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.

For people living with primary sclerosing cholangitis or PSC, medical options have always been painfully limited. Until now, there has been no approved drug that can slow the disease itself. Treatment has mostly meant managing symptoms and waiting, often for years, until a liver transplant becomes the only option. That is why new results around a monoclonal antibody called nebokitug are being seen as a turning point.

Researchers from the University of California Davis have reported promising findings from a Phase 2 clinical trial showing that nebokitug appears safe and may actually reduce liver inflammation and scarring. The study was published in the American Journal of Gastroenterology and has brought cautious optimism to both doctors and patients.

What Exactly Is PSC?

PSC is a rare, long-term liver disease that mainly affects the bile ducts. These ducts act like tiny pipelines that carry bile from the liver to the small intestine, where it helps digest fats. In PSC, these ducts become inflamed, damaged, and scarred over time. As they narrow, bile starts backing up in the liver, slowly causing liver injury.

Many people with PSC also have inflammatory bowel disease, especially ulcerative colitis. This strong link has led researchers to believe that ongoing gut inflammation may trigger immune reactions that damage the liver as well. Symptoms can range from extreme tiredness and itching to yellowing of the skin and eyes. Some patients have no symptoms at all in the early stages, which makes the disease harder to catch.

Why Treatment Has Been So Difficult

One of the biggest challenges with PSC is that doctors have not had a way to stop the scarring process itself. Once fibrosis sets in, it slowly progresses and increases the risk of liver failure and bile duct cancer. While medications can help with itching or infections, they do not change the course of the disease. This gap in treatment is what makes the nebokitug study so important.

How Nebokitug Works

Nebokitug is a lab-made antibody designed to block a protein called CCL24. This protein plays a key role in driving inflammation and fibrosis in the liver. In people with PSC, CCL24 levels are higher than normal and are found around the bile ducts where damage is most severe.

By blocking CCL24, nebokitug aims to calm the immune response and slow down the scarring process. Earlier lab and animal studies suggested this approach could work. The new trial is one of the first to test this idea in people with PSC.

What the Trial Found

The Phase 2 study included 76 patients from five countries. Participants received either one of two doses of nebokitug or a placebo through an IV every three weeks for 15 weeks. The main goal was to check safety, since this was still an early-stage trial.

The results were encouraging. Nebokitug was found to be safe and well tolerated. More importantly, patients who already had more advanced liver scarring showed improvements in liver stiffness and markers linked to fibrosis when compared to those on placebo. These changes suggest that the drug may be doing more than just easing symptoms.

Experts involved in the study say these findings could change the future of PSC care. Reducing inflammation and fibrosis could slow disease progression and delay or even prevent the need for a transplant in some patients. While larger trials are still needed, nebokitug represents one of the strongest signals yet that PSC may finally have a disease-modifying treatment on the horizon.

Now, drinking beer too could increase the risk of mouth cancer. On Tuesday, researchers at the Tata Memorial Centre (TMC) reported this adding new evidence. They found a 59 per cent higher risk of mouth cancer in people who drank, on average, just two grams of alcohol from beer daily, compared with those who did not drink. The research suggests that there may not be any safe limit to drink.

What Did The Study Reveal About Beer And Cancer?

Their study in India's large scale analysis that probs link between alcohol and cancer of the buccal mucosa. This is the pink lining of cheeks and lips. In India, this kind of cancer is the second most common malignancy in India after breast cancer. It also leads to 1,40,000 new cases and nearly 80,000 deaths each year.

Who Are More Prone To Buccal Mucosa Cancer?

People who consume more than one glass of alcohol a day and chew tobacco on a day to day basis are five times more at risk of developing this cancer as compared to those who do not drink or chew tobacco.

The findings of the study was published in the journal BMJ Global Health and it suggests that joint use of both, alcohol and tobacco leads to 62 per cent of all buccal mucosa cancer in the country.

As Telegraph reported, Tata Memorial Centre for Cancer Epidemiology unit's head of molecular epidemiology and population genomics unit Sharayu Mhatre said, "We see an unmistakable pattern: the more alcohol people drink, the greater their risk of buccal mucosal cancer."

Buccal mucosal cancer continues to pose a serious public health challenge in India. Among 100 patients diagnosed with locally advanced stages of the disease, 57 die within five years, a mortality rate that experts say highlights the urgent need for prevention, early detection, and stronger regulation of risk factors.

