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.

Ozempic (semaglutide) has quickly become a widely used drug for managing type 2 diabetes and supporting weight loss. With its growing use, many people are wondering whether it has any interaction with alcohol. There have also been reports suggesting that Ozempic may reduce alcohol cravings in some users.

While it is not always necessary to completely avoid alcohol while taking Ozempic, doctors say there are certain side effects and risks that should not be ignored. To understand this better, we spoke with Dr Monika Sharma, Senior Consultant in Endocrinology at Aakash Healthcare.

Can Ozempic Make Alcohol Hit Twice as Hard?

Yes, alcohol can feel noticeably stronger when taken alongside medications like Ozempic, and this has a lot to do with how the drug alters digestion, metabolism, and brain signalling. Ozempic belongs to a class of medicines called GLP-1 receptor agonists. It is primarily prescribed for type 2 diabetes and is increasingly used for weight management. One of its key actions is slowing down stomach emptying, meaning that both food and liquids stay in the stomach longer before moving into the intestines.

Dr Sharma explains, “When alcohol is consumed, delayed gastric emptying can lead to uneven absorption. In some people, alcohol enters the bloodstream later but more rapidly once absorption begins, which can raise blood alcohol levels faster and intensify intoxication even with smaller amounts.”

Ozempic and Alcohol: Reduced Appetite and Drinking On An Empty Stomach

Another major factor is appetite suppression. Many people on Ozempic eat significantly less or skip meals altogether, either intentionally or due to reduced hunger. Drinking alcohol on an empty or nearly empty stomach allows it to be absorbed more quickly, as there is little food to slow the process. As a result, an amount of alcohol that once felt manageable may suddenly cause dizziness, flushing, nausea, or loss of coordination much sooner than expected.

Ozempic and Alcohol: Brain Effects and Alcohol Sensitivity

Ozempic also affects areas of the brain linked to reward, fullness, and impulse control. Emerging research suggests that GLP-1 receptor agonists may lower cravings for substances like alcohol, while at the same time increasing sensitivity to its effects. This means that even if the desire to drink decreases, the body’s reaction to alcohol may feel stronger or more unpleasant. Many users report unusual tiredness, light headedness, or nausea after just one drink, often describing it as alcohol “hitting twice as hard.”

Ozempic and Alcohol: Blood Sugar Changes and Hypoglycemia Risk

Blood sugar regulation is another concern. Alcohol can cause fluctuations in glucose levels, and when combined with a medication that tightly controls insulin release and glucose use, the risk of low blood sugar increases, particularly for people with diabetes. Symptoms of hypoglycemia include sweating, shaking, confusion, and palpitations. These signs can resemble alcohol intoxication or worsen its effects, making the experience more intense and potentially dangerous.

Ozempic and Alcohol: Dehydration and Slower Recovery

Dehydration also plays a role. Ozempic can cause side effects such as nausea, vomiting, and reduced fluid intake, all of which increase the risk of dehydration. Alcohol further depletes fluids, and when the body is already low on hydration, alcohol’s impact on the brain and heart becomes stronger. This can lead to faster intoxication, headaches, and a longer recovery time after drinking.

Ozempic and Alcohol: Gut Sensitivity and Worsening Side Effects

Gastrointestinal sensitivity should also be considered. Ozempic commonly causes nausea, bloating, acid reflux, and stomach discomfort, especially in the early months of treatment. Alcohol irritates the stomach lining and relaxes the lower oesophageal sphincter, which can worsen these symptoms. Together, even small amounts of alcohol can trigger stronger negative reactions, reinforcing the feeling that tolerance has suddenly dropped.

Why Alcohol Feels Stronger On Ozempic

While Ozempic does not directly interact with alcohol the way some medications do, its indirect effects on digestion, hydration, metabolism, and the nervous system can make alcohol feel more potent. This is why moderation is strongly advised. People taking Ozempic should limit alcohol intake, avoid drinking on an empty stomach, stay well hydrated, and pay close attention to how their body responds.

