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.

The NHS has released a warning for people who take levothyroxine to manage thyroid conditions. With an estimated 33 million prescriptions issued every year across the UK, levothyroxine is among the most frequently prescribed medicines provided by the NHS.

Levothyroxine is mainly used to treat an underactive thyroid, a condition medically known as hypothyroidism. Depending on a patient’s needs and a GP’s assessment, the medicine is usually prescribed either as a tablet or as a liquid taken by mouth.

What Is Levothyroxine?

The NHS website explains that while most adults and children can safely take levothyroxine, there are specific situations where it may not be recommended. These restrictions are based on a person’s medical history and current health conditions.

People Who May Not Be Able to Take Levothyroxine

According to NHS guidance, levothyroxine may not be suitable if any of the following apply:

1. You have a heart condition such as angina, heart disease, or heart failure
2. You have a condition that affects your adrenal glands
3. You have previously suffered a heart attack
4. You have an overactive thyroid that produces excess thyroid hormone, known as thyrotoxicosis
5. You have diabetes
6. You have had an allergic reaction to levothyroxine or another medicine in the past
7. You have high blood pressure
8. Patients are advised to inform their GP or specialist about any of these conditions before starting treatment.

Levothyroxine: Possible Side Effects to Be Aware Of

Levothyroxine can cause a range of side effects, some of which may require urgent medical attention. Common side effects associated with the medication include:

• Flushing or excessive sweating
• Feeling restless, anxious, or overly energetic
• Difficulty sleeping
• Nausea
• Headaches
• Vomiting
• Shaking or trembling
• Diarrhoea
• Muscle cramps

The NHS notes that this is not a complete list, and other side effects may occur. Patients are advised to read the information leaflet included with their medication for full details.

Levothyroxine: When to Seek Medical Help

Although these side effects can be unpleasant, they are usually mild and do not typically require a hospital visit. If symptoms persist or become troublesome, the NHS recommends speaking to a doctor or pharmacist for advice.

However, certain symptoms should not be ignored. If you notice a fast or irregular heartbeat while taking levothyroxine, you should contact a doctor or call NHS 111 as soon as possible.

More serious symptoms require immediate action. Anyone experiencing chest pain while on levothyroxine is advised to call 999 without delay, as this could signal a medical emergency.

Disclaimer: This article is for general information only and is not a substitute for medical advice. Levothyroxine should be taken only as prescribed by a qualified healthcare professional. Do not start, stop, or change your medication without consulting your doctor. If you experience severe symptoms or a medical emergency, seek immediate medical attention or call emergency services.

Delhi, on Wednesday morning, woke up to 'very poor' air. The visibility was low and, in fact, the India Meteorological Department (IMD) issued an orange alert for dense fog between 8.30am and 10am. Visibility remained low, and as per the 24-hour average Air Quality Index, Delhi stood at 384, as confirmed by the data from the Central Pollution Control Board (CPCB). In certain areas, including Anand Vihar, AQI remained under 'severe' level, at 452.

This has resulted in cancellation of t least 148 flights and over 150 flights were delayed at the Delhi airport.

However, there may be a silver lining, in an interview with TOI, Tarun Kumar Pithode, who took charge as the new full-time member secretary of the Commission for Air Quality Management (CAQM) said that Delhi can expect "more blue-sky days over next 3-4 years".

How Does The Commission for Air Quality Management Plan To Bring Delhi's Pollution Down?

Delhi’s fight against air pollution is set to intensify over the next few years, with the CAQM outlining a multi-pronged plan aimed at delivering “more blue-sky days” for the capital. Rather than relying on emergency measures alone, the strategy focuses on long-term, structural fixes across transport, industry, energy and regional coordination.

Cutting Emissions at the Source

One of CAQM’s core priorities is reducing pollution from vehicles, which remain a major contributor to Delhi’s poor air quality. The plan pushes for faster adoption of electric vehicles, tighter checks on polluting commercial vehicles, and a stronger public transport network. Scrapping old, high-emission vehicles and discouraging diesel use through stricter enforcement are seen as key steps to curb everyday emissions, not just during winter spikes.

Cleaning Up Industry and Power Generation

Industrial pollution is another major target. CAQM has stressed a shift away from coal and other dirty fuels toward cleaner energy sources. Industries operating in and around Delhi are being pushed to adopt cleaner fuels such as natural gas, along with better emission-control technologies. Power plants in the region are also under scrutiny, with stricter norms to ensure they do not become pollution hotspots during peak winter months.

