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.

It can feel overwhelming to understand the wide range of conditions neurologists deal with. Their work spans cerebrovascular problems such as stroke and carotid artery disease, seizure disorders, and progressive illnesses like Alzheimer’s disease and frontotemporal dementia. They also treat headaches and facial pain, movement disorders including Parkinson’s, muscle conditions, sleep disorders such as narcolepsy, and many other issues.

“If there’s a nerve somewhere, a neurologist could get involved,” explains Dr. Andrew Dorsch, division chief for general neurology at Rush University System for Health and a specialist in neurologic rehabilitation. “Nerves run through the entire body. That means there are countless ways the nervous system can be affected, and figuring out the cause often requires real detective work.” He notes that many people dismiss neurological symptoms for years, blaming them on ageing or assuming they will pass. That delay can be costly.

What Are Neurological Symptoms?

Neurological symptoms are warning signs that something may be affecting the brain, spinal cord, or nerves. They can look very different from person to person. Some experience headaches, changes in vision, speech, or hearing, or sensations like numbness and tingling.

Others notice tremors, weakness, poor balance, or trouble coordinating movements. Cognitive changes such as memory lapses, confusion, seizures, sleep problems, and intense pain can also fall under this category. These symptoms happen when nerve signals are disrupted, interfering with sensation, movement, thinking, and even consciousness, according to the Cleveland Clinic.

Neurological Symptoms That Can Become Life-Threatening

According to TIME, four neurologists shared the symptoms that should never be brushed aside, along with what they could mean.

Double Vision In One Eye

Double vision affecting one eye is a symptom many people underestimate. It can stem from a range of serious conditions, including multiple sclerosis, stroke, aneurysm, myasthenia gravis, brain tumours, or infections of the brain, says Dr. Luis Cruz-Saavedra, a neurologist at Memorial Hermann Health System.

So when does it require action? “Right away,” he says. “Sudden double vision is a reason to go straight to the emergency room.” Doctors will assess vital signs, look for signs of stroke, examine the eyes and nervous system, and may recommend imaging tests such as a CT scan or brain MRI.

Weakness In One Hand Or Leg

Have you noticed one leg dragging when you walk, or found yourself limping without a clear reason? Maybe holding a cup or writing with your usual hand has become difficult. If so, it is time to see a doctor.

“I’m always struck by how many people downplay weakness on one side of the body,” Cruz-Saavedra says, noting this is far from a good thing. “Patients often come in months after it starts. Many assume it’s a pinched nerve, but it could signal a stroke, a brain tumour, multiple sclerosis, or inflammation in the brain.” During evaluation, neurologists assess muscle strength, reflexes, coordination, and walking patterns to narrow down the cause.

Transient Unresponsiveness

Some neurological conditions cause brief moments where a person seems to switch off, then quickly returns to normal without remembering what happened. These episodes are often linked to temporal lobe seizures, which affect brain areas involved in memory and emotional processing, Cruz-Saavedra explains.

Problems With Speech

Stroke remains one of the leading causes of death in the United States, yet many people fail to recognize its signs and delay seeking help. “I hear stories all the time where someone has stroke symptoms and decides to lie down and wait it out,” says Dr. Enrique Leira, director of the division of cerebrovascular diseases at the University of Iowa.

Stroke symptoms usually come on suddenly and involve a loss of function. Speech changes are a common example. A person may slur words, speak unusually slowly, struggle to find the right words, or have trouble understanding others. In such cases, immediate medical attention is essential, Leira stresses.

Sudden Headache During Physical Effort

Headaches can be tricky for neurologists because there are so many possible causes, many of them harmless. Still, certain types raise red flags. A headache that is extremely intense and appears out of nowhere, rather than building gradually, deserves attention. If it strikes during physical exertion, that concern increases.

“If it’s severe, sudden, and linked to effort, it needs to be checked right away,” Leira says, as it could point to something serious like a stroke.

Numb Feet And Fingers

When patients report numbness, it most often affects their fingers or toes. “That usually means the nerves aren’t sending signals back to the brain properly,” Dorsch explains. “The nerve may be temporarily stunned, or in some cases, permanently damaged.” This differs from tingling, which tends to suggest irritation rather than loss of signal.