In short, Ozempic can make alcohol feel stronger not because it increases alcohol levels directly, but because it changes how the body processes and reacts to alcohol. Being aware of this interaction can help people make safer, more informed choices while using this medication.

Dense, toxic smog covered India’s capital on Monday, driving air pollution to its highest levels in weeks, disrupting travel, and prompting authorities to enforce the strictest containment measures. More than 40 flights were cancelled, with several dozen more delayed. Over 50 trains arriving and departing from New Delhi faced delays of several hours, officials reported. Healthcare experts urged residents to stay indoors as hospitals recorded a surge in patients with breathing problems and irritated eyes. Now, a pulmonologist is warning that indoor air in Delhi might actually be more hazardous than the smog outdoors.

Delhi Pollution: Indoor Air More Toxic Than Outdoor Smog

Indoor air quality in Delhi is reportedly worse than the air outside, according to a lung specialist. Dr. Vivek Nangia, head of pulmonology at Max Healthcare, said indoor spaces can have particulate matter, or PM2.5 levels, nearly two-and-a-half times higher than outdoor readings, even when there are no direct pollution sources indoors.

Also Read: Delhi Sees Rising Cancer Burden With Sharp Increase in Oral and Lung Cancers; Breast Cancer Remains Most Common

“Indoor air can be 20 to 30 times more polluted than outdoor air, so it’s important to monitor and improve it,” he explained. Studies have shown that lung-damaging tiny particles inside homes are “substantially higher” than what nearby government monitors report outdoors. This was also confirmed by a study conducted by the Energy Policy Institute at the University of Chicago (EPIC) between 2018 and 2020, which surveyed thousands of Delhi households across different income levels, finding that both rich and poor families are affected equally.

Researchers noted that wealthier households were 13 times more likely to own air purifiers than low-income ones, yet indoor pollution in those homes was only about 10% lower than in disadvantaged settings.

“In Delhi, the bottom line is—whether someone is rich or poor, nobody gets to breathe clean air,” said Dr. Kenneth Lee, the study’s lead author. “It’s a complex, vicious cycle.”

Also Read: Delhi Is a Gas Chamber Where Nothing Comes In or Goes Out, Says Expert; Neighboring States Not to Blame for AQI

How Does Indoor Air Quality Affect Your Lungs?

Poor indoor air quality (IAQ) can harm the lungs by causing inflammation, weakening the body’s defenses, and triggering or worsening conditions such as asthma and COPD. Pollutants like dust, mold, VOCs, and smoke can lead to coughing, wheezing, infections, and long-term lung damage, even raising the risk of lung cancer over time. Because the lungs are constantly exposed to air, they are extremely sensitive to irritants, which can reduce lung function and capacity—particularly in children, older adults, and those with pre-existing conditions, according to the American Lung Association.

Dr. Nangia noted that patients are now showing a different kind of chest congestion. “These days we’re seeing two kinds of patients—those who never had lung issues before but are now coming in, saying their coughs, sneezing, and chest congestion started once air quality worsened, and those with existing lung problems who are experiencing much worse symptoms,” he said.

How To Protect Yourself From Indoor Toxic Air?

According to the American Lung Association, protecting yourself from indoor air pollution involves controlling sources of pollutants (no smoking, using low-VOC products), improving ventilation (opening windows, using exhaust fans), using HEPA air purifiers, cleaning regularly (dusting and vacuuming), managing humidity to prevent mold, and wearing N95 masks on days with high outdoor pollution to reduce indoor air infiltration.

Influenza and other respiratory viruses are surging, note the United Nations. In fact Dr Wenqing Zhang, Unit Head for Global Respiratory Threats at the Department of Epidemic and Pandemic Threats Management of the World Health Organization said that this year is marked by "the emergence and rapid expansion of a new AH3N2 virus subclade". This new variant is called J.2.4.1 or subclade K. This was first reported in August in Australia and New Zealand and has since been detected in over 30 countries.

