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.

Living in more intensely developed neighborhoods may actually protect you against a stroke, a new University of Michigan study suggests.

Researchers tracked more than 25,000 adults across the US for over a decade and have now found that residents in areas with higher levels of development with more buildings, sidewalks and infrastructure, had a 2.5 percent lower risk of suffering a first-time stroke compared to residents in less developed areas.

Cathy Antonakos, research specialist senior in the U-M School of Kinesiology and first author explained: ""High-intensity development typically includes greater housing density and more commercial/retail outlets.

"These areas are more likely to feature compact land uses with access to health care, food stores, public transport and physical activity infrastructure like sidewalks, bike facilities and parks."

However, the study did not examine these environmental features, but there are some practical applications, Antonakos noted.

"For physicians, the study suggests that neighborhood-level factors may influence first-time stroke risk, in addition to individual-level factors," she said. "For planners, the findings suggest that enhancing environments with features that support cardiovascular health and physical activity may help lower the risk of first-time stroke."

Strokes: A Rising Crisis In India

Heart strokes are also one of the leading global health burdens, causing significant deaths and disability worldwide, including in India. Compared to Western countries, stroke also tends to occur at a younger age and is associated with a higher case fatality rate in the country.

One in seven stroke patients in India are young adults aged below 45 years, with hypertension leading as the major risk factor, according to a study by the Indian Council of Medical Research (ICMR).

The Global Burden of Disease Study 2021 identified hypertension, air pollution, tobacco smoking, high cholesterol, increased salt intake, and diabetes as the leading risk factors of stroke.

Incidence of stroke is increasing significantly in low- and middle-income countries (LMICs), especially in India, due to population growth, aging, and greater exposure to risk factors.

Wine Reduces Your Risk Of Strokes

A new global study suggests that moderately drinking wine can decrease your risk dying from cardiovascular disease by 21 percent.

A group of Chinese researchers who analyzed 340,924 adults in the UK between 2006 and 2022 classified a 12-ounce beer, a 5-ounce glass of wine or a 1.5-ounce shot of liquor each contains about 14 grams of pure alcohol.

Those who consumed less than 20 grams per week, about 1.5 standard drinks, were classified as never or occasional drinkers. The low alcohol consumption group included men who drank more than 20 grams per week but no more than 20 grams per day, and women who drank between 10 grams per day and 20 grams per week.

They found those with high alcohol consumption were 24 percent more likely to die from any cause, 36 percent more likely to die from cancer and 14 percent more likely to die from heart disease.

Additionally, even low intake of spirits such as beer or cider was associated with a nine percent higher risk of dying from cardiovascular disease compared with drinking never or occasionally.

Researchers at the University of California Riverside have developed a low-cost fake drug detector that can detect fake medicines by studying how pills dissolve in water.

Tested on 30+ medicines, the detector identified drugs with about 90 percent accuracy and could even distinguish between brand-name and generic versions.

William Grover, associate bioengineering professor at the University of California, Riverside explained: "Watered-down or illicit versions of drugs like Botox or popular GLP-1 inhibitors have caused serious injuries or death.

"The theory here is that if it's a legitimate medicine, the manufacturer made every pill identical enough that they'll all behave roughly the same way when they dissolve.

"So if you test a suspect pill, and it dissolves at a different rate than the real thing, this suggests the suspect pill is counterfeit."

Talking about the success of the device, Grover said: "We took Bayer aspirin pills and drug-store-brand aspirin - these are basically identical medicines with the same active ingredient and very similar inactive ingredients but when ran through our tests, we could easily tell the difference between the two products."

Costing as little as $5–$30, the device could help tackle the global issue of fake medicines, which the World Health Organization estimates affect 1 in 10 drugs worldwide.

How Does It Work?

The fake drug detector is essentially a low-cost infrared sensor made for use in toy robots able to follow lines drawn on paper. The researchers repurposed the sensors to instead track the rate at which pills dissolve in water.

All pills of a given drug dissolve or ideally should dissolve at roughly the same rate. Legitimate medications don't necessarily dissolve any faster or slower than counterfeit ones however since, the are made by different people at different facilities and with different ingredients, each drug's dissolution rates form a "fingerprint" that makes them identifiable and different from that of a fake drug.

What Else Can The Fake Drug Detector Be Used For?

Grover notes that he would like to use this method to detect fake antimalarial drugs as they are a major cause of death in many tropical regions. Malaria is treatable with the right medications.

"Unfortunately, bad actors know they can make money preying on the need for antimalarials. They sell pills that have the same packaging as authentic antimalarials, but don't contain the active ingredients. If someone gives these pills to their child, they won't cure their infection."

