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.

In a what doctors call an "exceptionally rare event', a Michigan man has died of rabies after receiving a kidney from a donor who was unknowingly infected with the virus. A recent report from the Centers for Disease Control and Prevention (CDC) gives information on how this rare medical event took place, with a surprising chain of exposures that vegan with a skunk scratch.

A Routine Kidney Transplant That Took a Sudden Turn

The Michigan patient underwent a kidney transplant at an Ohio hospital in December 2024. For several weeks, he seemed to be recovering normally. About five weeks after the procedure, he suddenly developed worrying symptoms such as tremors, weakness in his lower limbs, confusion and urinary incontinence. His condition deteriorated quickly and he was admitted to the hospital, soon requiring ventilation. Despite treatment, he passed away. Postmortem tests confirmed that he had rabies, a diagnosis that shocked doctors since his family said he had not been around any animals.

The Donor’s Skunk Encounter Comes to Light

The unexpected diagnosis pushed doctors to take another look at the kidney donor, a man from Idaho. In the Donor Risk Assessment Interview, he had mentioned that a skunk had scratched him. At the time, this detail did not raise major concern. When investigators spoke to the donor’s family again, they learned more about the incident. A couple of months before his death, the donor had been holding a kitten in a shed on his rural property when a skunk approached and behaved aggressively. He stepped in to protect the kitten and managed to knock the skunk unconscious. Before that happened, the animal scratched his shin deeply enough to draw blood. He believed he had not been bitten, and the incident was never viewed as a medical emergency.

The Donor’s Rapid Decline

Around five weeks after the skunk encounter, the donor began showing symptoms that closely resemble rabies. He became confused and had trouble swallowing and walking. His family said he experienced hallucinations and complained of a stiff neck. Two days later, he was found unresponsive at home after what was believed to be a cardiac arrest. He was resuscitated and hospitalized but never regained consciousness. He was declared brain dead after several days, and his organs, including his left kidney, were donated.

What Investigators Found

Once rabies was detected in the kidney recipient, authorities examined stored laboratory samples from the donor. These tests were initially negative. However, kidney biopsy samples revealed a strain that matched silver-haired bat rabies. This finding suggested that the donor had in fact died of rabies and unknowingly passed the virus to the transplant recipient.

Investigators believe a likely three step transmission occurred. A bat infected a skunk, the skunk infected the donor, and the donor’s kidney infected the recipient. The CDC noted that only three other cases of rabies transmission through organ transplantation have been reported in the United States since 1978.

Steps Taken to Protect Other Recipients

Three other people had received cornea grafts from the same donor. Once the risk was identified, the grafts were removed and all three individuals received Post Exposure Prophylaxis. They remained healthy and showed no symptoms.

A Reminder of Rare but Real Risks

Rabies is not routinely tested for in organ donors because human cases are extremely rare and difficult to diagnose. In this situation, the donor’s earlier symptoms were attributed to existing health conditions. Speaking to the New York Times, Dr Lara Danziger-Isakov said the case was exceptionally rare and reminded the public that the overall risk to transplant recipients remains very small.

Delhi continues to wake up to thick haze on Wednesday morning, with 28 stations in 'poor' category, while nine stations remained under 'very poor'. Though there is a slight improvement as the average AQI stood at 269, in poor category. The Chief Minister of Delhi has enforced stricter measures like imposing fines up to Rs. 5,000 for open burning, and use of coal and firewood.

Delhi pollution has now affected people way beyond their respiratory health, it has now attacked almost all organs of their body, including fetus, reproductive health, liver, kidneys, and even chronic diseases like diabetes, obesity, blood pressure, and even mental health illness.

But could Delhi do more? Right now all the measures, including emergency measures like GRAP have not worked more than a dent. However, China seems to have reverse its pollution problem.

What Did China Do That Delhi Too Can Adopt?

In 2013, Beijing was battling with pollution problem. As per the data by the World Health Organization (WHO), in 2013, the annual means of PM2.5 levels reached 64.9 micrograms per cubic meter, whereas, in India, it was at 58.2. However, by 2019, China was able to bring it down to 38.15 micrograms per cubic meter while India remained at 50.17.

So, what did China do?

Since 2013, almost 80% of China has experienced air quality improvement. Beijing declared a war on pollution by shutting 3,000 coal boilers, which slashed coal use by 30%. It also forced factory to either close or comply with the guidelines. Clean energy also replaced soot and electric buses replaced diesel ones. The subway was expanded to 1,000 kilometers and by 2020, 40% of new cars were electric.