2025 - A Year Of Flu

Earlier in November, the Public Health Ontario's (PHO) data revealed that Ontario and Canada as a whole could be in a "very tough" flu season this year, thanks to the Influenza A or the flu A. The PHO data revealed a 1.8% rise in influenza cases in the last week of October. Now, amid the influenza A outbreak, 3 children have died from the same in Ottawa and Eastern Ontario region.

US is also facing a flu outbreak and as per the Centers for Disease Control and Prevention (CDC) data, an estimated 2.9 million people have gotten sick so far this season. Among them, 1,200 have also died. This is the 'worst' flu season, point out many experts. For US, the country is seeing a post-Thanksgiving spike in influenza, and saw an 8% increase in people testing positive for the flu.

Super flu or the mutated variant of flu, clade K, has swept the world and caused an early spike in cases worldwide. In Australia, it has caused an early summer spike, while in the UK, it has caused a surge in hospitalization. As per the National Health Service (NHS) England, the number of cases of K flu has been increasing since December 7 and December 11. Hospitalization is up 55% in a week, noted NHS.

Read: Flu Outbreak: Close To 3 Million People Affected, With 1.2k Dead In the US; Where's the Virus Hitting Hardest

Is Flu Shot Effective?

The strain driving the current spike has picked up the nickname “super flu” because it is believed to be a mutated form of influenza A (H3N2), known as “subclade K.”

Influenza H3N2 does not circulate as often as some other flu strains. Dr Simon Clarke, associate professor of cellular microbiology at the University of Reading, explains that the letters “H” and “N” refer to two proteins found on the virus surface, haemagglutinin and neuraminidase. “The numbers simply tell us which versions of those proteins are present,” says Dr Clarke. “It’s a way of grouping strains. This year, H3N2 happens to be the one in the lead.”

“H3 subtypes are relatively uncommon,” he adds. “That means fewer people have built up immunity. There is also evidence they spread more easily and mutate faster, which makes them harder for vaccines to keep up with.

“What we are seeing now is the outcome of that: cases rising sharply earlier than usual, with numbers likely to climb further as winter goes on.”

Recent figures suggest the flu vaccine cuts the risk of hospital admission by roughly 30 to 40 per cent in older adults. That protection rate is lower than for some other vaccines, but it is in line with flu vaccine performance in past years. For that reason, advice has not changed. Vaccination remains the single most effective step people can take to protect themselves and to ease pressure on the NHS.

Super Flu or The K Strain

Known as the superfly, this is H3N2 'subclade K'. It is a type of seasonal influenza A virus and people have not encountered much of it in the recent years. This is why there is less immunity against it. However, the National Health Service (NHS), UK, has already sent out a 'flu jab SOS' to vulnerable people.

NHS has confirmed that the super flu is circulating in England this year, and due to less immunity, it is making it easier to spread across people. The UK Health Security Agency (UKHSA) has urged people to get a flu jab. As per the early data, this year's vaccine has offered good protection despite the new strain.

Daniel Elkeles, chief executive of NHS Providers, said that the major concern is that H3N2 is associated with a more severe illness and superflu could be "a very nasty strain of flu". He said that UK could be experiencing a "tidal wave" of illness.

What Is Influenza A?

As per the National Institutes of Health, US, influenza viruses that contains single-stranded RNA that are classified into three types: A, B, and C. Type A and B cause annual epidemics and even pandemics, while type C is a less common disease.

As per the Centers for Disease Control and Prevention (CDC), Influenza A viruses are descendants of the 2009 H1N1 pandemic virus that emerged in the spring of 2009 and caused a flu pandemic. These viruses, scientifically called the "A(H1N1)pdm09 virus," and more generally called "2009 H1N1," have continued to circulate seasonally since 2009 and have undergone genetic and antigenic changes.

Influenza A(H3N2) viruses also change genetically and antigenically. Influenza A(H3N2) viruses have formed many separate, genetically different clades in recent years that continue to co-circulate.