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.

Heart attacks were largely seen as a disease of older age. But lately cardiologists have been increasingly treating patients in their 20s and 30s, including people who appeared healthy, exercised regularly and had no obvious warning signs.

One of the youngest patients treated by Dr Zakia Khan, Director – Interventional Cardiology, Fortis Hospital, Mumbai, was just 18 years old. Dr. Khan told HealthandMe that the young man was a heavy smoker and developed chest pain, which he initially ignored.

“At such a young age, people often do not think of chest pain as a possible heart problem, which can delay treatment,” Dr Khan said.

Dr Girish B Navasundi, Cardiologist, Apollo Hospitals, Bangalore, also told HealthandMe that he has treated an 18-year-old college student with a 100% blockage in one of his coronary arteries. Dr. Navasundi revealed that the patient smoked and used recreational drugs.

These cases highlight a worrying reality that being young does not make one immune to heart disease. Dr. Aseem R. Srivastava , Chief – Pediatric CTVS & Chief – Adult CTVS , Artemis Hospital, Gurugram told HealthandMe, "The situation is so grim that we are no longer surprised if a man in his 20’s comes to our ER with a heart attack."

On World Heart Day, we spoke to cardiologists about their young heart attack patients, the biggest red flags they saw, and what their advice for young people about maintaining a healthy heart.

Heart Attacks Are On The Rise Among Young People

Smoking remains an important reason, but doctors say it is rarely the only factor. Dr Khan says she commonly sees a combination of various factors. Experts also say that a person can look healthy on the outside while carrying several cardiovascular risk factors underneath.

She said, “Smoking is one of the common risk factors I have seen in younger patients. Along with this, family history of premature coronary artery disease and an unhealthy diet, particularly one high in junk food and trans fats, can significantly increase risk. Some patients may otherwise appear healthy.”

Dr Srivastava explained that most often they have a strong family history of heart disease. And very often, youngsters make this genetic predisposition worse by smoking (tobacco). He also said that recurring pattern in patient with heart attack/coronary artery disease is tobacco use. He said, "The most common denominator is usually smoking or tobacco use."

He advises, "Please understand - genetic predisposition is modifiable only little bit but our lifestyle and habits are completely modifiable. And we can greatly reduce the risk by simple changes to our habits."

He also said that even if someone eats healthy, exercises, and maintains a healthy sleep schedule, they will always be at high cardiovascular risk if they smoke.

Dr Navasundi says many young patients appear well and may even report having no symptoms. But several lifestyle factors can contribute to risk.

“Most of them have four lifestyle factors in the form of stress at work, smoking, improper sleep, lack of physical exercise as some of the precipitating factors for heart attack. Also at least one third of them have had abnormally high cholesterol, blood sugar or blood pressure,” he said.

Also read: Inflammation May Be Quietly Changing Your Heart: Study Finds 43% Higher Risk Of Heart Attack & Stroke

Symptoms May Not Look Like A Heart Attack

According to the doctors, one of the biggest problems among younger people is that they don't recognise their symptoms as a cardiac problem. Chest pain is a common symptom, but young patients may dismiss it as acidity, gas, indigestion or even muscle pain.

“Many young people describe it as acidity, gas or indigestion and do not take it seriously. Some ignore the discomfort altogether, assuming it will settle on its own. This can delay medical attention,” Dr Khan said.

Dr Navasundi has seen an even wider range of symptoms. “Common symptoms that they’ve had is uneasiness in the chest, centre of the chest, in the form of burning or choking or as pain, gas, not able to burp or tightness in the chest. Some of the people have had slightly unusual symptoms such as pain only in the left arm or both arms or upper back without having pain in the front of the chest.”

Other patients, he said, have reported excessive tiredness, jaw pain, a sensation of something being stuck in the throat, or a feeling of gas and not being able to burp.

The problem is compounded by the misguided belief that heart attacks happen to older people. Young adults may therefore wait for symptoms to become severe before seeking help, which may lead to preventable fatalities.

Also read: Your Heart After A Cardiac Event: What Recovery Really Looks Like

Sometimes It Could Be Genetic

The experts also say that not every young heart-attack patient may arrive with an obvious lifestyle explanation. Dr Navasundi says some patients have clotting disorders, familial hypercholesterolaemia or a strong family history of premature heart disease.

