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.

Many men believe that as long as they feel healthy, active, and free from major illness, their fertility remains intact. While men do not have a sudden fertility cut-off like women, age still plays an important role when it comes to male fertility. Currently, a large number of men wish to start families later in life, often thinking their good health guarantees easy conception and fatherhood. They often neglect the age factor, even though it is linked to hormonal imbalance, stress, and genetic issues. A large number of men are unaware of their fertility health and continue to suffer. However, even in the absence of visible health problems, older men may face unexpected fertility challenges. Dr Madhukar J Shinde, Fertility Specialist at Nova IVF Fertility, PCMC, Pune, answered this for Health and Me.

Read more: The Overlooked Role of Men in IVF: Why Their Silent Strength Is Key to Fertility Success

Why do older men struggle with infertility?

Decline in sperm quality: Various studies have confirmed that as men age, sperm count, movement, and shape can slowly decline. Even if the numbers appear normal, DNA damage in sperm increases with age, which can reduce the chances of successful fertilisation.

1. Hormonal imbalance: It is important to note that testosterone levels naturally decrease over time. Lower testosterone can affect sperm production, sexual function, and overall reproductive performance, even when a man feels physically fit.
2. Some medical conditions tend to take a toll on fertility: Conditions such as diabetes, high blood pressure, and thyroid disorders become more common with age. These may be well-managed and symptom-free, but can still affect sperm health and fertility.
3. Stress and other lifestyle factors can impact fertility: Chronic stress, lack of sleep, smoking, alcohol consumption, or exposure to pollution can take a toll on sperm quality and lead to fertility issues that can be worrisome for men. Preservatives in a lot of frozen and junk food not only contribute to poor fertility health, but research suggests they may also affect DNA function. Therefore, men should stay vigilant.
4. Genetic issues: Advanced paternal age is associated with a higher risk of genetic mutations in sperm. This can further affect embryo development and increase the risk of miscarriage or certain developmental conditions.

Men must stay in touch with a fertility consultant who can design an appropriate treatment plan. The expert will evaluate them thoroughly and suggest lifestyle modifications such as a well-balanced diet, exercise, stress management through meditation, and medication for conditions such as diabetes, hypertension, and cholesterol. Awareness helps men take informed steps towards parenthood, even later in life. Certain pre-medications, including antioxidants advised by a fertility consultant, may significantly help in reducing DNA fragmentation, which contributes to poor sperm function. Therefore, men should prioritise their reproductive health, stay informed, and not suffer in silence.

High blood pressure (BP) has become a public health problem that is driving cardiovascular diseases like heart attacks and strokes globally. While medications are important to keep hypertension under control, lifestyle changes and healthy practices are also crucial.

Several global health guidelines recommend regular physical activity, but adhering to exercise programs daily becomes a challenge for many people. But in the overtly busy schedules, sparing 10 minutes for an exercise regimen can be easier than travelling to the gym.

A large randomized clinical trial, published in the Journal of the American College of Cardiology (JACC), has proved that a traditional Chinese mind-body practice — baduanjin — may help lower blood pressure, that too, without any equipment.

Baduanjin is a slow, structured movement, focused on deep breathing and meditation.

Importantly, the clinical trial proved that the ancient Chinese technique could lower BP as effectively as brisk walking.

In people practicing baduanjin, BP reductions were seen after three months and were sustained for one year.

"Given its simplicity, safety, and ease with which one can maintain long-term adherence, baduanjin can be implemented as an effective, accessible, and scalable lifestyle intervention for individuals trying to reduce their blood pressure," said Jing Li, Director, National Center for Cardiovascular Diseases in Beijing, China.

Baduanjin: The 10 Minute Routine

Baduanjin is a standardized eight-movement sequence that integrates aerobic, isometric, flexibility, and mind-body components.

It has been in practice for centuries and commonly performed in community settings across China. The routine typically takes 10–15 minutes and requires no equipment and only minimal initial instruction.

Because it is low- to moderate-intensity, it is considered safe and accessible for many adults.

Also read: Cardiovascular Diseases Lead As India’s Top Killer: US Cardiologist Points Out Risk Factors

The Clinical Trial

A team of Chinese researchers led the first large, multicenter randomized trial to look at the impact of baduanjin on blood pressure.

They followed 216 participants, aged 40 years or older, across seven communities to determine changes in 24-hour systolic BP from baseline to 12 and 52 weeks.

Compared to people indulging in self-directed exercise, practicing baduanjin five days a week reduced

• systolic blood pressure by approximately 3 mg Hg
• systolic blood pressure by 5 mg Hg.

Notably, the benefits were sustained even without ongoing monitoring, a key challenge for many lifestyle interventions that struggle to maintain long-term adherence outside structured programs.

