70 percent, which promoted the concentration of ammonium nitrate and chloride.

Additionally, the study found that PM2.5 levels increased sharply near the top of this shallow layer, leading to higher concentrations at around 100 metres.

Based on these observations, the researchers concluded that residents in 28–30-storey buildings may face higher exposure to pollutants and inorganic material than indicated by ground-based monitors.

They also noted that drone-mounted low-cost sensors are a much more effective tool for studying the lower atmospheric boundary layer to improve air quality monitoring, model evaluation and mitigation strategies in cities such as Delhi.

What Is Alzheimer’s Disease?Alzheimer's disease is one of the most common forms of dementia and mostly affects adults over the age of 65.

About 8.8 million Indians aged 60 and above are estimated to be living with Alzheimer's disease. Over seven million people in the US 65 and older live with the condition and over 100,00 die from it annually.

Alzheimer's disease is believed to be caused by the development of toxic amyloid and beta proteins in the brain, which can accumulate in the brain and damage cells responsible for memory.

Amyloid protein molecules stick together in brain cells, forming clumps called plaques. At the same time, tau proteins twist together in fiber-like strands called tangles. The plaques and tangles block the brain's neurons from sending electrical and chemical signals back and forth.

Over time, this disruption causes permanent damage in the brain that leads to Alzheimer's disease and dementia, causing patients to lose their ability to speak, care for themselves or even respond to the world around them.

While there is no clear cause of Alzheimer's disease, experts believe it can develop due to genetic mutations and lifestyle choices, such as physical inactivity, unhealthy diet and social isolation.

Early symptoms of Alzheimer's disease include forgetting recent events or conversations. Over time, Alzheimer's disease leads to serious memory loss and affects a person's ability to do everyday tasks.

There is no cure for this progressive brain disorder and in advanced stages, loss of brain function can cause dehydration, poor nutrition or infection. These complications can result in death.