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.

Urine leakage when you cough, sneeze or exercise is often dismissed as something women simply have to live with after pregnancy or childbirth. But pelvic floor problems can affect both women and men and may interfere with daily activities, confidence, relationships and sexual health.

Many people quietly live with symptoms such as urine leakage, urgency, pelvic pressure or pain, while even those who seek medical help may not know the underlying cause. Speaking to HealthandMe, doctors said these can be signs of pelvic floor dysfunction — a treatable condition that should not be ignored.

Early identification and appropriate treatment can help prevent symptoms from disrupting everyday life.

What Is Pelvic Floor Dysfunction?

Pelvic floor dysfunction occurs when the muscles in the pelvis do not relax, contract or coordinate properly. These muscles support the bladder, bowel and reproductive organs.

According to the Cleveland Clinic, the pelvic floor muscles act like a supportive hammock. When they are too tight, weak or poorly coordinated, normal bladder, bowel and sexual functions can be affected.

Pregnancy and childbirth are important risk factors, but pelvic floor problems can also affect men. Symptoms may include urinary urgency or leakage, pelvic pain or pressure and bowel problems.

Other factors such as sedentary lifestyles, stress, obesity and constipation may be contributing to pelvic floor dysfunction.

What Can Increase The Risk Of Pelvic Floor Problems?

Dr Nirmala M, Consultant, Obstetrician, Gynaecologist & Fertility Specialist, Motherhood Hospitals, Bengaluru, told HealthandMe that sedentary office work, stress, obesity and constipation can contribute to pelvic floor problems. Poor water intake and regularly holding urine can also play a role.

“It is seen that almost four of every five cases of incontinence observed in hospitals have been identified among young women aged 25 to 35 years old,” she said.

Pelvic floor dysfunction can affect men too, particularly in association with urinary, bowel or prostate-related problems.

Dr Meghana Reddy Jetty, Senior Consultant - Obstetrics, Gynecology, Laparoscopy and Aesthetic Gynecology, Aster Women and Children, Bengaluru, said men may also experience urinary leakage and bowel control problems, including in association with pelvic operations and prostatic procedures.

“Men have pelvic floor muscles too, which are responsible for bladder and bowel control and proper functioning of the pelvis,” she said.

What Are The Early Signs?

Symptoms can vary depending on whether the pelvic floor muscles are weak, too tight or poorly coordinated.

Common signs include:

• Urine leakage while coughing, sneezing or exercising
• A sudden or uncontrollable urge to urinate
• Difficulty emptying the bladder or bowel
• Pelvic heaviness or pressure
• Pelvic discomfort
• Pain during intercourse

Dr Nirmala said urinary leakage during physical strain and a sudden, uncontrollable urge to urinate are among the early symptoms.

Dr Meghana said occasional urine leakage, difficulty emptying the bladder or bowel, pelvic heaviness, discomfort and pain during sexual intercourse can indicate that the pelvic floor is not functioning properly.

How Can Pelvic Floor Dysfunction Affect Daily Life?

The condition can affect more than bladder or bowel control. Fear of leakage, urgency or pain may cause people to avoid exercise, travel and social activities.

Dr Nirmala said some women avoid parties and long-distance travel because of difficulty finding a nearby bathroom. In serious cases, they may rely on diapers or sanitary pads, affecting confidence and increasing stress.

Pelvic floor dysfunction can also affect sexual health. Pain and difficulty relaxing the pelvic muscles may lead women to avoid sexual activity.

“It can hurt sexual health if pain and difficulty in relaxing pelvic muscles cause one to avoid sexual activity. This kind of problem that seemingly just involves the physical aspect can slowly but surely have a great effect on one's confidence, relationships and behavior in general,” said Dr Meghana.

Can Exercise Make Pelvic Floor Symptoms Worse?

Exercise can support pelvic health, but the type, intensity and technique matter.

Dr Swati Rai, Senior Consultant-Obstetrician and Gynecologist at Cloudnine Group of Hospitals, Noida, said exercises such as Kegels, diaphragmatic breathing, pelvic tilts, glute bridges and gentle core strengthening can help support the pelvic floor during and after pregnancy, depending on the individual.

“Kegels involve gently contracting the muscles used to control urine, holding briefly and then completely relaxing; they should not be routinely practized while urinating,” she told HealthandMe.

