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.

Cancer is often feared as a silent disease, but in many cases, the body does give early warning signs. The challenge is that these signals are either ignored, misunderstood, or detected too late.

A large number of cancer cases are diagnosed at advanced stages—not because symptoms were absent, but because they were overlooked or diagnosis was delayed.

Understanding the early signs and the reasons behind delayed detection can help save lives.

Speaking to HealthandMe, Dr Siddharth Sahai, Director & Unit Head - Medical Oncology, Max Super Speciality Hospital, Dwarka, shared seven signs of cancer that should not be neglected.

1. Unexplained weight loss

Losing weight without trying—especially more than 4–5 kilos in a short time—can be an early sign of cancers such as stomach, pancreas, or lung cancer.

2. Persistent fatigue

Feeling unusually tired despite adequate rest could signal underlying issues like blood cancers or colon cancer. This kind of fatigue does not improve with sleep.

3. Changes in bowel or bladder habits

Chronic constipation, diarrhea, blood in stool, or changes in urination patterns should not be ignored. These may point toward colorectal, bladder, or prostate cancer.

4. A lump or thickening in the body

Any new lump—especially in the breast, neck, or underarms—needs medical evaluation. Not all lumps are cancerous, but it’s important to rule it out early.

5. Persistent cough or hoarseness

A cough lasting more than 2–3 weeks, or voice changes, could be early signs of lung or throat cancer, especially in smokers.

6. Unusual bleeding or discharge

Bleeding between periods, after menopause, blood in urine, or unusual discharge can be warning signs of cancers such as cervical, uterine, or bladder cancer.

7. Non-healing sores or skin changes

Sores that do not heal, changes in moles, or new skin growths could indicate skin cancer or oral cancer (especially in tobacco users).

Also read: New Breast Cancer Guidelines Recommend Mammograms Every Two Years for Women

Why Cancer Diagnosis Often Gets Delayed

Dr Sahai also mentioned six common causes of delayed cancer diagnosis

Factors that contribute to late detection include:

1. Lack of awareness

Many people are not aware that these symptoms could be linked to cancer. They often dismiss them as minor issues like acidity, infection, or weakness.

2. Ignoring symptoms due to busy lifestyles

In both urban and rural settings, people tend to delay doctor visits due to work commitments, family responsibilities, or simply hoping the problem will resolve on its own.

3. Fear and denial

The fear of being diagnosed with cancer leads many individuals to avoid medical consultation. Denial becomes a major barrier, especially when symptoms are mild initially.

4. Limited access to healthcare in some areas

In smaller towns and rural regions, access to diagnostic facilities and specialists is still limited. This leads to delays in proper testing and referrals.

5. Financial constraints

Concerns about the cost of investigations and treatment often prevent timely medical attention. Many patients wait until symptoms worsen significantly.

6. Misdiagnosis or delayed referral

In some cases, early symptoms may mimic common illnesses. Without timely screening or specialist referral, diagnosis can be delayed.

The Importance Of Early Detection

Dr Sahai stressed that early detection significantly improves cancer outcomes. Most cancers, if identified in the initial stages, are treatable and even curable. The key lies in listening to your body and acting without delay.

Simple steps like regular health check-ups, cancer screening (such as mammography, Pap smear, or oral screening), and timely consultation can make a crucial difference.

Ignoring symptoms may seem convenient in the short term—but early action can save not just time, but life itself.

Earlier this week, in shocking news, an investigative BBC report showed that more than 330 children in Pakistan have contracted HIV due to the reuse of syringes in a hospital in Pakistan’s Punjab.

The incident captured on camera was filmed over 32 hours inside THQ Taunsa Hospital in late 2025 and showcased persistent unsafe practices, including the reuse of syringes on multi-dose vials, and other unhygienic practices at the healthcare facility.

In an interview with HealthandMe, Dr Ishwar Gilada, the President Emeritus of the AIDS Society of India, spoke about how reusing needles raises health risks.

The Mumbai-based top infectious disease expert noted that the risk of HIV transmission is much less for reused syringes and that the risk is potentially higher for hepatitis B and hepatitis C.

Dr. Gilada, the only Indian serving on the International AIDS Society (IAS) Governing Council, also stressed that the probability of transmission may vary depending on factors such as viral load and the amount of blood present. However, the danger is never zero, he said, stressing the importance of safe and single-use injection practices critical in every healthcare setting.

Risks Of Reusing Syringes

Dr Gilada noted that all the transfusion-transmissible infections can be transmitted, albeit with lesser chances than blood transfusion.

Other than HIV, it can raise the risk of several infections, including:

• Hepatitis B,
• Hepatitis C,
• Syphilis,
• Malaria,
• Ebstein-Barr virus infection,
• Tetanus infection,
• Septicemia,
• Bacterial endocarditis.

Importantly, Dr. Gilada stated that even a tiny amount of infected blood can cause transmission.

However, there is a simple principle in microbiology - the chances of transmission are directly proportional to the inoculum.

"The higher the inoculum, the more the chances. Lower inoculum lowers the risks, but the odds are not zero," the expert added.

Does HIV Spread Through Reused Syringes? How?

Dr Gilada said that the chances of infections are usually through freshly used needles.

"In the needle that was used 15-20 minutes earlier, the blood clots in the bore of the needle. Usually, a drop of blood remains in used needles due to 'capillary action'.

"When the same needle is pricked in the new patient, that drop gets mixed with his/her blood by 'surface tension'. The chance of getting HIV infection through such a mix-up is around 0.1per cent if the previous person had HIV," the expert said.

