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.

A globally introduced, newer-generation cataract lens was used in India for the first time, enhancing patient’s recovery journey and treatment outcome

Since her diabetes diagnosis 5 months ago, Mrs Vani Vaish had done what doctors tell every diabetic to do - turn up regularly for an eye exam because diabetes can quietly damage the blood vessels and nerves in your eyes. The eye damage often gives no major noticeable warning until real damage has been done, which is exactly why the screening isn't optional, symptoms or not.

How A Routine Eye Check-Up Revealed A Cataract

During one of these routine visits, Mrs Ahuja complained of blurring in her vision and increasing glare around headlights and streetlamps at night. Her ophthalmologist identified a cataract. For people living with diabetes, regular eye examinations can be important for more than monitoring diabetic retinopathy, as diabetes can also increase the risk of developing cataracts and may lead to their occurrence at a younger age.

The treatment options were discussed with her in detail, including the potential benefits and limitations of the technology, individual variations in outcomes and the considerations involved in selecting a presbyopia-correcting lens. Following a detailed evaluation, Mrs Ahuja underwent cataract surgery with implantation of the Clareon PanOptix Pro, a newer-generation trifocal intraocular lens that had recently become available in India.

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What The Newer-Generation Lens Is Designed To Do

The significance of the technology lies in what it is designed to change in cataract vision correction. Trifocal lenses split incoming light to provide vision across near, intermediate and distance ranges. The newer-generation optical design used in PanOptix Pro is intended to use available light more efficiently and reduce light scatter — an advancement that aims to support better quality of vision across different distances while addressing some of the visual compromises associated with multifocal lens technology.

Because no two patients have the same visual demands, expanding access to newer technologies plays a critical role in modern care. Our role is to evaluate each patient’s unique needs and ensure that the most suitable and advanced treatments available actually reach the patient, giving them every opportunity for a better quality of life.

The procedure marked the first use in India of the globally introduced Clareon PanOptix Pro lens. For MRs Vaish, the outcome of the treatment has matched what she hoped for. She reports clear vision and no floaters or other visual disturbances. Her recovery has also been smooth, and she has not even needed the temporary protective glasses in the days following the procedure.

Why Regular Eye Exams Matter For People With Diabetes

Her case highlights two important aspects of modern eye care. Regular eye examinations are important especially for people living with diabetes. A routine screening intended to monitor retinal health can also help identify other conditions affecting vision, including cataracts.

It also demonstrates that access to advanced medical technologies can significantly expand treatment possibilities and enhance the patient's recovery journey. When newer innovations are combined with careful clinical evaluation and personalised decision-making, they can help doctors move beyond a one-size-fits-all approach to treatment and offer patients options better suited to their individual visual needs and lifestyles.

By Dr Sudipto Pakrasi, Chairman, Ophthalmology, Medanta Mediclinic Defence Colony

Major sporting events such as the IPL, FIFA World Cup, Olympics and Asian Games have become powerful platforms for brands to promote unhealthy products through sponsorships, endorsements and social media.

In an exclusive interview with HealthandMe, Dr. Robin Ireland, public health activist and honorary research fellow at the University of Glasgow, UK, discussed how the commercialization of sport has helped normalize junk food, sugary drinks and alcohol, and its impact on children “who may not always recognize the difference between advertising and fact”.

“It's an awful lot healthier to play sport than to watch it, because sport is now associated with junk food, sugary drinks and alcohol,” he said.

Excerpts from the interview

Q: How does unhealthy-product marketing in sport affect children? And do “zero sugar” or “alcohol-free” labels change that?

Dr. Robin: I think it has a huge impact. Worldwide, we're seeing major problems with overweight and obesity from a very early age, as well as type 2 diabetes. Many causes of cancer and heart disease are preventable through healthier lifestyles, yet we're constantly being promoted things that aren't good for us.

Alcohol companies often promote alcohol-free products. In India, I'm aware of surrogate marketing, where alcohol companies produce packaged drinking water using the same brand, colourway and distribution networks. So it's hardly surprising these brands are normalised to young people. Even where alcohol advertising is banned, alcohol can still be heavily promoted.

A lot of this comes down to what we eat, but very specifically what we drink — alcohol, sugary drinks and now energy drinks. For most of us, we're much better off drinking water.

Q: Does elite sport give sugary drinks, fast food and alcohol a “health halo”?

Dr. Robin: Sport presents glamour and excitement, and children look up to big performers and superstars who often promote products they probably don't consume themselves because they're not good for sporting performance. Yet their names and images are used to create that excitement and, as you described, a health halo.

Brands want to be associated with that healthy image. Athletes think that if they want to perform like a Sachin Tendulkar or another superstar, they need a sports drink or energy drink. And of course, they don't. But that's what the brands are trying to do.

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Q: Cristiano Ronaldo famously pushed away a soft drink and asked for water. Where should athletes and sports bodies draw the line on unhealthy-product sponsorships?

Dr. Robin: It was one of those iconic moments, wasn't it, where he pushed the sponsored bottle away and said, “Agua.” The line is difficult for sportspeople. I don't necessarily want to blame them. It's the rules set by the governing bodies. I've just looked up the IPL sponsors, and you immediately find cola brands across the teams and on shirt branding. It's everywhere.

