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.

Recent photographs of former US President Donald Trump with the UK’s King Charles III have drawn attention after visible discoloration was observed on his left hand, raising fresh questions about his health.

While Trump’s right hand has appeared discolored in earlier public appearances—a concern previously downplayed by both the former president and the White House—the latest images show similar changes on his left hand as well.

“Trump's right hand has been in bad shape for a long time now, but this picture taken today shows discoloration on the back of his left hand," independent journalist Aaron Rupar wrote on social media platform X.

Speaking to HealthandMe, Dr. Amit Prakash Singh, Consultant - Internal Medicine at the CK Birla Hospital, Delhi, explained the possible underlying causes that can result in hand discoloration. He noted that the condition may be due to:

• Bruising (bleeding under the skin)

This appears as blue, purple, or black patches. It may occur due to minor trauma or sometimes even spontaneously. The use of blood thinners or antiplatelet agents like aspirin can increase the likelihood of bruising. With age, blood vessels become more fragile, making bruising more common.

• Low oxygen or poor circulation

• Swelling (fluid buildup in tissues)

• Infection or inflammation

Dr. Singh advised people "to be concerned if there is sudden swelling in one hand, severe pain or tightness, persistent blue or black discoloration, breathlessness, fever with redness and warmth, or numbness and weakness".

"A purple or blue patch often suggests bruising, blue fingers may indicate circulation or oxygen issues, puffy hands suggest fluid retention, and red, hot swelling points toward infection," the expert said.

However, there is no official medical update on the discoloration in Trump's left hand. Therefore, any claims remain speculative. But it is not the first time that various speculations have been going around about the health of Trump.

Also read: Heat Stroke or Heat Exhaustion? AIIMS Doctor Explains Key Symptoms, How To Prevent

In an interview with The Wall Street Journal, in January this year, the US President informed that he takes aspirin doses more than his doctors recommend, and that is the reason for the bruising seen on his right hand. He has repeatedly said that his health is in "excellent" condition.

In the interview, he said, "They say aspirin is good for thinning out the blood, and I don't want thick blood pouring through my heart."

Trump, now 70, was diagnosed with chronic venous insufficiency, a condition that occurs when veins have trouble moving blood back to the heart. He also showed signs of bruising on his hand, which many attributed to frequent handshaking and to the use of aspirin.

Aspirin may still be considered for some people under 60 or 70 who have a higher risk of heart disease, but this decision should be made carefully. Factors like high blood pressure, high cholesterol, diabetes, smoking history, or a strong family history can influence whether aspirin makes sense for an individual.

With temperatures rising sharply, experts at the All India Institute of Medical Sciences (AIIMS) have warned that young children are significantly more vulnerable to heat stress than adults, urging parents to take preventive measures and recognize early warning signs.

Despite morning showers offering some relief, the national capital still recorded temperatures close to 40°C.

How Extreme Heat Affects Young Kids

Shefali Gulati, Professor, Department of Pediatric Neurology at AIIMS, highlighted that children are predisposed to both heat and cold stress and also tend to get dehydrated more quickly. She noted that global temperatures have been rising over the past few decades, and cited 2020 data from UNICEF, which showed that 76 per cent of children under 18 in South Asia—around 460 million—are exposed to extremely high temperatures, with 83 or more days in a year exceeding 35°C.

Dr. Gulati explained that young children often exhibit early behavioral changes when affected by heat. These can include irritability,

• reluctance to engage in outdoor activities,
• restlessness,
• excessive sweating,
• uneasiness,
• weakness.

She added that heat exposure, when combined with air pollution, can worsen health conditions, particularly in children with lung diseases and asthma.

“Heat can affect all parts of the human body. It begins with irritability and can progress to exhaustion,” she said.

In more severe cases, heat stress may lead to brain exhaustion, loss of consciousness, seizures, dehydration, and electrolyte imbalance.

Dr. Gulati further explained that the human body maintains its core temperature through physiological mechanisms, but these are less efficient in young children. During dehydration, increased blood flow to the skin reduces supply to vital organs like the brain. In patients with pre-existing kidney issues, this can result in acute or chronic injury.

Children with conditions such as cerebral palsy and other neurological disorders may also experience worsening symptoms due to heat exposure.

Further, dehydration can additionally strain the cardiovascular system, thickening blood and leading to tachycardia, thereby affecting cardiac function.

Beyond children, pregnant women exposed to extreme heat may face risks such as preterm birth, neurodevelopmental problems, and cognitive issues in newborns.

Dr Gulati emphasized the importance of fluids, Oral Rehydration Solution (ORS), and small, frequent meals, along with reduced outdoor activity. Preventive measures include wearing loose clothing, avoiding direct sun exposure, and limiting outdoor activities during peak heat hours.

