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.

People who take methotrexate for different health conditions have been cautioned by the NHS that certain symptoms and side effects should not be ignored and may require urgent medical help, including a visit to A&E or calling 999. Methotrexate works as an immunosuppressant, meaning it dampens the immune system to help control inflammation in the body.

What Is Methotrexate?

Methotrexate belongs to a group of medicines known as antimetabolites. It helps manage rheumatoid arthritis by dampening the body’s immune response, controls psoriasis by slowing the rapid buildup of skin cells, and is used in cancer treatment to limit the growth and spread of cancer cells, as per Mayo Clinic.

Doctors commonly prescribe it for conditions such as rheumatoid arthritis, Crohn’s disease, and psoriasis. In some situations, it is also used as part of cancer treatment. Methotrexate is usually taken as a tablet, a liquid medicine that is swallowed, or as a pre-filled pen or syringe that is injected under the skin. While many people benefit from the drug, it can also cause serious side effects that may be worrying for some patients.

Side Effects Of Methotrexate And When To Call For Emergency?

Certain severe side effects linked to methotrexate are rare and affect fewer than 1 in 10,000 people. Even so, the NHS advises contacting your doctor or calling 111 if you notice any of the following symptoms:

• Swelling in the hands, feet, or ankles along with shortness of breath, which may point to a kidney issue
• A long-lasting cough, chest discomfort, or trouble breathing, which could suggest lung inflammation
• Yellowing of the skin or the whites of the eyes, which can indicate liver damage
• Bleeding gums, vomiting blood, unexplained bruises, or blood in the urine, which may signal a blood disorder
• A high temperature, sore throat, or body aches, which could be signs of an infection

Symptoms of this can include:

• Swelling of the lips, throat, or tongue
• A tight sensation in the throat or difficulty swallowing
• Confusion
• Collapsing or fainting and being hard to wake
• Skin, lips, or tongue turning blue, pale, or grey
• Very rapid breathing or severe difficulty breathing

Methotrexate: What Should You Watch Out For While Taking This Medication?

See your care team regularly so they can monitor how the treatment is working. It may take a while before you notice any improvement. You may be asked to get routine blood tests during the course of treatment.

If your care team has prescribed folic acid along with methotrexate, they may advise you not to take folic acid on the same day as your methotrexate dose.

This medicine can make your skin more sensitive to sunlight. Try to stay out of direct sun exposure. If that is not possible, wear covered clothing and apply sunscreen. Avoid sun lamps, tanning beds, or tanning booths.

Contact your care team if you have severe diarrhea, ongoing nausea or vomiting, or heavy sweating. Losing too much fluid from your body can make this medicine unsafe. This drug can raise your chances of developing an infection. Call your care team if you develop a fever, chills, sore throat, or flu-like symptoms. Do not self-medicate. As far as possible, stay away from people who are unwell.

Discuss your cancer risk with your care team. Long-term use of this medication may increase the risk of certain cancers.

Speak to your care team if you or your partner could become pregnant. Methotrexate can cause serious birth defects if taken during pregnancy or within six months after the last dose. A negative pregnancy test is required before starting treatment. Reliable contraception should be used while on this medication and for six months after stopping it. Your care team can guide you on suitable options.

If your partner can become pregnant, use condoms during sexual activity while taking this medication and for three months after the final dose. Do not breastfeed while using this medication and for at least one week after the last dose.

This medication may affect fertility. If this is a concern, discuss it with your care team.

America is aiming to align with global trends in sun protection. On December 11, the Food and Drug Administration proposed allowing the use of bemotrizinol in sunscreens — an ingredient that has been widely used in other countries for years.

Bemotrizinol provides stable, long-lasting defence against both types of UV rays that can harm the skin. According to the FDA announcement, it is gentle enough to be safe for young children and could be on shelves in time for next summer.

"The agency has historically moved too slowly in this area, leaving Americans with fewer options than consumers abroad. We’re continuing to modernize the regulation of sunscreen and other over-the-counter drug products,” FDA Commissioner Marty Makary said in a press statement. “Americans deserve timely access to the best safe, effective, and consumer-friendly over-the-counter products available.”

What is Bemotrizinol?

Bemotrizinol, also called BEMT, is a chemical that absorbs both UVB and UVA rays. If those terms sound familiar, it’s likely because you’ve seen them on nearly every sunscreen bottle. The sun emits ultraviolet (UV) radiation, which is exactly what sunscreen is designed to block.