“Some young people truly have unconventional risk factors like clotting disorders, familial hypercholesterolaemia, that means very high cholesterol from a very young age, and a strong family history of premature heart disease even when these people have a very disciplined lifestyle including eating very healthy, exercising very well, sleeping well. In spite of that, their genetic make-up, the gene and family history make them more vulnerable.”

Dr Khan similarly emphasises that family history can be a warning sign even when someone feels completely healthy.

“A person may feel completely healthy but still carry an inherited tendency towards cardiovascular risk. Knowing your family history can help you identify the need for earlier screening and lifestyle changes.”

Dr. Srivastava gave examples of genetically-induced heart attacks in a 9-year-old and an 11-year-old who had familial hyper cholesterolemia (in which her cholesterol level was very high) and kawasaki disease (in which antibodies form against a virus that attack the coronary arteries) respectively.

Also read: How To Reduce Heart Disease Risk Naturally: Diet, Exercise & Lifestyle Tips

Can You Be Fit And Still Be At Risk?

Regular exercise is beneficial for heart health, but doctors caution against treating gym habit as proof that the cardiovascular system is healthy. Exercising everyday is not enough to believe that your heart is completely healthy.

“Going to the gym does not automatically mean that a person has no cardiovascular risk. People can overlook smoking, family history, high cholesterol, blood pressure, or an unhealthy diet. Fitness should not be judged only by how much one can exercise,” Dr Khan said.

This is noteworthy for young adults who exercise intensely but do not know their blood pressure, blood sugar, or cholesterol levels. Dr Khan recommends a baseline health assessment with a family history of early heart disease or other risk factors before undertaking very intense training.

Also read: Stopping Ozempic, Wegovy, Mounjaro Linked To 22% Higher Heart Attack, Stroke Risk: Study

If You Are Going To Engage In Intense Exercise...

Dr Navasundi recommends that healthy young adults who are planning to begin intense gym training, marathon running or strenuous recreational activities undergo a comprehensive cardiovascular and lung-function test after consultation with a cardiologist.

Dr. Khan said, “A baseline health check is important, especially for someone with a family history or other risk factors. Blood pressure, blood sugar and cholesterol should be assessed, and any symptoms should not be ignored. It is better to understand your cardiovascular risk before starting very intense training.”

Depending on the person, a cardiologist may recommend tests like an ECG, echocardiogram, stress treadmill test, lipid profile, blood sugar and other investigations. In people with a strong family history of premature disease, further testing may sometimes be considered.

Also read: Preeclampsia May End With Pregnancy. Your Heart Risk May Not

Cardiologists Reveal An Alarming Heart Attack Pattern

Dr Navasundi says the biggest change he has observed over his three-decade career is the age at which heart attacks are occurring and the severity of disease in some young patients.

He said, “Compared to my early career I see much younger patients right from the age of 20 onwards having heart attacks and much larger number of heart attack patients. Patients are younger these days. At least 25% of my heart attack patients are less than 40 years of age and close to about 40% of our heart attack patients are less than 50 years of age.”

He also says he is seeing recurrent heart attacks in young people, multiple blockages and, in some patients in their 30s, three-vessel disease. He added, “Many young people are having severe damage during the very first heart attack compared to people in earlier years.”

Dr. Khan said that young cases are showing much earlier than they expected. She said, “I have been seeing this trend of heart attacks occurring in younger patients, sometimes nearly a decade earlier than what we traditionally expected, for the past 10 to 15 years. The increasing presence of risk factors such as smoking and unhealthy dietary habits in younger people is concerning.”

Dr. Srivastava pointed towards another alarming pattern in which doctors increasingly started cases of coronary heart disease among women.

He said, "We used to consider that young females are protected from having a heart attack (coronary artery disease) because of their hormones but we are seeing more and more young females come to us with coronary artery disease and is placing a question mark on our age old understanding."

Three Things Young Adults Should Not Ignore

Dr Khan has three simple messages for people in their 20s and 30s: “First, age does not completely protect you from heart disease. Second, never dismiss chest discomfort as acidity without considering other possibilities. Third, know your family history and get a baseline health check, particularly if you smoke, have risk factors or are planning intense exercise.”