The expert also hopes to get his tool into the hands of those who can use it to fight fake antimalarials and other fake drugs.

"I can't imagine a more despicable person than someone who would sell fake medicine to a child. I hope our work makes those criminals' lives a little harder."

While multiple studies and experts sound the alarm over the dangers of bad lifestyle habits on heart and brain health, doctors are also warning against these secret habits that may be causing serious damage to your kidneys.

Dr Sridhar Shetty, MBBS, MS (General Surgery), DNB (Urology), MNAMS (Urology), FRTS, FIMS, Apollo Spectra Hospital, Bengaluru exclusively tells Healthandme: "Kidneys have many different functions including filtering out approximately 150-180 liters of blood each day in a healthy adult; removing waste from the body; balancing fluids; regulating blood pressure; and maintaining minerals including sodium, potassium, and calcium.

"Unfortunately, many people don't realize they have kidney issues until substantial damage has occurred. There is now a growing body of evidence that indicates many common habits put unnecessary strain on kidneys over time."

Dr Vikas Agarwal, Director & HOD, Robotic Urology, Aakash Healthcare also added: "Poorly managed high blood pressure and diabetes are among the largest causes of kidney damage and are strictly related to everyday lifestyle, including diet and physical activity, stress levels, the presence or absence of medication taking.

"Not every person is aware that seemingly insignificant lifestyle habits may dramatically predispose an individual to chronic kidney disease in the long-term."

Chronic Dehydration and Kidney Stress

According to Dr Shetty: "One of the biggest impacts on overall kidney health is dehydration due to not drinking enough water every day. Not getting enough fluid requires the kidneys to work much harder by producing concentrated urine to save water within the body; therefore, over time this may contribute to kidney stones or the inability of the kidneys to filter properly.

"Concentrated urine also causes more mineral crystallization which could be a greater risk for developing stones."

The US National Academies of Sciences, Engineering, and Medicine suggest about 3.7 liters (approx. 15.5 cups) for men and 2.7 liters (approx. 11.5 cups) for women daily.

However, if you exercise or live in a hot climate, you should increase your intake. The American College of Sports Medicine recommends adding 12 ounces of water for every 30 minutes of exercise.

Dr Agarwal recommends: "Regular medical check-ups, blood pressure, and blood sugar tests, and urine examination is hence very important in detection of early kidney stress. Early diagnosis enables timely interventions which can be used to slack down or avoid further deterioration."

Excessive Salt Consumption

Speaking about how consuming excessive salt can increase heart strain and end up affecting the kidneys, Dr Agarwal said: "Hypertension or high blood pressure is a condition that causes major damage in the kidney across the world. The kidneys have a system of small blood vessels known as glomeruli that removes wastes in the blood.

"In the event that blood pressure is always high then the pressure exerted on these fragile vessels may cause them to narrow, weaken or even to scar. With time, such damage impairs the effectiveness of the kidneys in the filtration process of blood, causing the gradual accumulation of poison and water in the body.

"Some of the daily habits like consuming too much salt, high processed foods, chronic stress, insufficient sleep and sedentary lifestyle may aggravate hypertension and hasten kidney damage. People who eat packed snacks, fast food, and salty food regularly are not aware that they are putting an extra burden on their kidneys."

As a result, Dr Shetty warns: "Processed foods, instant meals, packaged snacks, and entrees sold in restaurants are generally the primary sources of hidden sodium in most people's daily food intake."

Overuse of Painkillers

Dr Shetty explains: "The regular consumption of everyday pain relievers, like non-steroidal anti-inflammatory drugs (NSAIDs), can negatively impact the kidneys without any visible signs. NSAIDs inhibit the production of prostaglandins, which are chemicals required for proper blood flow in the kidneys.

"Therefore, excessive consumption can lead to a decrease in blood supply to the kidneys, resulting in analgesic nephropathy or damage to the kidneys."

To maintain kidney health, he recommends: "People can protect their kidneys through basic yet regular health practices which include

drinking enough water, eating less sodium, using their prescribed medications correctly, and doing regular tests to check their blood pressure and blood sugar and kidney health.

"Daily knowledge about these habits enables people to minimize their chances of experiencing permanent kidney damage."

Dr Agarwal added: "Eating a balanced diet with minimal amounts of excessive salt and refined sugars is useful in controlling the blood pressure and blood glucose levels. Exercise aids in normal metabolism and enhances the work of the heart, saving the kidneys. Kidney protection can also be achieved through proper hydration, stress avoidance, and healthy body weight maintenance.

"Moreover, patients with hypertension or diabetes are also required to take medications regularly and according to the recommendations of the doctors with references to changes in the diet and style of life."