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.

A Parliamentary Standing Committee on Health and Family Welfare has raised serious concerns about growing doctor burnout, especially among junior and senior resident doctors, and warned that it is now affecting both doctor well-being and patient safety. Noting that overworked doctors are a risk for patient safety, the panel said that fatigue-driven errors and burnout could compromise care.

To tackle this, the committee recommended that the government introduce and strictly enforce a formal “Clinical Duty Hours Regulation” policy. This should mandate fixed rest periods and monitored duty rosters, with oversight mechanisms to prevent violations, stated the panel in its 172nd report presented before the Parliament.

The recommendation comes amid growing concern over long, unregulated shifts in teaching hospitals, where residents often work extended hours with limited rest.

The panel warned that such conditions not only increase the likelihood of clinical mistakes but also contribute to burnout and mental health stress among young doctors.

What The Parliamentary Panel Said

The Panel noted that due to persistent human resource shortages, the working hours of junior and senior residents doctors often stretch from 24 to 36 hours. This increases risk of clinical errors and burnout, thereby compromising patient safety. Thus it recommended a mandatory working-hour regulatory framework:

• to minimize fatigue-induced clinical errors
• safeguard their mental and physical well-being,
• improving patient safety.

However, it noted the contractual engagement must not substitute regular appointments, as excessive reliance on contractual staff may dilute institutional accountability and continuity.

Instead, the panel has recommended adopting a "Total Support model for medical professionals" to attract and retain qualified doctors and specialists in the public health system.

Also read:India Must Integrate Technology To Build Preventive, Holistic Healthcare: Experts

What Is Clinical Duty Hours Regulation policy

The policy calls to:

• Ensure mandatory rest periods, monitored rosters.
• Ensure the presence of senior faculty in wards and in operating theatres during peak hours
• Align faculty schedules with clinical demand
• Offer Structured mentorship
• Protected teaching time for trainees to gain supervised clinical experience
• Improved working conditions, including accommodation, transportation, and administrative support, on par with the facilities afforded to senior civil servants,
• Transparent career progression with time-bound promotions.
• Integrate Yoga and the Indian Knowledge System (IKS) within the workforce to address depression and psychiatric issues.

Also read: Doctors Share Preventable Risk Factors That Can Land You in the Emergency Ward

What Is Burnout?

Burnout is distinct from depression, which influences every aspect of life and often involves persistent thoughts of hopelessness or worthlessness. Burnout typically involves limited manifestations to the work environment, although its impact can resonate into other areas.

Symptoms of Burnout

1. Exhaustion: Prolonged mental and physical depletion of your energy levels.

2. Depersonalization: Cynicism and lack of concern creep into relationships and communication.

3 Reduced Personal Achievement: Your work loses worth, and you may feel you are not up to standards, giving in to frustration and reduced originality.

These signs frequently coincide with physical signs (headaches, muscle pain, sleeplessness), emotional signs (self-doubt, loneliness, unhappiness), and behavioral signs (social withdrawal, outbursts of anger, abandonment of obligations).

Continuing the legacy of football legend Joe Thompson, his wife Chantelle revealed she is pregnant with his baby after IVF treatment using frozen embryos.

Joe Thompson died in 2025 after developing cancer for a third time - beating the illness twice.

But after the former Manchester United star was diagnosed with Hodgkin Lymphoma for a third time, which had spread to his lungs, he died aged 36.

"It just means absolutely everything. I know it's never going to replace Joe obviously. Joe's Joe. But to be able to bring his baby into the world again is beautiful," Chantelle said.

She said Joe had two visions of their family with a baby boy before he died, and he even gave her the name for the baby boy he predicted, and she got pregnant on her first attempt of IVF after he had died.

How Egg Freezing Works

Egg freezing, also known as oocyte cryopreservation, is an option that has gained significant traction in recent years. It offers women the ability to pause their biological clock and preserve the possibility of having children in the future.