The first step is a thorough evaluation to identify which nerves are involved and why. Diabetes is a common cause, but not the only one. Genetic disorders or immune conditions that attack nerves can also be responsible, Dorsch says.

A Sense Of Déjà Vu

Almost everyone experiences déjà vu now and then. But frequent episodes are a different matter. “If it’s happening regularly, it’s worth getting evaluated,” Dorsch advises. Repeated déjà vu can be an early sign of temporal lobe seizures. He recalls treating a patient who experienced these episodes weekly or every few weeks, far more often than is typical.

Difficulty Getting Out Of A Chair On A Regular Basis

With age, stiffness and slower movement are common. Still, certain difficulties stand out. If standing up from a chair becomes a recurring struggle, a medical check-up is important.

“It could be joint-related, but we also need to rule out problems with the muscles, nerves, or spinal cord,” Dorsch says. Conditions such as Parkinson’s disease or amyotrophic lateral sclerosis (ALS) may be involved. “That’s not something I’d want anyone in my family to ignore.”

Changes In Voice

Neurologists watch closely for changes in how someone speaks. One example is hypophonic speech, where the voice becomes unusually soft or breathy, which can be a sign of Parkinson’s disease, says Dr. Alexandru Olaru, a neurologist at University of Maryland St. Joseph Medical Center. Slurred speech, on the other hand, may point to a stroke.

Another concerning sign is wet dysarthria, when speech sounds gurgly, often due to saliva or mucus pooling at the back of the throat. “Muscle loss in that area makes it harder to manage saliva,” Olaru explains. Common causes include Parkinson’s disease, ALS, and multiple sclerosis.

Persistent Muscle Twitches

Occasional muscle twitching is normal. It can happen anywhere in the body and may even be visible under the skin as small ripples. “You can sometimes feel it if you place your hand over the muscle,” Olaru says. Persistent or widespread twitching, however, may warrant further evaluation.

Paranoia

Sudden shifts in behaviour or personality can signal neurological disease. Conditions such as autoimmune encephalitis, frontotemporal dementia, or other cognitive disorders may present this way. One frequent example is new-onset paranoia. A person might believe they are being targeted, betrayed, or plotted against, even when there is no logical basis, Cruz-Saavedra says.

Neurologists also take note when a typically reserved person becomes unusually talkative or disinhibited. “Some people may develop hypersexual behaviour or make inappropriate remarks,” he adds. Others may change in the opposite direction, becoming withdrawn and quiet. Dementia can also show up as new obsessive behaviours or hoarding, Cruz-Saavedra notes.

Been wondering what are Ozempic burps and how the drug works inside your body?

In a podcast episode of The Diary Of A CEO, insulin resistance expert Dr Benjamin Bikman explains how the blockbuster GLP-1 drug can alter the digestion process in your body to reduce weight.

Dr Bikman, a Professor of Cell Biology and Physiology at Brigham Young University in Utah explained: "GLP-1 is primarily a satiety hormone. It'll tell the brain that we're done eating and it will slow down the intestines significantly."

Ozempic (semaglutide) is a prescription injectable GLP-1 medication primarily approved for adults with Type 2 diabetes to manage blood sugar levels. However, the drug has gained immense popularity among those trying to lose weight as it can reduce hunger and help people feel full for longer, which forces the body to burn fat deposits to stay functional.

Also Read: UK Toddler Dies Of Rare Kawasaki Disease: What You Need To Know

In clinical trials, people with obesity using semaglutide have shown to lose an average of about 15% of their body weight over 68 weeks. Most people begin to see noticeable results within 8 to 12 weeks of taking the drug.

The official price in India for a once-weekly Ozempic injection pen ranges from approximately ₹8,800 for the 0.25 mg dose to around ₹11,175 for the 1 mg dose per month. Insurance coverage is generally inconsistent for weight loss indications.

How Does Ozempic Change Your Digestion?