The Importance of Diet: Avoiding Sugary Drinks

Also read: Heat Stroke or Heat Exhaustion? AIIMS Doctor Explains Key Symptoms, How To Prevent

Parmeet Kaur, Chief Dietitian at AIIMS reiterated the importance of proper hydration, food safety, and dietary habits during extreme heat, warning that both children and adults face increased risk of dehydration and related complications.

“One has to avoid consuming extra sugary and salty foods, drinks, and snacks, because if one is consuming highly processed drinks or snacks loaded with sodium and sugar, it may lead to dehydration,” Kaur said.

"Hydration is key, and one should not wait to feel thirsty," she added, stressing the need to consume home-made and simple food.

For immediate management, homemade Oral Rehydration Solution (ORS) can be used, prepared with six teaspoons of sugar and half a teaspoon of salt in one liter of water.

However, she cautioned "against sugary drinks and packaged snacks like chips, explaining that high sugar and sodium content can worsen dehydration while giving a false sense of energy. While these products may create the impression of quick rehydration or an instant energy boost, they can instead contribute to greater fluid loss and increase the risk of severe dehydration.”

Instead, the expert recommended traditional cooling options such as bael sharbat, lassi, sattu, and gond katira. Ingredients like coriander, mint and onion were also suggested as part of summer dietary practices.

The dietician advised small, frequent meals that are easy to digest, including roasted and unsalted chana or peanuts, while avoiding heavy meals.

Food safety is another major concern during the summer. High temperatures increase the risk of microbial growth in stale or improperly stored food.

Kaur warned to "not consume food left at room temperature for more than two hours", as it can lead to microbiological growth. Sprouts were also flagged as potentially risky in hot weather.

Further, the expert also urged for "high heat cooking method with vegetarian food to be cooked at around 70°C, while non-vegetarian items require temperatures between 70°C and 80°C".

The expert reiterated the need to

• maintain hydration levels of approximately 2.5 to 3 liters per day.
• ensure electrolyte balance,
• take preventive action before body temperature rises.

Even as heatwave conditions continue to intensify across parts of the country, cases of heat-related illnesses are on the rise, leaving many confused between heat stroke and heat exhaustion.

While both are caused by prolonged exposure to high temperatures, their severity, warning signs, and management can differ significantly.

Speaking to HealthandMe, Dr. Naval Vikram, Professor, Department of Medicine, at the AII India Institute of Medical Sciences (AIIMS), explained the key symptoms to watch out for, how to tell the difference between the two conditions, and the simple yet crucial steps individuals can take to protect themselves during extreme heat.

“The general features of a patient with heat stroke are: first, his or her body temperature will be very high. It will not be around normal levels like 104, 105, or 106—it will be significantly elevated. Second, the person may be delirious, confused, or even in a state of unconsciousness or coma. The breathing will also be labored. These are the features of heat stroke,” Dr Vikram said.

On the other hand, a person with heat exhaustion remains conscious, but looks and feels very tired. The individual is also likely to experience

• body ache,
• muscle pain,
• headache,
• muscle cramp,
• body pain or fatigue.

"If this has happened after exposure to heat, it is similar to the feeling one gets after jogging, running, or playing for about half an hour and then feeling exhausted. If that same feeling occurs without doing any such activity, then it is a stage of heat exhaustion, because it is happening due to the heat,” Dr Vikram told HealthandMe.

Who Is More At Risk With Heat-related Problems?

The most vulnerable category for heat-related problems is the extremes of age—the younger children and older adults.

The expert noted that younger children may not be able to express their symptoms completely. They may not be able to tell you exactly what they are feeling.

At the other end, older adults often have multiple health issues—neurological conditions, diabetes, hypertension, and kidney problems.

"So multiple organs may already be affected to some extent. In such situations, if heat-related illness occurs, it becomes difficult to diagnose, especially if they already have neurological problems like confusion or altered behavior," Dr Vikram said.

With existing comorbidities, other organs may already be compromised, so the tipping point towards severity happens very quickly. In contrast, younger individuals generally have greater body reserves.

Therefore, people at the extremes of age are more vulnerable, also because it can sometimes be difficult to recognize and diagnose the condition in them.

How Can One Prevent?

While it may be impossible to avoid rising temperatures, the focus should be on how much you can protect yourself. The expert suggested measures such as:

• Try to avoid exposure to extreme heat as much as possible.

• In case of being exposed, make sure to cover yourself—cover your head and upper body, use an umbrella, stay hydrated, and take breaks in between.

• If you have to work in a hot environment for a couple of hours, take a break in a cooler or temperature-controlled environment for at least half an hour before resuming, rather than continuously working in the heat. These steps can help prevent heat-related problems.

• If symptoms do occur, and it is heat exhaustion, take rest and avoid further activity for some time.

• In more severe cases—if someone shows symptoms like loss of consciousness or very high body temperature—they should be taken to a hospital immediately. Do not try to manage such cases at home.”