Chin's 11th Five Year Plan That Made Pollution A Priority

In the late 2000s, China began taking air pollution more seriously than ever. As per the UCLA Law professor Alex L Wang, China's 11th FYP (2006-10) made pollution a priority and used the "cadre evaluation system". This pushed officials to meet environmental targets. The system evaluates governors, mayors, and local leaders based on how well they perform compared to others in tackling pollution problem, which influences their promotions.

To cut pollution, China invested heavily in cleaner technology and shut down old, highly polluting factories such as power plants, smelters, and chemical units. The government also encouraged the shift to electric vehicles. Even though much of China’s electricity comes from coal, EVs still produce fewer emissions overall and create no tailpipe pollution in cities.

By 2017, Shenzhen became the first city in the world to fully electrify its 16,000 buses. Shanghai too followed its lead.

Studies by Tsinghua University and the Beijing Environmental Bureau showed that between 2013 and 2017, major improvements in air quality came from reducing coal boiler use, cleaner home heating, shutting down polluting industries, and controlling vehicle emissions.

The result was nothing less than remarkable. From 2013 to 2017, Beijing’s PM2.5 levels dropped by 35%, and life expectancy rose by 4.6 years.

As men step into their 50s and beyond, prostate health becomes an essential part of overall wellbeing. The gland naturally undergoes changes with age, many of which are not cancerous but can still cause discomfort, disrupt daily routines, and affect long-term health. Awareness, early screening, and preventive habits play a crucial role in staying ahead of potential problems.

Why the Prostate Changes With Age

One of the most common age-related concerns is benign prostate hyperplasia (BPH), a non-cancerous enlargement of the prostate. This happens due to hormonal shifts that cause the gland to grow slowly over time.

“Most men assume urinary symptoms are just a normal part of aging, but that mindset often delays treatment,” says Dr. Vineet Malhotra, Director and Founder, VNA Hospital. “BPH itself is not dangerous, but if ignored, it can seriously affect quality of life and even lead to complications.”

A larger prostate can press against the urethra, causing symptoms such as:

• Frequent urination
• Weak or interrupted urine flow
• Difficulty starting to urinate
• A feeling of incomplete bladder emptying
• Waking up multiple times at night to urinate

These symptoms often creep up gradually, making them easy to dismiss until they start interfering with sleep, work, or general comfort.

The Importance of Screening for Prostate Cancer

While BPH is not cancer, men must remain vigilant about prostate cancer, especially because its risk rises with age.

“Prostate cancer in early stages is usually silent,” explains Dr. Malhotra. “That is exactly why screening becomes so important once men cross 50.”

Two common screening tools include:

• PSA (Prostate-Specific Antigen) test
• Digital Rectal Examination (DRE)

These tests help detect abnormalities long before symptoms appear. Early detection not only improves treatment outcomes but also prevents unnecessary anxiety or uncertainty.

Men should also stay alert for red-flag symptoms, including persistent pelvic pain, unexplained weight loss, blood in urine or semen, and sudden urinary changes.

Lifestyle Choices That Support Prostate Health

Beyond medical screening, everyday habits have a strong influence on prostate wellbeing.

Dr. Malhotra emphasizes the role of lifestyle:

“A balanced diet, regular exercise, and maintaining a healthy weight can significantly reduce inflammation and support better prostate function.”

Healthy habits that help include:

• A diet rich in antioxidants (tomatoes, berries, leafy greens)
• Omega-3 sources like fatty fish and walnuts
• Limiting alcohol and caffeine
• Staying well-hydrated
• Avoiding smoking
• Regular physical activity

These choices not only support the prostate but also improve urinary health and hormonal balance.

Since stress can worsen urinary symptoms, incorporating yoga, meditation, or deep-breathing practices also makes a noticeable difference.

Breaking the Silence Around Prostate Health

One of the biggest challenges is the reluctance many men feel when discussing urinary or sexual symptoms.

“Men often suffer quietly because these issues feel too personal,” says Dr. Malhotra. “But silence delays diagnosis and treatment. Open conversations can literally save lives.”

Families, caregivers, and partners can play a supportive role by encouraging early checkups and normalizing discussions around prostate health.

The Bottom Line: Proactive Care Matters

With rising life expectancy and a more active older population, prioritizing prostate health is no longer optional—it’s essential.

Early diagnosis, informed decision-making, and evidence-backed treatments give men the chance to maintain independence, comfort, and quality of life well into their later years.

As Dr. Malhotra puts it, “Prostate health is not just a medical concern—it’s a foundation for staying energetic, confident, and healthy as you age.”