Dr Srivastava said, "1. TOBACCO kills, 2. ⁠QUIT tobacco, 3. ⁠Stop Smoking. And of course- be careful if you have family history of a heart disease, exercise, eat healthy and watch your blood sugar."

Dr Navasundi urges young adults to know their numbers, including blood pressure, heart rate, blood sugar and cholesterol, rather than simply being told that their results are “normal” or “abnormal”.

His final message is that heart health should not become a concern only after a cardiac event. He added, “So live with sense of vulnerability and responsibility to prevent heart disease in your early life. Know your family history, know your numbers.”

Waking up at night can make it difficult to fall back asleep, especially when the mind becomes alert and starts racing. Neuroscientist Andrew Huberman has suggested a simple eye-movement routine that he says may help people drift back to sleep. But does it actually work?

How Does Andrew Huberman’s Sleep Trick Work?

The routine is performed with the eyes closed:

• Slowly move the eyes to one side, then the other, followed by up and down.

• Trace a circle with the eyes, first counterclockwise and then clockwise.

• Point the eyes toward the nose and take a long exhale.

Huberman suggests repeating the sequence two to three times.

His theory is that the movements may interact with brain circuits involved in tracking the body's position, including pathways involving the eyes, brainstem and cerebellum.

Also read: Struggling With Sleep? Neurologist Shares 3 Simple Tips For Better Sleep Health

Sleep Experts Say The Idea Is Unproven

Shelby Harris, a psychologist and board-certified sleep expert, says there are reasonable grounds to try it, Women's World magazine reported.

“I think it’s a very reasonable thing to try. It’s free, low effort, carries essentially no risk and has solid reasons it could help,” Harris was quoted as saying.

She notes that sleep tends to become more fragmented with age.

“Sleep naturally becomes more fragmented with age, with less time in deep sleep and more time in the lighter stages where it’s easy to wake up,” Harris said.

Hormonal changes with age can also contribute to more fragile sleep in women. But a plausible explanation does not mean the technique has been proven.

Michael Grandner, a clinical psychologist and sleep researcher at the University of Arizona, told Inc.com that eye movements, balance signals, the brainstem and cerebellum all contribute to how the brain tracks the body's position in space.

However, he said he is “not aware of studies that have directly tested that chain of events, or clinical trials showing that this particular eye-movement exercise reliably shortens sleep onset.”

Brant Hasler, co-director of the Behavioral Sleep Medicine Training Program at the University of Pittsburgh School of Medicine, added that the technique does not resemble a validated behavioral sleep intervention.

A Relaxing Technique Not A Treatment

According to Grandner, the exercise may be better understood as a relaxation or focused-attention technique.

He said he would place it “closer to a relaxation, focused-attention, or mindfulness exercise than to an established treatment for insomnia.”

The repetitive movements could give the mind something neutral to focus on instead of worrying, planning for the next day or checking whether sleep has returned.

Further, Hasler said bedtime activities can be useful when they occupy the mind without becoming stimulating. The eye exercise could work in that way, he said, “regardless of any additional effects via proprioception.”

The slow breathing paired with the exercise may also help with relaxation.

It Could Backfire If You Try Too Hard

Hasler said expectancy effects could explain some positive experiences with the technique. Grandner also cautioned against repeatedly checking whether the trick is working.

If the exercise becomes another task to perform perfectly, “it could become another form of sleep effort, which can actually perpetuate insomnia,” he said.

Rabies is most often associated with dog-mediated transmission in humans, but the virus can infect a wide range of mammals. In 2026, unusual cases involving farm goats, beavers and Cape fur seals raised fresh questions about how rabies moves between species.

Since July 2026, multiple US jurisdictions have reported human rabies exposures involving known rabies vectors or animals in which rabies is less commonly reported. The CDC issued a health advisory on September 10 “in response to recent reports of increases in human exposures to rabid or possibly rabid animals.”

The concern is not limited to North America. At least 176 people had been bitten by rabid Cape fur seals along South Africa’s coastline by the end of 2025, while researchers have warned that the disease could spread to other marine mammal species.