So it's hard to criticise individual athletes. Some earn huge sums of money, so perhaps it would be nice if one or two took the Ronaldo position. There are also athletes who, because of their religion, will not drink alcohol or associate themselves with alcohol products.

But I think it's the governing bodies. How have we allowed this to happen? This deluge of sugary drinks at a time when we have high levels of type 2 diabetes and children living with overweight and obesity. It's really wrong.

Q: What can sport learn from the ban on tobacco advertising when regulating alcohol, sugary drinks and ultra-processed foods?

Dr. Robin: The short answer is I believe yes, but I think we're quite a long way from that. I grew up with tobacco advertising all over the place, particularly in cricket and F1. I remember F1 saying, “We're not going to be able to survive without tobacco advertising.” They were basically mobile tobacco packet ads with Marlboro ads on the cars going past; it was completely absurd. And we've got rid of it.

That was partly through the World Health Organization Framework Convention on Tobacco Control. We simply have to take these things much more seriously.

I get very cross with people who say we couldn't survive without this. I love sport, but I think we probably could. Across pretty much all sport, there is a lot of money coming in from other places. We don't have to be dependent on junk food and alcohol. It's completely inappropriate.

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Q: Are food labels enough, or should sports advertising also be restricted?

Dr. Robin: Labelling helps, but it's only part of the solution. Not everybody has the time or resources to read labels, and people will still buy what they can afford and what is accessible.

In the UK, we've had some advertising controls, but as we saw with tobacco, sport does its own thing. Sport seems to be allowed a free ride.

In India and the UK, sport is huge, and politicians are in love with it. Advertising, particularly for junk food, is everywhere. Sport will find a way around restrictions unless it's specifically mentioned. In India, you're not allowed to have alcohol advertising, but sport seems to have found a way around it.

We need to take regulation more seriously and recognise that people will find ways around it. It has to be robust to work.

Q: What would effective regulation of unhealthy-product marketing in sport look like?

Dr. Robin: We could be talking about that a long time, so let's come up with one or two manageable measures. I don't think sugary drinks companies or alcohol should be named in event titles. I also don't think brands should appear on the front of shirts or uniforms.

You can also have rules around advertising when events are broadcast. In the UK, we've taken steps around gambling. In the English Premier League, gambling brands have been removed from the front of shirts, and gambling ads can't be shown during the advertising break in the middle of games. It's a limited move, but it's a start.

The IPL has a cola sponsor and a packaged drinking water sponsor that happens to be an alcohol brand. We need to get away from that. It's inappropriate. The Asian Games, interestingly, has 62 sponsors. As far as I can tell, only one is particularly unhealthy, and I'd rather they weren't there either, because it's an official hydration partner that is yet again a sugary drink. But it shows there are people willing to support sport outside these industries, and we perhaps need to look at them more.

For many Indians, especially those with busy work schedules, a morning cup of tea or coffee has become a daily necessity. From a quick cup before heading to work to coffee breaks during long office hours, caffeine is now a regular part of urban routines. But this habit may have implications for digestive health.

For most healthy people, moderate coffee consumption can be part of a normal diet. In some individuals, however, it may lead to symptoms like heartburn, acidity, abdominal discomfort, bloating, or an increased urge to pass stools.

Coffee can affect the digestive system in multiple ways. It is known to stimulate the secretion of gastric acid and increase movement in the colon. This is why some people feel the need to use the toilet shortly after having coffee. The intensity of these effects varies from person to person.

The link between coffee and gastroesophageal reflux disease, or GERD, is often discussed. Coffee may worsen reflux symptoms in certain people, although research findings have not been entirely consistent. A 2026 systematic review and meta-analysis involving over 122,000 people found a small statistical increase in GERD among coffee drinkers, but the clinical significance of this association is still considered uncertain.

This suggests that not everyone with acidity needs to stop drinking coffee altogether. It is more important to observe whether coffee consistently triggers symptoms. Factors such as the quantity consumed, the timing of consumption, individual sensitivity, and what is added to the drink can all play a role.

In India, people often drink coffee with generous amounts of sugar, milk, or cream. For some people, these additions may contribute to digestive discomfort. Drinking several cups a day can also increase overall caffeine intake, which may aggravate symptoms in sensitive individuals.

Rather than blaming coffee entirely for digestive issues, it helps to identify individual triggers. If coffee repeatedly causes heartburn or other discomfort, it may be sensible to reduce intake and consult a gastroenterologist for guidance.

The stimulating effect of coffee on intestinal movement, which leads to a bowel movement soon after the morning cup for some, is not necessarily a sign of an unhealthy gut.

However, persistent symptoms such as frequent heartburn, difficulty in swallowing, repeated vomiting, unexplained weight loss, ongoing abdominal pain, or a significant change in bowel habits should not be attributed to coffee alone and require proper medical evaluation.

Dr. Pradipta Kumar Sethy, Director, Gastroenterology, Manipal Hospitals, EM Bypass and Mukundapur