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.

Parkinson's disease is a progressive, neurodegenerative movement disorder caused by the loss of dopamine-producing brain cells, primarily affecting people over 60. Apart from motor loss, the disease also causes cognitive decline, depression, anxiety and swallowing problems.

The first symptom may be a barely noticeable tremor in just one hand or sometimes a foot or the jaw. Over time, swinging your arms may become difficult and your speech may become soft or slurred. The disorder also causes stiffness, slowing of movement and trouble with balance that raises the risk of falls.

However, before clear symptoms begin to appear, Neurologist Rachel Dolhun says certain signs may help identify the onset of the disease decades before it is diagnosed.

“It’s important to stress that not everyone who has these symptoms goes on to develop Parkinson’s,” said neurologist Rachel Dolhun. “But we know that in some people, these can be some of the earliest signs," she told The Washington Post.

Here is what you should look out for:

1. Loss Of Smell

Loss of smell, or hyposmia, is a common and early non-motor symptom of Parkinson's disease, affecting up to 90 percent of patients. This symptom can significantly impact quality of life by reducing the enjoyment of food and diminishing appetite.

While strongly linked to Parkinson's, smell loss can also stem from other causes, including sinus problems, COVID-19, or aging.

2. Acting Out Dreams

Acting out dreams, known as REM Sleep Behavior Disorder (RBD), involves physically enacting vivid, often unpleasant dreams through shouting, punching, or kicking during sleep.

This typically happens because the brainstem fails to temporarily paralyze muscles during REM sleep. It is a strong early warning sign of Parkinson's disease, often appearing years or decades before motor symptoms. About 50 percent of people with Parkinson's experience RBD.

READ MORE: Parkinson’s Patients May Soon Walk Better With This New Personalized Brain Therapy

3. Constipation

Constipation is a very common and significant non-motor symptom of Parkinson's disease that is caused by nerve changes slowing gut muscles and potentially exacerbated by low activity and dehydration.

Constipation can also be caused by Parkinson's medications such as anticholinergics, amantadine and other common drugs such as opioids, iron/calcium antacids.

4. Dizziness As You Stand

The autonomic nervous system fails to properly constrict blood vessels or increase heart rate upon standing, often due to a lack of norepinephrine. This causes the autonomic nervous system to fail in regulating blood pressure. Over time, this leads to Neurogenic Orthostatic Hypotension.

Beyond dizziness, symptoms include blurred vision, weakness, fatigue, cognitive "fog," and "coat hanger pain" (pain in the neck/shoulders). Often times, patients experience dizziness in the morning or immediately after meals.

Diagnosing Parkinson’s disease is mostly a clinical process, meaning it relies heavily on a healthcare provider examining your symptoms, asking questions and reviewing your medical history. Various imaging and diagnostic tests used to detect disease includes CT scan, PET scan, MRI scan and genetic testing.

Beyond icy roads and fogged-up car windscreens, the coldest season can also bring on a painful condition that leaves the skin covered in red, itchy patches. Doctors have issued a warning about this lesser-known illness, which tends to worsen in low temperatures.

The condition, known as cold urticaria, affects around one in 2,000 people. It causes swelling and itching of the skin when it comes into contact with cold air, cold water, or even air conditioning. Red welts or hives can appear within minutes, and the discomfort may last for as long as two hours.

What Is Cold Urticaria?

Cold urticaria is an uncommon condition in which the body reacts abnormally to cold temperatures. It typically causes rashes or hives after exposure to cold air, water, food, or drinks. In some cases, symptoms can be more serious. According to the Cleveland Clinic, the condition may sometimes be linked to an underlying blood cancer or an infectious illness.

Griet Voet, head of a dermatology clinic in Ghent, Belgium, as per Express UK, said the condition is often confused with common winter skin problems such as eczema. “This is not just dry skin caused by cold weather, it is a genuine allergic reaction to cold,” she explained. In more severe cases, large areas of the body may be affected, particularly after swimming in cold water or spending extended periods outdoors. This can lead to intense itching, facial flushing, and even headaches, stomach pain, or fainting. Sudden temperature shifts, such as moving from a warm indoor space into cold outdoor air, can also trigger symptoms. Drinking ice-cold beverages may cause swelling of the lips, mouth, or throat.

Cold Urticaria: What Are The Symptoms Of This Disease?