However, excessive or improperly performed high-impact exercise, intense interval training, repeated jumping and weightlifting can place additional pressure on the pelvic floor, particularly when breathing and core control are inadequate.

Dr Meghana said pelvic-floor training should focus on muscle control rather than simply increasing repetitions.

“So, training of pelvic muscles should be more about learning muscle control - knowing when to contract and when to relax - rather than just doing more and more repetitions,” she said.

Dr Swati said excessive straining, breath-holding or incorrectly performed high-impact exercises may aggravate symptoms.

Is Pelvic Floor Dysfunction Treatable?

Pelvic floor dysfunction can improve significantly with appropriate, personalized treatment. However, treatment depends on whether the muscles are weak, overly tight or poorly coordinated.

Treatment may include:

• Pelvic floor retraining
• Physical therapy
• Core strengthening
• Relaxation and breathing exercises
• Biofeedback

Noncommunicable diseases such as heart disease, cancer, diabetes and chronic respiratory diseases affect billions of people worldwide and cause around 43 million deaths every year, with most deaths occurring in low- and middle-income countries.

These conditions often require lifelong care. From diagnosis and medication to monitoring and follow-up, each stage can carry safety risks, making timely, coordinated and patient-centered care essential.

World Patient Safety Day is observed every year on September 17 to raise awareness about patient safety and accelerate action to reduce avoidable harm in healthcare. Around the world, one in 10 patients experience harm while receiving health care, and approximately half of these incidents are preventable.

In 2026, the campaign focuses on safe care for noncommunicable diseases (NCDs), with the slogan “Safe care for life!”

“World Patient Safety Day is an annual reminder that if it's not safe, it's not care. This year, we're shining a light on safe care for non-communicable diseases. People with heart disease, cancer, diabetes, and chronic respiratory disease need care throughout their lives,” Dr Tedros shared in a post on X.

He noted that every interaction with the health system comes with benefits and risks.

“A delayed diagnosis, the wrong medicine, an unsafe procedure, or poor communication can have deadly consequences. Safe care must be built into every stage of the care journey, from prevention and early diagnosis to treatment, long-term management, and self-care,” the chief added.

Also read: World Patient Safety Day: With 2800% Margin, Costly Hospital Consumables Can Threaten Patient Safety; Here’s How

Why Do Chronic Conditions Raise The Risk Of Harm?

People with chronic diseases often need medicines, tests, consultations and other healthcare services over many years, increasing safety risks, particularly when care is fragmented or healthcare providers are not well coordinated.

Patient safety risks can occur at different stages of care. Common sources include:

• Missed prevention opportunities

• Delayed or incorrect diagnosis

• Medication errors

• Healthcare-associated infections

• Unsafe use of medical devices

• Poor communication and coordination

How Can Patients With Chronic Diseases Stay Safe?

Understanding your diagnosis and treatment can help you take an active role in your care.

• Know your diagnosis, treatment plan and why tests or medicines are needed.

• Use trusted health sources and ask questions when something is unclear.

• Confirm instructions and follow up on test results.

• Speak up if something feels wrong.

• Keep an updated list of your diagnoses, medicines and treatment plan, especially when seeing multiple doctors.

• Attend regular appointments and know the warning signs that need medical attention.

• Plan how you will access essential medicines, tests and follow-up care during disruptions.

Continuity of care is particularly important for people with NCDs. Poorly coordinated referrals, handovers and discharge processes can create safety gaps, especially for those managing multiple conditions or medicines.

Read More: Stem Cell Therapy For Autism: What India’s New Advisory Means For Patients

Safer Care Also Depends On The Health System

Patient safety cannot be addressed by patients alone. Strong policies, coordinated healthcare services and well-supported health workers are essential to reducing avoidable harm.

Fragmented care can put people managing complex chronic conditions at greater risk. Better communication between multidisciplinary teams can help identify problems earlier and reduce gaps in care.

Delayed referrals can also cost valuable time. Well-coordinated referral pathways can help patients receive the right care at the right time.

What Should Healthcare Systems Do?

The WHO called on healthcare facility managers, health leaders and policymakers to strengthen patient safety as part of everyday NCD care. This includes building resilient facilities, strengthening risk management, supporting health workers and establishing reliable systems for continuous care before, during and after emergencies, according to the WHO.