According to Dr Bikman, ingested food sits in the stomach and intestines for about six hours on average for digestion. However, when the body receives GLP-1 hormones from injections, the body will considerably slow down the digestion process and food can stay in the body for about 24 hours.

"If we injected ourselves with a GLP-1 drug, which puts an artificial amount of GLP-1 in our body, boom, we shoot it in. Then it would it slows down people's intestines so much that they'll have food sitting in there for 24 hours," he said during the episode.

Experts have previously noted that slowing down the digestion process on purpose using drugs is unhealthy and risky unless done under strict medical supervision to treat a specific condition (such as chronic diarrhea or dumping syndrome as it can lead to gastroparesis.

Gastroparesis is a condition that occurs when the stomach muscles become weak and slow, failing to move food into the small intestine which can reduce nutrient absorption in the body and severe constipation. It can also form a hard mass called a bezoar, which can cause blockages and may require surgery.

What Are Ozempic Burps?

"So, one of the things people talk about is what's called Ozempic burps where they just have this kind of belching bubbling gas because the food is sitting in the stomach for way longer than it's supposed to.

"So, no surprise the people are less interested in food. GLP-1 tells the brain they don't need to eat as much and slows down the intestines," Dr Bikman noted.

READ MORE: Wegovy 7.2 mg: Higher-Dose Weight-Loss Jab Cleared For Launch In UK

Can You Regain Your Ozempic Weight?

Yes. A new BMJ study has found that people who stop using weight-loss medications can regain weight and return their original size within two years.

Researchers have found that those who lose weight using blockbuster GLP-1 drugs such as Ozempic could regain about 0.4kg every month after quitting these treatments. In contrast, those who lost weight through exercise, diet and other factors only gained 0.1kg.

A two-year-old boy from Bristol, UK has died from a rare heart disease, known to mostly affect children with only flu-like symptoms, on January 8.

Hudson Martin had been diagnosed with Kawasaki disease when he was seven months old and was placed on lifelong medication including aspirin and blood thinners to reduce the risk of clots. Since then, he had been living a normal and happy life, according to father Damien Martin.

He told Bristol Live: "You’d never know anything was wrong from pictures or videos. He bounced off everything. He loved climbing, dancing, music, he was a proper daredevil."

But days before his third birthday, he suddenly collapsed while playing at home. Despite being given CPR by paramedics for an hour, his heart did not restart and he passed away.

“They did absolutely everything they could,” Damien said. "His heart just wouldn't come back."

What Is Kawasaki Disease?

Also known as mucocutaneous lymph node syndrome, Kawasaki disease causes inflammation in the walls of small to medium-sized blood vessels that carry blood throughout the body which can damage to the heart and blood vessels, mostly in children younger than five years old.

When this happens, the heart doesn't work as well to pump blood to the body and could burst (coronary artery dilation and aneurysms). It also causes swelling in the lymph nodes and mucous membranes inside the mouth, nose, eyes and throat.

It remains unknown what causes Kawasaki disease in children and if it affects adults. Diagnosis involves ruling out other diseases that cause the same symptoms which include:

• Scarlet fever
• Juvenile rheumatoid arthritis
• Stevens-Johnson syndrome (a disorder of the mucous membranes)
• Toxic shock syndrome
• Measles
• Some illnesses caused by ticks, such as Rocky Mountain spotted fever

What Are The Symptoms of Kawasaki Disease?

Apart from a 102.2 degrees Fahrenheit (39 degrees Celsius) fever that can last for five days, children with Kawasaki may also experience some or all of the following symptoms:

• Rash on the main part of the body or in the genital area
• Swelling and redness of their hands and feet
• Irritation and redness of the whites of their eyes
• Swollen lymph glands in the neck
• Irritation and inflammation of the mouth, lips, and throat

Is It Curable?

While this non-contagious disease can be treated with a mixture of antibodies given through the veins (intravenous immunoglobulin) and aspirin, it remains uncurable. Doctors may also advice steroids if intravenous immunoglobulin is not effective.

After receiving treatment for Kawasaki disease, most children recover fully and long-term follow-up care remains unnecessary. However, children who have suffered through aneurysms or other complications related to the disease will need lifelong monitoring with a cardiologist.