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.

Obesity is a very significant modifiable risk factor for brain stroke, which is an extremely dangerous illness caused by an insufficient or lack of blood supply to the brain. Stroke leads to disability, memory impairment, paralysis, and sometimes death. As obesity is related to many illnesses, regulation of weight can considerably decrease the probability of suffering a brain stroke.

Dr Bhupesh Kumar Mansukhani, Director of Neurology at Neuromet Wellness Care & Diagnostics, in an interview with Health and Me, said, "Obesity is an excessive accumulation of fat in the body, which causes damage to health. Obesity is determined using the BMI index. Those who suffer from obesity are more prone to illnesses like hypertension, diabetes, and elevated cholesterol levels, all of which put people at a higher risk of suffering a brain stroke. Excessive fat, particularly abdominal fat, affects the arteries, leading to their constriction."

Can hypertension trigger a stroke?

Hypertension, or high blood pressure, is yet another major connection between obesity and stroke. Obesity causes stress on the cardiovascular system and elevates blood pressure levels. Such a state poses a risk of injury to the blood vessels in the brain, causing their rupture or blockage. Obesity usually results in diabetes, and both conditions harm the walls of the blood vessels and increase the risk of blood clot formation. Besides, the increased concentration of cholesterol contributes to plaque accumulation in the arteries.

The presence of obesity in the body stimulates inflammatory reactions and reduces the rate of circulation, which may cause the formation of blood clots. As a result, these clots are delivered to the brain and prevent blood from delivering oxygen to it, and ischaemia becomes the trigger for an ischaemic stroke, which is the leading type of stroke.

Is obesity a modifiable risk factor?

The advantage here is that obesity is a modifiable risk factor, which can actually be avoided or managed. Proper nutrition, physical exercise, adequate sleep, and the absence of negative behaviours will enable an individual to maintain a healthy body weight. It is also important to take part in preventive measures, such as having regular medical examinations and testing one’s blood pressure, glucose levels, and cholesterol.

To conclude, it can be noted that obesity contributes significantly to increased risks of developing a brain stroke due to many reasons, including hypertension, diabetes mellitus, and vascular diseases. Being a modifiable risk factor, it can be easily avoided.

Cancer is, without a doubt, one of the most feared diseases known to man. According to the Indian Council of Medical Research - National Cancer Registry Programme (ICMR-NCRP), India gets 1.5 million new cases of the disease every year, with one in nine people likely to develop cancer in their lifetime. On the other hand, the American Cancer Society (ACS) and National Cancer Institute (NCI) expect about 2,114,850 new cases in the United States this year alone.

A new study claims that the weight loss drug, glucagon-like peptide-1 (GLP-1), may help slow the spread of some cancers. The research was done by the Cleveland Clinic and claimed that the medications may slow down the spread of several obesity-related cancers, including lung, breast, colorectal, and liver cancers.

The official press release by the Cleveland Clinic mentions their research being included 12,112 patients with the following types of obesity-related cancers, ranging from stage 1 to stage 3, and half of these participants started a GLP-1 medication after their cancer diagnosis. The others were taking a DPP-4 inhibitor comparator, "gliptins," a different class of diabetes medications.

The comparison between the two groups clearly shows that the patients who took GLP-1 have a much lower progression to stage 4 disease for four types of cancers.

The study author, Mark David Orland, MD, of the Taussig Cancer Institute at Cleveland Clinic, said, "Our study found that use of GLP-1 drugs, compared to DPP-4 inhibitors and other antidiabetic drugs, was associated with a meaningful reduction in cancer progression across four solid tumor types."

How To Reduce The Risk Of Cancer?

• Consuming a healthy and balanced diet rich in fruits, vegetables, whole grains, and lean proteins can reduce cancer risk.
• Regular physical activity keeps the body fit and reduces the risk of breast, colon, and endometrial cancers.
• Smoking and alcohol consumption should be avoided.
• Skin cancer is one of the most preventable types of cancer. Applying sunscreen with high SPF, finding shade, and avoiding tanning beds would save you from harmful ultraviolet rays.
• Long-term stress can weaken the immune system and may contribute to an increased risk of cancer. Incorporating stress-relief techniques such as mindfulness, practising deep-breathing exercises, and engaging in enjoyable hobbies can enhance overall well-being.
• Exposure to environmental elements like pesticides, pollutants, and workplace chemicals can increase the risk of cancer. To avoid this risk, wearing protective gear, opting for organic produce, and ensuring adequate ventilation in living or working areas can greatly assist.
• By vaccinating against Hepatitis B and HPV, individuals can protect themselves against infections closely linked to liver and cervical cancers; apart from vaccination, adopting proper hygiene practices and steering clear of high-risk activities can help prevent the risk of cancer-causing infections.