In North Carolina in 2026, a wild skunk entered a pen containing baby goats, some of which later tested positive for rabies. Of the 284 people evaluated by local health departments, post-exposure prophylaxis (PEP) was recommended for 213. In Maryland, a 13-year-old boy was attacked by a beaver while swimming at a state park and required surgery for his injuries.

These cases raise a bigger question: Are unusual infections simply spillover from established rabies hosts, or can the virus establish sustained transmission in a new species? To understand this better, HealthandMe spoke to two experts.

Also read: US CDC Warns Of Rising Human Rabies Exposure Risk: How To Stay Safe

Are These New Rabies Hosts Or Spillover?

Dr Anish T S, Professor at the School of Public Health, Kerala University of Health Sciences, told HealthandMe that rabies can infect mammals, but an infected animal is not necessarily a reservoir host.

Genetic sequencing can help establish where an unusual infection came from and whether the virus is changing.

“So one thing that we can do is genetic analysis. If we are able to pick up these animals infected by rabies, we find what kind of rabies virus it is and do maybe a sequencing of the genome of this virus.”

“These kinds of analysis could be done still, but it is a question that whether this particular virus is changing its host or the virus is accumulating some kind of genetic mutations so that it can get maybe involved with some other animals. It can choose some other animals also as their host. It is actually a very pertinent question.”

The Cape fur seal cases add another dimension to this question, with sustained rabies transmission reported within the marine mammal population.

What Happens After Exposure?

Dr NK Ganguly, former Director General of the Indian Council of Medical Research (ICMR), told HealthandMe that rabies in goats is rare, while beaver exposures need particular caution.

“Beaver is one animal where we have to be very careful.”

Dr Anish said rabies can also present as paralytic or “dumb” rabies, which may not show classic signs and could lead people to handle or treat an infected animal without recognizing the risk.

Dr Ganguly stressed the need for prompt medical care after exposure.

“The rabies incubation period is around 10 days. So if somebody has been exposed, they should be immediately vaccinated. And if the exposure is with a bite or something at the upper limbs, then they need to be given an antiserum as well as vaccinated.”

“So depending on the exposure, you are given a vaccine which is available, and you are also given the cocktail of antibodies, the monoclonal antibodies, which act immediately.”

Why Wildlife And Livestock Surveillance Matters

Read More: Rabies Day Exclusive: ‘We Need To Target The Source’ For A Rabies-Free India By 2030, Says Veterinary Epidemiologist

Dr Ganguly said rabies can also circulate in wild and feral animals, including foxes, while cats and other species can also be infected.

He said surveillance should extend beyond dogs to domestic animals that are in close contact with them and to wildlife where feasible.

“Surveillance should include domestic animals also which are in close contact with the dogs.”

“There should be surveillance. There should be sentinel surveillance. We should carry out, if it is affordable.”

He also pointed to dog vaccination and sterilization, as well as bait vaccination for wildlife and stray animals.

Could The Virus Be Changing?

Dr Anish said unusual infections need investigation to determine whether they are isolated spillover events or linked to changes in the virus.

“The real issue is if the virus is changing much because of mutations. Because rabies virus is not that much notorious for mutations. That is why most of our vaccines are working.”

He said genetic studies could help answer whether existing vaccines and treatments would remain effective if significant mutations emerge.

“So the genetic studies of the virus may give us the answers to these questions.”

India’s Rabies Elimination Challenge

For India, the experts said the priority remains breaking established dog-mediated transmission chains before focusing on less common pathways.

“If you just look at the rabies situation in India, we are not even able to manage the pure dog-mediated rabies. That is, people are bitten by rabid dogs and people are getting infected, and we are not able to have maybe full coverage of vaccination, and all the other things are actually the biggest concern,” Dr Anish said.

Dr Ganguly added that surveillance should include domestic animals also which are in close contact with the dogs.

"But essentially, in the urban areas, the dog is the main animal, and we should—the Supreme Court has given now a lot of directions in this particular regard—that the dogs may be sterilized," the expert said.

The pet dogs need to be vaccinated and other stray dogs should be taken to facilities where they need to be sterilized and they need to be vaccinated, the experts said.