Tackling Dust and Construction Pollution

Construction dust and road dust significantly worsen Delhi’s air quality, especially during dry months. CAQM’s plan includes stricter enforcement of dust-control norms at construction sites, better mechanised road sweeping, and regular water sprinkling on major roads. Authorities are also being asked to improve urban planning to reduce exposed soil and unpaved areas that contribute to dust pollution.

Managing Seasonal Pollution and Stubble Burning

A major part of Delhi’s pollution problem comes from outside the city, particularly crop residue burning in neighboring states. CAQM has emphasized regional coordination, working with states like Punjab, Haryana and Uttar Pradesh to reduce stubble burning. This includes promoting alternative methods for crop residue management, providing financial incentives, and ensuring accountability when violations occur.

Data-Driven and Year-Round Action

Unlike earlier approaches that focused largely on winter emergencies, CAQM’s plan relies on year-round monitoring and data-driven action. Expanded air-quality monitoring, better forecasting, and early interventions are expected to prevent pollution levels from spiralling out of control. The aim is to move from reactive crisis management to consistent prevention.

A Long Road Ahead

CAQM officials acknowledge that Delhi’s pollution problem will not disappear overnight. However, with coordinated action across sectors and states, they believe the capital can see steady improvement over the next three to four years. The promise of more blue-sky days hinges not just on policy, but on strict enforcement and sustained public cooperation.

"There is a big mistake you are making when you fly and no one talks about how to prevent it," writes Dr Rema Malik, a board-certified vascular surgeon, based in Houston, Texas. On her Instagram post she talks about how our body deals with much of a serious challenge once we enter the plane and the cabin doors shut. She points out that while most of us are busy settling into our seats, our veins enter a risky environment that could raise the chance of developing a blood clot. These risks include deep vein thrombosis or DVT. She points out that this risk is not just limited to older adults, but to people with known health issues too.

What Really Happens to Your Body Mid-Flight

Dr. Malik explains that air travel creates what she calls a “three-hit combo” that puts your circulation under stress.

First is prolonged sitting. When you stay seated for hours, your calf muscles, often called your second heart, stop doing their job. These muscles help push blood back up toward the heart. Without movement, blood begins to pool in the legs instead of flowing upward.

Second comes dehydration. Cabin air is extremely dry, far drier than most natural environments. This causes your body to lose moisture faster than you realize. As dehydration sets in, your blood becomes thicker and more sluggish, which makes clot formation easier.

The third factor is cabin pressure. Lower pressure at cruising altitude causes veins to dilate or expand. This stretching weakens the tiny valves inside your veins that normally prevent blood from flowing backward. Gravity then does the rest, encouraging blood to settle in the lower limbs.

This combination is not about discomfort. It is about safety.

Read: Not Boarded Any Flight And Still Monday Feels Like A Jetlag? You Are Not Alone

Why Age Is Not the Only Risk Factor

There is a common belief that blood clots only affect the elderly or people with chronic illnesses. Dr. Malik strongly disagrees. Whether you are 25 or 65, long flights place similar stress on your circulation. Sitting still, dehydration, and pressure changes affect everyone, regardless of how fit or young they feel.

That is why she recommends preparing your body for travel just as seriously as you prepare your suitcase.

Wear the Right Protection Before You Fly

Compression socks are not just for people with medical conditions. Dr. Malik calls them non-negotiable for air travel. A compression level of 15 to 20 mmHg helps mechanically push blood upward, prevents swelling, and supports healthy circulation.

The key is timing. Put them on before you leave home, not after you board the plane, so your veins are supported from the very start.

Hydration Is a Flight Essential

Her rule is simple. Drink eight ounces of water for every hour you are in the air. This helps keep your blood from becoming too thick.

Coffee, alcohol, and wine do not count. In fact, they make dehydration worse. If you are serious about flying safely, water needs to be your main beverage.

Keep Your Calf Muscles Active

Every 30 minutes, Dr. Malik recommends doing 30 ankle pumps. Lift your toes up and down as if you are pressing a gas pedal. This simple movement activates your calf muscles and helps clear stagnant blood from your legs, even if you cannot get up and walk.