UVB and UVA describe different kinds of rays, according to the University of Texas MD Anderson Cancer Center. For our skin, the difference isn’t huge. UVA causes tanning and burns faster than UVB, while UVB can be partially blocked by barriers like windows or clouds.

About 95% of UV reaching the ground is UVA, with UVB making up the remaining 5%, according to the Anderson Cancer Center. Sunscreens work in two ways: creating a physical barrier with minerals or using chemicals that absorb rays before they reach the skin. BEMT falls into the latter category.

Why Is BEMT Good For Use In Sunscreen?

BEMT ticks many boxes for an effective sunscreen ingredient. It is broad-spectrum, shielding against both UVA and UVB, and achieves higher SPF protection in smaller amounts than some other popular chemicals, according to Certified Laboratories and the FDA via USA Today. It is also photostable, meaning it breaks down more slowly when exposed to sunlight, and being oil-soluble makes it easy to mix into creams.

The ingredient is minimally absorbed into the body through the skin and rarely causes irritation, which is why the FDA considers it safe for children as young as six months old.

When Will BEMT Come To Sunscreen In The US?

Following the proposal, the FDA has opened a 45-day public comment period. Once the agency reviews feedback and confirms safety, it will issue a final order to allow the ingredient. Over-the-counter approvals are generally faster than the one-to-two years typical for prescription drugs. The FDA told Today that BEMT sunscreens could be available by summer or fall of 2026.

What Caused FDA Delays in Sunscreen Approvals?

Recent holdups at the U.S. Food and Drug Administration in clearing new sunscreen ingredients have largely stemmed from long-standing regulatory slowdowns, which left American shoppers with fewer choices than those offered in many other countries.

The agency’s plan to permit the use of bemotrizinol, a filter already common abroad, marks a step toward updating its approach to sunscreen oversight and giving people access to more advanced formulas. Updates from the agency note that bemotrizinol delivers steady, broad-spectrum defense against UVA and UVB rays and is mild enough for children, bringing U.S. standards closer to what is widely available worldwide.

As a strong wave of “superflu” and other seasonal infections moves through the country, large numbers of people have fallen ill this winter. The rise has been serious enough for some NHS officials to advise anyone with symptoms to wear a mask. Newly released data shows how quickly the situation has worsened, with flu admissions jumping by 55 percent in a single week.

This sharp climb has pushed the NHS into what leaders describe as a “worst case scenario” for December. As per The Independent, over the past week, hospitals saw an average of 2,660 daily admissions for flu, the highest figure ever recorded at this point in the year. With so many people under the weather, many are trying to work out which pain reliever offers better comfort. An expert previously spoke to the Mirror on this exact point.

Superflu Cases Rise In UK

Figures released today highlight the severity of the situation, with flu hospitalisations having surged by more than half (55%) in just one week. This massive increase has officially plunged the NHS into a "worst case scenario" situation for the month of December. Last week, an average of 2,660 patients per day were admitted to hospital beds with flu, marking the highest number ever recorded for this time of year.

Superflu Cases: What To Take Paracetamol Or Ibuprofen?

With so many people falling poorly, it can be helpful to know which medicine is best to take. Thankfully an expert previously spoke to the Mirror about ibuprofen and paracetamol. Abbas Kanani, the superintendent pharmacist at Chemist Click, said: "Paracetamol is probably more effective at bringing down temperature, so it's almost like a double-whammy, you get rid of your headache and bring your temperature down. "But if you feel that you have more body aches, that's your main symptom, then ibuprofen is probably slightly better as it's an anti-inflammatory."

However, he cautioned users to be mindful of potential allergies to ibuprofen, which belongs to a specific class of drugs.

He also revealed that many people are unaware that they can actually take both medicines together when feeling particularly unwell. "If you feel that one isn't enough you can take ibuprofen as well as paracetamol, you can take them together. A lot of people don't know that it's not one or the other, you can put them together as they work in different ways."

While these two medications can alleviate aches, pains and fevers, as well as mild cold and flu symptoms, Abbas notes that they won't be particularly effective for those struggling with coughs and nasal congestion.

To address these specific symptoms, you'd need to utilise cold and flu products instead.

Choosing Medicine Based on Your Symptoms

Many people assume one medicine works better for all flu complaints, but the expert’s guidance shows that the right choice depends on what you’re feeling. Fever and headache respond more readily to paracetamol, while body aches and inflammation may ease faster with ibuprofen. For coughs or blocked sinuses, cold-and-flu formulas are needed because standard pain relievers do not target those issues.