Alcohol Emerges as a Major Risk Factor

While the link between alcohol and cancer is well known, new findings reinforce just how dangerous alcohol consumption can be for oral health. Researchers found that people who consumed alcohol had a 68% higher risk of developing buccal mucosal cancer compared to non-drinkers.

What stood out most was the type of alcohol consumed. Unregulated, locally brewed liquor carried the highest risk, increasing cancer likelihood by 87%, compared to 72% among consumers of regulated, commercially sold drinks. Experts point out that these local brews often contain significantly higher ethanol concentrations and lack quality control.

Not Just Heavy Drinking—Even Small Amounts Matter

The study analyzed drinking patterns among over 3,700 participants, comparing cancer patients with healthy individuals. Alcohol types ranged from beer and spirits like whisky and vodka to traditional local drinks such as bangla and tharra. Ethanol levels varied widely—from 5% in beer to as high as 90% in some locally distilled spirits.

Alarmingly, increased cancer risk was seen even at low levels of alcohol intake. As little as two grams of alcohol a day from beer, or roughly one glass of stronger liquor, was enough to raise concern.

Alcohol and Tobacco: A Dangerous Combination

The risk escalates dramatically when alcohol use is combined with tobacco chewing. Tobacco alone raised cancer risk by 200%, alcohol alone by 76%, but together, the risk shot up to 346%. Researchers explain that alcohol may damage the mouth’s protective lining, making it easier for tobacco-related carcinogens to penetrate and cause harm.

Health experts stress that these findings underline the need for greater public awareness, stricter monitoring of locally brewed alcohol, and stronger prevention strategies. The World Health Organization has already warned that no level of alcohol is safe, noting that even light or moderate drinking contributes to a significant number of alcohol-related cancers globally.

For India, where oral cancers remain widespread, these insights serve as a critical reminder: everyday habits can have life-altering consequences.

Delhi finds itself in a little relief as the AQI of the city has dropped to 221 as per the CAQM. GRAP IV restrictions have also been lifted, however, pollution and smog continues to take over the city. The Meteorological Department has issued a yellow alert for the next few days, which could affect road and air traffic.

While GRAP IV is now removed, measures under GRAP I, II, and III will continue. As per the IMD forecast, this is what could happen for the next 5 days in Delhi

• December 26: Dense fog will prevail in the morning. Visibility is likely to be low.
• December 27: Yellow alert, dense fog in the morning and afternoon.
• December 28: Yellow alert, moderate to dense fog expected in the early morning.
• December 29-30: Fog will reduce slightly, but moderate haze will prevail in the morning.

Union Transport Minister On Delhi's Pollution

Nitin Gadkari, Union Minister of Road Transport and Highways also highlighted the alarming conditions of Delhi's smog and pollution. He said, "I stay for hardly two days in Delhi, and get an infection," as he spoke on how pollution impacts one's health conditions. However, he did speak on the severity of pollution and highlighted how the transport sector could play a huge role to bring relief to Delhi.

He highlighted that fuel combustion and transport emission leads to most of Delhi pollution.

In an interview with the news agency ANI, the minister also said that his ministry and Central Government are working on several projects and initiatives that will free Delhi from air pollution in the next five years.

Gadkari stated that the Ministry of Road Transport and Highways is undertaking projects worth Rs 1 lakh crore in Delhi to ease traffic congestion. He stated that all these efforts will not only help free Delhi of air pollution but also reduce the country's imports, increase job opportunities, and help farmers.

Electric Buses, Cars, and Scooters

The minister highlighted that 40% of the air pollution in the National Capital region is due to the burning of fossil fuels. In this regard, the government introduced electric buses in the city and enabled automakers to introduce electric cars and two-wheelers in the country.

He further stated that alternate fuel vehicles, such as those that run on CNG, LPG, and flex fuels (E20), are also being introduced and that all these efforts combined will reduce the city's pollution levels.

CNG And Bitumin From Rice Straw

Gadkari pointed out that nearly 200 lakh tonnes of rice straw or parali is burnt in Haryana and Punjab, a major cause of air pollution in the Delhi-NCR region. In this regard, the government is setting up 400 plants to convert the rice straw into CNG. At the moment, 60 plants are operational.

The minister also discussed a new project in Panipat in which rice straw is being used to create 1 lakh litres of Ethanol, 1.5 tonnes of bitumen, and 78,000 tonnes of jet fuel.