Healthcare systems should also ensure uninterrupted access to essential medicines, diagnostics and medical devices while strengthening referral pathways and communication between healthcare providers.

Investing in preparedness, continuous learning and quality improvement can further help reduce avoidable harm and improve the safety and quality of chronic disease care.

Something as basic as an IV set, syringe, cannula or catheter can make a huge difference in a patient’s essential care and treatment. But a recent FDA survey has raised questions about the affordability of these hospital consumables and whether the lack of transparency in pricing can pose a threat to patient safety.

Maharashtra Food and Drug Administration Commissioner Tukaram Mundhe recently flagged exorbitantly priced hospital consumables and medical devices used in inpatient departments.

The food and drug regulator sought Centre’s intervention to straighten pricing of essential and life-saving medical devices, saying these practices should be ideally “fair, transparent and ethical”.

Maharashtra FDA Chief Tukaram Mundhe Flags Costly Hospital Consumables

The Maharashtra State Price Monitoring Resource Unit, operating under the state FDA, recently conducted the market survey covering medical devices used in inpatient departments, including IV sets, syringes, nebuliser, and oxygen-mask kits, and other consumables.

The survey found that some commonly used medical devices had a gap of up to 2,841% between procurement prices and printed maximum retail prices (MRPs).

For example, an IV infusion set purchased for Rs 11.05 was listed at an MRP of Rs 325. A 10 ml syringe purchased for Rs 6.75 had an MRP of Rs 57.20, while a catheter bought for Rs 29.41 had an MRP of Rs 310.

Maharashtra FDA Commissioner Tukaram Mundhe has sought intervention from the Centre and the National Pharmaceutical Pricing Authority (NPPA), arguing that patients admitted to hospitals are not in the position to bargain over medical products that are essential to their treatment. They may not have the opportunity to compare prices, search for another brand, or simply refuse the product.

In a recent interview, Mundhe said, “A trade margin of 2800 per cent is by any terms not acceptable, either as a consumer or as a hospital or as a regulator.”

Mundhe highlighted this problem in his letter to the Department of Pharmaceuticals, writing, “Because hospitalised patients critically require these non-negotiable surgical consumables during active treatment, they possess zero bargaining power in IPD settings.”

He also described the steep pricing as “completely irrational and unjustified” and argued that the absence of strict statutory price caps for several medical-device categories can leave patients facing large and opaque price differences.

The Centre has now sought a report from the NPPA on the price discrepancies flagged by the Maharashtra FDA.

Also read: Syphilis Among Australian Women Has Risen By 167% In The Last Decade: How It Can Affect Pregnancy & Newborns?

Costly Hospital Consumables May Become A Patient-Safety Issue

World Patient Safety Day is observed on September 17 every year to raise global awareness about the safety of patients and reduce preventable harm in healthcare.

As far as patient safety is concerned, it is not only about whether a device is sterile, functional, or medically appropriate. Affordability and transparency can also influence whether patients are able to access and continue necessary treatment.

A fat hospital bill may cause financial burden, discouraging patients from seeking timely treatment. For families paying out of pocket, unexpected costs can affect decisions about where to seek care, whether to continue treatment or whether to delay non-emergency follow-up.

Mundhe has described the issue directly as a patient-protection concern, saying, “This is not merely a pricing issue; it is a patient-protection issue.”

Also read: Ferritin Face: Can Pale Skin Signal Iron Deficiency?

Industry’s Response To The Maharashtra FDA

The procurement price of a device, however, cannot automatically be treated as the final cost of safely delivering it to a patient.

Hospitals may incur costs related to sterile storage, inventory, staff, emergency availability, wastage, expiry, infrastructure, quality checks, and safe disposal.

Industry representatives have therefore argued that pricing frameworks should distinguish between basic commodity consumables and complex medical technologies.

In a statement, the Association of Healthcare Providers of India (AHPI) said, “Price of device or medicine is very small part of overall cost of administering healthcare, which include manpower (doctors, nurses, paramedical, administration etc.) maintaining infection free environment, infrastructure etc.”

They also reacted to Maharashtra FDA’s pricing concerns and said that hospitals play no part in setting up MRPs of these products.