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.

Amid a significant surge in H1N1 cases in India, experts say the flu can affect more than just the respiratory system—it can also cause eye symptoms.

H1N1, a strain of influenza A virus, is usually associated with fever, cough, sore throat, body ache, fatigue and other respiratory symptoms. It spreads mainly through respiratory droplets when an infected person coughs, sneezes or talks. However, influenza can sometimes affect areas beyond the respiratory system, including the eyes.

Some people may develop watering, redness, irritation, photophobia or dryness during a flu infection. While these symptoms may improve as the flu resolves, sudden changes in vision should not be ignored.

How Does H1N1 Affect the Eyes?

Speaking to HealthandMe, Dr. Sfurti Maan, Senior Consultant, Internal Medicine, Shalby International Hospital, said that in most cases, eye symptoms are mild and settle with appropriate care. One of the more noticeable problems is viral conjunctivitis.

“The eyes may become red and watery, with burning, irritation or mild discharge. More intense inflammation may cause swelling of the eyelids or conjunctiva,” the expert said.

A person may also develop light sensitivity or general discomfort in the eyes.

Another possible finding is a bright-red patch on the white portion of the eye. This is called a subconjunctival hemorrhage and can sometimes occur after severe coughing or vomiting.

When Should You See A Doctor?

Most H1N1-related eye problems are limited to conjunctivitis. However, rare cases of deeper eye inflammation, including uveitis, retinitis and optic nerve involvement, have also been reported. These complications are uncommon but can affect vision.

“If someone has influenza and develops persistent blurred vision, severe eye pain, marked sensitivity to light or a sudden drop in vision, that should not be treated as routine conjunctivitis. These symptoms need an eye examination,” Dr. Sfurti said.

Dr. Poninder Kumar Dogra, Senior Consultant, Ophthalmology at ShardaCare – Healthcity, said people with influenza should see an ophthalmologist if they experience:

• Sudden loss of vision

• Blurred or double vision

• Flashes of light

• An increase in eye floaters

• Vision problems when looking close up

• Substantial eye pain

• Intense redness or redness around the eye

• An unusual increase in photophobia with discharge

What About Contact Lens Wearers?

Contact lens wearers may develop eye pain, redness and changes in vision. Contacts should not be worn, and an eye examination should be arranged until the eyes have been investigated and an ophthalmic practitioner says they can be worn again.

Fluid loss, dehydration and fever during the flu can cause dryness and discomfort. Various medications may also cause dry eyes.

How Can You Prevent Eye Symptoms?

Annual flu vaccination is one of the key ways to reduce the risk of influenza. Others include:

• Good hand hygiene,
• covering the mouth and nose while coughing or sneezing,
• avoiding close contact with people who are sick
• staying home when unwell.

Dr. Sfurti advised people with flu symptoms to also avoid touching or rubbing their eyes, particularly with unwashed hands. If conjunctivitis is present, sharing towels, tissues, pillows or personal eye-care products should also be avoided.

“It is important not to panic just because H1N1 can affect the eyes. Serious ocular complications are very rare. The important thing is to recognise the warning signs. If there are only redness, watering and mild irritation, it is usually not a reason for alarm. But any significant change in vision deserves prompt medical attention.”

Dr. Poninder told HealthandMe that antibiotic drops or steroids should never be self-prescribed without seeing an ophthalmologist, as they can potentially delay diagnosis or affect the diagnosis of another condition.

Redness with a slight amount of discharge, discomfort or irritation with transient dryness that gradually resolves may not require an ophthalmologist referral. However, sudden loss of vision, intense pain, extreme redness and progressing inflammation should be checked.

It usually starts small, a sting during a bowel movement, a smear of blood on tissue, an ache that feels like it will pass on its own. The instinct is to go for an old antiseptic ointment or a painkiller left over from something else. For a few days, it works. The pain eases, the bleeding stops showing up, and the natural conclusion follows, it's healed. Then, weeks or months later, it comes back. The same cream goes on, the same tablet gets swallowed, and the cycle repeats, each round quietly convincing the patient that this is something to manage rather than consulting a doctor.

Why Repeated Self-Medication Can Delay The Right Diagnosis?

That cycle is where the real cost shows up. Every round of self-medication is also a round of postponed diagnosis, pain, bleeding, or discharge gets suppressed instead of investigated, and a fissure or fistula that could have been caught and treated early is left to become chronic instead. It's a more common pattern than it should be: a 2025 study on haemorrhoidal symptoms found that only 30.8% of patients had sought medical advice at all, citing embarrassment and fear of invasive examinations as the main barriers.

An anal fissure is a small tear in the lining of the anal canal. Many improve with the right conservative care, soft stools, and medication suited to that specific case. What concerns me is when a patient keeps self-treating through repeated episodes. A fissure that keeps coming back usually means something underlying hasn't been resolved, however many times the symptoms have been calmed down.

Also read: Ulcerative Colitis vs Crohn’s Disease: 8 Key Differences Every Person Must Know

Why Recurring Symptoms Should Not Be Self-Diagnosed?

Another common mistake is assuming that recurring symptoms are caused by the same condition as before. A fissure two years ago cleared up with a certain cream, so when something similar happens now, the same tube comes back out. But recurring symptoms don't automatically mean the same condition has returned. Fissures, fistulas, and haemorrhoids can look remarkably alike from the outside, which is exactly why self-diagnosis is unreliable more often than people expect.