Symptoms of cold urticaria differ from person to person and can range from mild to severe. They may be limited to a small patch of skin or spread across the entire body.

The most common sign is a skin rash that appears after contact with something cold. The rash usually develops once the exposure ends, as the skin begins to warm up.

The rash may include:

• Hives, bumps, or raised welts
• Itching
• Redness
• Swelling

• Fatigue
• Fever
• Headache
• Joint pain

• Fainting
• Heart palpitations
• A severe allergic reaction known as anaphylaxis
• Shortness of breath or wheezing

How Is Cold Urticaria Diagnosed?

A medical professional can often diagnose cold urticaria using a simple test. An ice cube is placed on the skin, usually on the arm, for a few minutes and then removed. If a hive or rash appears several minutes later, the result is considered positive.

In cases of familial cold urticaria, diagnosis may involve exposure to cold air for a longer duration.

Doctors may also suggest blood tests to check for any underlying illness or infection that could be contributing to the condition.

Health authorities have urged the public to stay alert to Nipah virus symptoms after doctors warned that up to 75 per cent of infected patients may not survive. The UK Health Security Agency (UKHSA) has classified Nipah as a “high priority pathogen” because of its severe fatality rate and the absence of any proven treatment.

In India, the federal health ministry has confirmed two cases in the eastern state of West Bengal. This has triggered large-scale containment measures, with local officials placing nearly 200 people who had contact with the infected individuals under quarantine.

Also Read: Vitamin D Supplements Under Scrutiny As It Fails Safety Test

In response, several Asian nations have stepped up airport checks and health surveillance for travellers arriving from India. Professor Paul Hunter, an infectious disease specialist at the University of East Anglia, said identifying Nipah cases at borders is challenging, as symptoms can take a long time to appear.

What Is Nipah Virus?

According to UKHSA, Nipah virus is a zoonotic infection, meaning it can pass from animals to humans. It can also spread through contaminated food or via direct human-to-human contact. The virus was first discovered in 1999 during an outbreak affecting pig farmers in Malaysia and Singapore.

Fruit bats, especially those belonging to the Pteropus species, are the virus’s natural carriers. Research shows that Nipah can also infect other animals, such as pigs, dogs, cats, goats, horses and sheep.

Nipah Virus Symptoms

• Sudden onset of fever or general flu-like illness
• Development of pneumonia and other breathing-related problems
• Swelling or inflammation of the brain (encephalitis) or meningitis

Symptoms usually appear between four and 21 days after exposure, although longer incubation periods have occasionally been reported. More severe complications, including encephalitis or meningitis, can develop between three and 21 days after the initial illness begins.

Also Read: Nipah Virus Outbreak In India: All That You Need To Know About This Infection

Nipah Virus Symptoms Explained As Doctors Warn 75% Fatality Rate

UKHSA has cautioned that between 40 and 75 per cent of people infected with Nipah virus may die. Those who survive can experience long-term neurological effects, such as ongoing seizures or changes in behaviour and personality. In rare instances, the virus has been known to reactivate months or even years after the first infection.

Nipah Virus: Can You Prevent It From Spreading?

For people travelling to regions where Nipah is known to occur, prevention largely involves reducing exposure risks:

• avoid contact with bats, their habitats, and sick animals
• do not drink raw or partially fermented date palm sap; if consuming date palm juice, make sure it has been boiled
• wash all fruits well with clean water and peel them before eating; avoid fruits found on the ground or those that appear partly eaten by animals
• use protective clothing and gloves when handling sick animals or during slaughter and culling
• maintain good hand hygiene, especially after caring for or visiting ill individuals
• avoid close, unprotected contact with anyone infected with Nipah virus, including exposure to their blood or bodily fluids

Nipah Virus Symptoms Can Be Transmitted Easily?

Many Nipah infections have been linked to eating fruit or fruit-based products contaminated by the saliva, urine or droppings of infected fruit bats. Human-to-human transmission can also occur through close contact with an infected person or their bodily fluids, according to Mirror.

Such transmission has been documented in India and Bangladesh, with cases often involving family members or caregivers tending to infected patients. At present, there is no specific, proven treatment for Nipah virus infection, and no licensed vaccine is available to prevent it.

So far, no Nipah virus cases have been reported in the United States or the United Kingdom.