As summer heat intensifies both in India and globally, many people may experience unusual heart sensations such as a racing heartbeat, chest fluttering, skipped beats, or pounding sensations, even while resting.

Speaking to HealthandMe, Dr. L.K. Jha, Associate Director and Head Unit-II, Cardiology, Asian Hospital, Faridabad, said that heatwaves can significantly increase the risk of heart palpitations.

Normal healthy people may experience occasional mild palpitations due to heat exposure, which usually resolve with rest, fluids, and cooling off. However, experts warn that when palpitations are accompanied by symptoms such as chest pain, loss of consciousness, shortness of breath, extreme light-headedness, or recurring episodes while resting, they may indicate an underlying cardiac rhythm issue requiring medical attention.

“The association between heatwaves and palpitations occurs more frequently than people think,” Dr. Jha said.

Dehydration: A Key Risk Factor

The human body constantly works to maintain a stable internal temperature.

During extreme heat, blood vessels dilate to release heat through the skin, while the heart pumps faster to circulate blood and cool the body. According to Dr. Jha, this additional strain on the cardiovascular system can make the heartbeat feel stronger or irregular, especially in people sensitive to heat.

Also read: Heatwave In India: Temperatures Continuously Rising; Stay Hydrated, Says PM Modi

Dr. Jha explained that dehydration is one of the biggest contributors to heat-related palpitations.

Excessive sweating leads to the loss of water and essential electrolytes such as sodium, potassium, and magnesium, all of which are crucial for maintaining a normal heart rhythm.

“Dehydration can lower blood pressure, forcing the heart to beat faster, which may cause dizziness, shakiness, or pounding sensations,” he said.

Existing Health Conditions Can Increase Risk

Heatwaves may also worsen existing conditions such as anxiety, thyroid disorders, anemia, diabetes, and heart disease, increasing the likelihood of palpitations.

Certain medications, including blood pressure drugs, diuretics, asthma inhalers, as well as excessive consumption of caffeine or energy drinks, may further contribute to irregular heartbeats during hot weather, Dr. Jha told HealthandMe.

Sleep disturbances caused by hot nights can also trigger stress hormones in the body, potentially leading to rapid heartbeat episodes or fluttering sensations.

Also read: Climate Change Fueling Chikungunya Spread To Europe, North America, Warns Study

When To Seek Medical Help?

Dr. Jha noted that occasional mild palpitations due to heat exposure are common and often improve with rest, hydration, and cooling down.

Doctors recommend drinking fluids regularly, replenishing electrolytes through coconut water, buttermilk, lemon water, or Oral Rehydration Salts (ORS), avoiding prolonged sun exposure, and limiting caffeine and alcohol intake during heatwaves.

However, persistent or severe palpitations may indicate a more serious condition.

“If palpitations are accompanied by chest pain, shortness of breath, fainting, severe light-headedness, or repeated episodes while resting, immediate medical evaluation is necessary,” Dr. Jha warned.

He added that some heat-related palpitations may actually signal an underlying heart rhythm disorder requiring treatment.

Yellow Alert In Delhi; Heat Dome in Europe

Meanwhile, the India Meteorological Department (IMD) has issued a yellow alert for heatwave conditions in Delhi.

Heatwave conditions in the national capital are expected to continue till tomorrow, with maximum temperatures remaining between 44 and 46 degrees Celsius.

The IMD forecast also includes relief in the form of thunderstorms, dust storms, and light rainfall from May 28 evening onwards.

At the same time, European countries like France, the United Kingdom, Spain, and Germany are experiencing early heatwaves and record-breaking conditions.

The sweltering heat conditions have affected scores of people, reportedly resulting in the deaths of about seven people in France. The unusually high temperatures early in May are being triggered by a phenomenon called a “heat dome”.

As a result, southern and southwestern regions, including Portugal, Spain, and France, will experience daytime temperature highs of 38°C. The majority of France is under a moderate to high temperature warning, while Germany and the UK are witnessing maximum temperatures exceeding 30°C, the Euronews reported.