None of this means every twinge needs a procedure, or that patients should panic at the first uncomfortable day. Plenty of cases genuinely settle with timely, conservative management. The real skill is recognising when self-care stops being enough.

If pain, bleeding, swelling, pus, or discharge keeps returning or never fully clears, that's the signal to get it looked at, not medicated into silence again. A proper specialist assessment can pin down what's actually happening and whether the right next step is conservative treatment, medication, or a procedure.

For anyone dealing with a fissure or a fistula, the goal isn't just to make the symptom vanish for a while. It's understanding why it showed up in the first place. Temporary relief feels like progress, but it isn't recovery.

Delhi-NCR is witnessing a sharp increase in seasonal influenza, with 1,777 confirmed H1N1 (swine flu) cases reported out of 2,392 total Influenza A cases.

According to data from the National Centre for Disease Control (NCDC), the corresponding period last year recorded just 229 H1N1 cases.

Several hospitals in the national capital have reported a significant increase in cases. However, so far there have been no reports of patients requiring ICU care or ventilator support.

“Delhi is fully prepared to deal with the present health situation. There is no shortage of beds, doctors, medicines or essential medical equipment, and every patient will receive timely and appropriate treatment,” health authorities said.

Is The H1N1 Surge Due To A New Strain?

The Indian Council of Medical Research (ICMR) has confirmed that the current surge is not due to a new strain of H1N1 and has advised people to follow precautions rather than panic, PTI reported.

According to the apex research body, the Influenza A (H1N1) viruses currently circulating in India belong to the A/Missouri/11/2025 (H1N1)pdm09-like virus strain.

“These viruses belong to clade 6B.1A.5a2a, subclade D.3.1.1, and have been in circulation since 2025,” the ICMR said. “Seasonal influenza, including H1N1, is mostly self-limiting,” it added.

Is The Current H1N1 Strain Covered By The Flu Vaccine?

The ICMR said the influenza strains currently circulating in India are well matched with the vaccine strains recommended for the Northern Hemisphere.

For both egg-based vaccines and cell culture-, recombinant protein- or nucleic acid-based vaccines, the World Health Organization (WHO) recommends an A/Missouri/11/2025 (H1N1)pdm09-like virus.

HealthandMe spoke to experts to understand whether people should consider getting a flu vaccine amid the current rise in H1N1 cases and who should prioritise vaccination.

Doctors stressed that annual influenza vaccination remains an important tool to reduce the risk of severe illness, complications and hospitalization, particularly among people at higher risk.

“Since the 2009 H1N1 pandemic, H1N1 is no longer given as a separate standalone vaccine. The H1N1 strain is included in the regular seasonal influenza vaccine, whether trivalent or quadrivalent. Therefore, getting the recommended annual flu vaccine also protects against H1N1,” Dr Tushar Tayal, Associate Director, Internal Medicine, CK Birla Hospital, Gurugram, told HealthandMe.

Who Should Prioritize Flu Vaccination?

The seasonal influenza vaccine is recommended every year for everyone aged six months and above. Doctors say vaccination is particularly important for:

• Pregnant women
• Older adults
• Young children
• Healthcare workers
• People with diabetes
• People with asthma
• People with heart disease

The Indian Medical Association (IMA) advises that the inactivated influenza vaccine can be given to the above high-risk groups.

“The live attenuated influenza vaccine (intranasal spray) can be given only to persons aged 2-49 years (not to pregnant females),” as per the IMA.

“The H1N1 flu vaccine is typically administered annually before flu season, around October, as a single intramuscular dose at clinics, pharmacies or hospitals,” Dr Atul Gogia, Head, Infectious Diseases, Sir Ganga Ram Hospital, New Delhi, told HealthandMe.

For most adults and children aged over nine years, one dose each year is sufficient. However, children aged six months to eight years who are receiving the flu vaccine for the first time may require two doses at least four weeks apart. After the initial vaccination, one annual dose is generally sufficient.

Should You Get The Flu Vaccine Now?

In India, influenza vaccination is ideally taken ahead of periods when flu activity tends to increase, particularly during the monsoon and winter months. The vaccine is available through hospitals, clinics and vaccination centers.

With H1N1 cases currently rising in Delhi-NCR, people who fall into high-risk groups may particularly benefit from discussing vaccination with their doctor.

Can The Flu Vaccine Prevent H1N1 Completely?

“While the shot drastically reduces hospitalizations and complications, its primary limitation is that it does not offer 100% protection against infection, nor does it cover non-influenza viruses. However, even if contracted, vaccination significantly softens the disease’s severity,” Dr Atul said.

Dr Tayal also explained that vaccine effectiveness can vary from season to season, depending on how well the vaccine strains match the influenza viruses circulating at the time.

Why Is Annual Flu Vaccination Needed?

According to Dr Tayal, annual vaccination can reduce the risk of severe influenza, complications, hospitalization and flu-related deaths. However, it does not provide complete protection against every respiratory infection.

The flu vaccine protects against influenza viruses, including H1N1, but does not prevent illnesses caused by other viruses or bacteria.

Along with annual vaccination, experts advised people to:

• Maintain good hand hygiene
• Follow respiratory etiquette, including covering the mouth and nose when coughing or sneezing
• Stay home when unwell
• Avoid close contact with others when experiencing flu-like symptoms