"Baduanjin has been practiced in China for over 800 years, and this study demonstrates how ancient, accessible, low-cost

approaches can be validated through high-quality randomized research," said Harlan M. Krumholz, Editor-in-Chief of JACC and the Harold H. Hines, Jr Professor at the Yale School of Medicine.

"The blood pressure effect size is similar to that seen in landmark drug trials, but achieved without medication, cost, or side effects. This makes it highly scalable for community-based prevention, including in resource-limited settings," they added.

Also read: AHA Cholesterol Guidelines 2026: How Indians Can Improve Heart Health

How To Practice Baduanjin

• Stand upright with your feet shoulder-width apart and keep your movements slow and controlled.
• Coordinate each motion with steady, deep breathing, inhaling and exhaling smoothly as you move.
• Move through the traditional eight postures in sequence, focusing on posture, balance, and relaxation rather than speed or force.
• Practice for about 10 to 15 minutes a day in a quiet space, maintaining calm attention throughout.

Back pain is a common problem seen among middle-aged men and women, especially those sitting for prolonged hours. The pain experienced is mainly due to poor posture, lack of physical activity, obesity, and stress.

However, for some, the pain occurs in the mid-back, indicating a far more serious problem. While it may appear like chronic back pain, it may actually signal the risk of spinal tuberculosis, which can creep in silently, according to doctors.

If left untreated, the dangerous infectious disease can lead to paralysis and spinal deformity.

“If your back pain persists for months, it is localized, or if it worsens with cough/breathing, don’t ignore it; seek expert evaluation,” said Dr. Sudhir Kumar, a neurologist from Apollo Hospitals Hyderabad, in a post on social media platform X.

Chronic Back Pain And Spinal TB

Dr. Kumar also shared the case of a 55-year-old man suffering from back pain for four months.

The man’s blood tests, nerve conduction studies, and MRI (neck and lower back) appeared normal. Yet his pain did not go away. He found no relief with painkillers, muscle relaxants, and rest.

Notably, his pain increased while coughing and taking deep breaths.

“That is not a random symptom. Pain that increases with coughing is suggestive of spinal nerve root irritation or compression. This immediately shifts thinking from “muscle pain” to spine pathology,” said Dr. Kumar. The expert advised an MRI of the dorsal (thoracic) spine, which suggested spinal TB.

The “MRI dorsal spine showed involvement of D8–D9 vertebrae, disc edema and paravertebral collection. These findings were suggestive of Spinal Tuberculosis,” said the neurologist, popularly known as the Hyderabad doctor.

Unlike lung TB, where prolonged fever or coughs are a key risk factor, Dr. Kumar just had persistent back pain and no fever, weight loss, or any such “typical TB symptoms”.

“This is why Spinal Tuberculosis is dangerous. It can be silent and slow, and the diagnosis can be easily missed, until it causes paralysis and spinal deformity,” Dr. Kumar said.

What Is Spinal TB?

Tuberculosis of the spine is also known as Pott’s disease, and is named after Sir Percival Pott, who described it in 1779.

Also called tuberculous spondylitis, it is a severe form of skeletal tuberculosis where the Mycobacterium tuberculosis bacteria infect the vertebrae — typically spreading from the lungs to the spine via the blood.

Unlike routine back pain, pain due to spinal TB is persistent, progressive, and does not respond to usual rest or medication.

Early identification is crucial to prevent complications such as spinal deformity or neurological damage, Dr. Manisha Mendiratta, Director & Head – Pulmonology, at Sarvodaya Hospital, Faridabad, told HealthandMe.

The common symptoms to watch out for include:

• Back pain lasting more than 4–6 weeks
• Pain that worsens at night or at rest
• Unexplained weight loss and fatigue
• Low-grade fever or night sweats
• Numbness, weakness, or difficulty walking.

How Can Spinal TB Be Diagnosed?

Early evaluation is key. If symptoms persist, a detailed clinical assessment should be done. Doctors may recommend:

• Imaging tests such as X-ray, MRI (more sensitive)
• Blood tests to check infection markers
• Biopsy or microbiological tests for confirmation

Is Spinal TB Preventable?

Dr. Mendiratta urged the need for ensuring early diagnosis and complete treatment of any TB infection. Further, maintaining good immunity through balanced nutrition and rest, as well as avoiding ignoring persistent or unusual back pain, is crucial to preventing spinal TB.

The doctor also stressed the need for regular follow-ups in people with a history of TB exposure, and to never stop TB treatment midway.

How To Manage Chronic Back Pain

• Seek medical advice if pain persists beyond a few weeks
• Follow the prescribed treatment completely if diagnosed
• Maintain good posture and ergonomic habits
• Do guided physiotherapy for spine strength
• Avoid self-medication or long-term painkiller use
• Don’t ignore systemic symptoms like fever or weight loss
• Don’t delay consultation if the pain is worsening.