However, he added that "it will also depend on the HIV viral load of the source person. Those with high viral load can lead to higher chances, but if the source person is on ART and is virally suppressed, the chances are near zero".

Also read: Why India Must Shift Towards Prophylaxis Care For Hemophilia

How Can One Prevent?

Dr. Gilada said that prevention is only through good hygiene practices, such as:

• Using spirit to wipe the body part to be injected,
• Needles should be disposed of in impervious containers.
• The containers should be disposed of in local municipal facilities
• Recycling of any type of needles should be a strict no.

Amid the growing burden of hypertension and related heart disease in India, a team of experts has suggested switching to potassium-enriched low-sodium salt substitutes (LSSS).

In India, more than 1 in 4 people have hypertension, and cumulatively, more than 90 per cent of adults with hypertension are either undiagnosed, untreated, or treated but live with uncontrolled hypertension. This burden needs to be tackled on an urgent basis

In view of this, experts from clinical medicine, public health, and nutrition released a consensus statement recommending potassium-enriched LSSS as an effective intervention to reduce hypertension and cardiovascular disease in India.

Current estimates show that Indians consume between 8 and 11 grams of salt (equivalent to 3.2–4.4 grams of sodium) per day, nearly double the WHO’s recommended limit of 5 grams (2 grams of sodium).

High sodium intake is a key driver of elevated blood pressure. At the same time, potassium plays a complementary role by helping counteract sodium’s effects—yet potassium intake in India remains below optimal levels.

With nearly 80 per cent of sodium intake in India coming from salt added during cooking at the household level, experts emphasized that interventions focused on reducing salt use at home can have the greatest impact.

“High-quality research shows India’s high sodium and low potassium intake is a key driver of hypertension and cardiovascular disease. Low-sodium salt substitutes address both—cutting sodium and restoring potassium, which is key to lowering blood pressure. With no change in taste and appropriate safeguards, this is a safe, scalable solution for India’s NCD prevention strategy,” Prof. Vivekanand Jha, Executive Director of The George Institute for Global Health India.

What Is A Low-sodium Salt Substitute? How Can It Boost Heart Health?

The low-sodium salt substitutes are composed of approximately 70–75 per cent sodium chloride and 25–30 per cent potassium chloride. It reduces sodium intake while increasing potassium consumption, thereby helping to lower blood pressure and reduce cardiovascular risk.

The World Health Organization (WHO), in January 2025, released guidelines recommending potassium-enriched salt to combat hypertension and related heart risks.

The WHO's guideline suggests using K-salt or potassium chloride instead of regular table salt, rich in sodium. It may reduce noncommunicable diseases (NCDs) such as cardiovascular diseases (CVDs) and chronic kidney disease by lowering blood pressure.

Also read: Two Potassium-Rich Foods That Could Lower Blood Pressure Better Than Cutting Salt

It also lowers the risks of other conditions associated with high sodium intake, such as gastric cancer. As per the WHO, every year 80 Lakh people die due to poor diet. Of these, 19 lakh deaths are attributable to high sodium intake.

These alternative salts contain less sodium than regular salt and often include potassium chloride (KCl), with or without other agents, to achieve a flavor similar to regular salt.

Evidence shows potassium - enriched low-sodium salt substitutes are a practical, effective, and scalable solution. The new consensus also marks an important shift from evidence to action, aligned with the Government of India’s commitment to reduce population-level salt intake.

India has committed to a global goal of reducing the average population level sodium intake by 30 per cent by 2030 to help prevent and control non-communicable diseases (NCDs).

Is Potassium Salt Safe?

While the WHO guidelines urged people to partially replace table salt with potassium, concerns have been raised about the safety of LSSS that contain potassium, because too high a level of blood potassium (hyperkalemia) may be harmful, especially to individuals with impaired kidney function.

Experts noted that potassium is safe for most people, including many with early-stage kidney disease, but maintained that caution is primarily necessary for individuals with advanced stages of kidney disease or when potassium levels are already high.

"While we have enough scientific data supporting the benefits of Low-Sodium Salt Substitutes, the evidence-to-action gap must be closed by treating LSSS as a ' dietary vaccine' to treat hypertension. It is the 'low-hanging fruit' of cardiology, a passive intervention that provides 24/7 cardiovascular protection without requiring patients to actually sacrifice the taste of their traditional diet," said Prof. Ambuj Roy, Department of Cardiology, AIIMS, New Delhi.

Also read: Pink Salt vs White Salt: What Difference Does It Make?

Dr. Sandeep Mahajan, Professor, Nephrology, AIIMS, New Delhi, added, “The potential risks of low-sodium salt substitutes are often overstated relative to their population-level benefits. While a small subset of patients—particularly those with advanced kidney disease or on specific medications—require caution, this group is clearly identifiable and can be guided through simple screening and labelling measures".

The expert noted that "nearly 90 per cent of the population can safely benefit from this intervention".

The Consensus recommends priority actions such as:

• Policy integration: Include potassium-enriched LSSS in national sodium reduction strategies, hypertension and NCD guidelines, and update FSSAI standards to enable the safe, widespread use of potassium-enriched LSSS as edible salt.

• Focus on everyday use: Prioritise replacing regular salt with potassium-enriched LSSS in homes and in government nutrition programmes and institutional kitchens, while requiring food industry reformulation to use potassium-enriched LSSS in high salt packaged foods and restaurant meals.