Egg freezing takes a woman's unfertilized eggs from her ovaries and stores them at sub-zero temperatures to be utilized later. It is made to enable women to keep their fertility intact, especially if they are not yet ready to have a baby.

Dr. Pavithra M, Obstetrician, Gynecologist, and Infertility Specialist, told HealthandMe that the workup begins with hormone workup and evaluation of various parameters, such as age, body mass index (BMI), and ovarian reserve.

"On the second day of the menstrual cycle, baseline ultrasound scanning is performed to assess the number of follicles; thereafter, various tests of blood are conducted to assess hormone levels. If a woman's parameters are all normal, then she is administered hormonal injections for about 10-12 days."

It causes ovarian hyperstimulation and multiple mature eggs, monitored through ultrasound scans. A trigger shot is administered once the follicles have reached optimal size to help with final egg maturation. It takes 34-35 hours from the trigger shot, wherein eggs are retrieved by minimally invasive procedures under general anesthesia.

"Using a transvaginal ultrasound probe with a needle, each follicle is punctured, and the follicular fluid is aspirated. The retrieved eggs are then screened for quality before undergoing vitrification—a rapid freezing technique that minimizes ice crystal formation and cellular damage," Dr. Pavithra added. The eggs are then stored in liquid nitrogen tanks for long-term preservation.

While egg freezing is possible at various stages of life, experts recommend doing it at an optimal age -- in the late 20s or early 30s when the eggs are of higher quality-- for better outcomes.

Annabelle Gurwitch, an American author, actress, and television host, has opened up about her lung cancer diagnosis in her new memoir.

In her sixth book, ‘The End of My Life Is Killing Me’, Annabelle Gurwitch offers a satirical take on her journey with stage 4 lung cancer. The best-selling author found out about her cancer status in 2020, when she went for a COVID-19 test.

In the book, Annabelle Gurwitch writes about her life as a "cancer slacker", her divorce, treatment with a targeted therapy that turns off the gene that has gone rogue, radiation, and chemotherapy, all with a humorous take.

Lung Cancer: A Stealthy Disease, Says Annabelle Gurwitch

Notably, the American actress had no symptoms and was not a smoker. She went to get her “persistent little cough” tested for COVID, when a doctor told her that there was something suspicious on her lungs.

Soon after, an X-ray and a biopsy confirmed her diagnosis of stage 4 cancer.

Annabelle Gurwitch called lung cancer a “stealthy disease" as, other than her little cough, she exercised every day and felt like she was in really good health.

“You know, you can be asymptomatic with Stage 4 lung cancer because lung cancer is a really stealthy disease, and this is why it's such a big killer, still the No. 1 cause of cancer deaths, because some lung cancers, like the one I have, are not recognized by the immune system," Annabelle Gurwitch told NPR.

"So my body didn't know that it was - anything was happening, which is, I mean, I was going to regular doctor's appointments. And this is why it's often diagnosed at a late stage, and such a big killer because it's not diagnosed at an earlier stage,” she added.

Also read: Early-Stage Lung Cancer Surgery Safe, Effective Even After 80, Reveals Lancet Study

Can Non-Smokers Get Lung Cancer?

Contrary to long-held assumptions, a significant proportion of lung cancer cases now occur in people with no history of smoking. The American Cancer Society reports that approximately 10-20 percent of lung cancers in the U.S are found in non-smokers, often attributed to genetic mutations like EGFR, environmental exposures, or radon gas.

These cases are more common in women, younger adults, and individuals of East Asian descent, but they can affect anyone.

Also read: New AIIMS Study To Probe How PM2.5 Is Surging Lung Cancer Risk In India

Early Signs and Symptoms to Look Out For

Lung cancer symptoms can mimic less serious conditions, which is why they’re often dismissed or misdiagnosed. If you experience the following symptoms persistently, don’t ignore them—regardless of your age or smoking history:

• Chest pain or discomfort
• Unexplained shortness of breath
• Persistent cough or wheezing
• Shoulder, back, or rib pain
• Fatigue or sudden weight loss
• Blood in sputum (though not always present).