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.

Doctors in India’s southern state of Tamil Nadu surgically removed a fully developed canine tooth from the upper eyelid region of a 16-year-old boy. They described the case as the first reported instance of an ectopic tooth in the upper part of the eye socket.

The case was reported by specialists at Aravind Eye Hospital in Madurai in the journal Ophthalmology.

What Did The Doctors Find?

The teenager visited the hospital with painless swelling of his left upper eyelid that had lasted a month. He had no history of injury to the area.

During the examination, doctors noticed two firm, whitish projections beneath the swollen area near the inner side of the upper eyelid, the experts shared in the paper.

A computed tomography (CT) scan revealed a dense structure resembling a tooth, with a crown and root, originating from the roof of the left eye socket. It extended towards the tissues in front of the orbital septum, a thin barrier separating the eyelid from the deeper eye socket, and protruded outwards with two tooth-like points on its surface.

The projections' appearance and texture raised the possibility that they were teeth. Dr. Meghana Tanwar, a medical consultant at Aravind Eye Hospital, told Live Science that they had a “fairly smooth surface and were hard on palpation.”

The doctors surgically removed the structure. Examination confirmed that it was a mature canine tooth without teratomatous elements, consistent with an ectopic tooth in the upper part of the eye socket.

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What Is An Ectopic Tooth?

An ectopic tooth develops or emerges in an abnormal location. Some remain within the mouth but appear outside their usual positions in the dental arch, while others develop outside the normal arrangement of teeth.

The latter is particularly unusual. In this teenager's case, the tooth was located in the upper orbital region rather than within the normal dental arch.

Before confirming the diagnosis, doctors considered whether the projections could be associated with a teratoma, a type of tumor that can contain different tissues, including bone and tooth tissue. They also considered whether a foreign object might be lodged in the eyelid.

Imaging and examination of the removed structure helped establish that it was a mature tooth rather than tissue associated with a teratoma.

Why Is This Case Unusual?

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Ectopic teeth have been documented in several locations, including the nasal cavity, chin and maxillary sinus, an air-filled cavity within the cheekbone. Previous reports have also described teeth in the lower part of the eye socket.

However, the doctors said they could not find an earlier report of an ectopic tooth in the superior orbit, the upper region of the eye socket.

“To the best of our knowledge this is the first and only ectopic tooth reported in the superior orbit,” Tanwar told Live Science.

“This was a first not just for us but the world over,” she said of the case. “We were very surprised by it.”

What Causes Ectopic Teeth?

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The doctors could not determine why the tooth developed in this unusual location.

Possible explanations for ectopic tooth development include abnormalities during development, genetic factors, infections and physical trauma. However, the cause in this case remains unknown.

Imaging did not reveal any additional ectopic teeth. Tanwar said the likelihood of the teenager developing another such tooth was low.

Pancreatic cancer is one of the cancers doctors find particularly difficult to detect early. The pancreas lies deep inside the abdomen, and early disease may cause few or vague symptoms. By the time symptoms such as jaundice, unexplained weight loss, abdominal or back pain or persistent digestive problems become apparent, the disease may already be advanced.

What Is PANXEON, The New Liquid Biopsy?

This is why the findings of a new international study on PANXEON, an investigational liquid biopsy, are attracting attention. Published in Nature Medicine, the study evaluated 1,785 people across four countries and explored whether a blood sample could identify early pancreatic ductal adenocarcinoma, the most common form of pancreatic cancer.

The principle behind the test is relatively simple. Cancer cells release molecular material into the bloodstream. PANXEON looks at a group of tiny molecules called microRNAs, including those carried inside microscopic packages called exosomes. These molecules can provide molecular clues about what is happening in the pancreas. The test combines this microRNA signature with CA19-9, a blood marker already used in pancreatic cancer, particularly for monitoring patients, although CA19-9 alone is not suitable as a general screening test.

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In the study, the microRNA test detected early-stage pancreatic cancer with a sensitivity of 83.8%. When combined with CA19-9, PANXEON reached 86.8% sensitivity for stage I-II disease. Importantly, false-positive rates were 3.2% among low-risk controls and 15.6% among high-risk controls. The researchers also reported that the test showed potential for identifying high-grade dysplasia in people with high-risk pancreatic cysts.

For India, this research is relevant because pancreatic cancer, although less common than several other major cancers, represents a significant clinical challenge. India’s National Cancer Registry Programme estimated about 21,000 pancreatic cancer cases in 2022. Globally, GLOBOCAN estimated more than 510,000 new cases in the same year.

Is PANXEON Ready For Routine Screening?

But there is an important caveat: PANXEON is not yet a routine screening test. There is currently no standard screening test recommended for people at average risk of pancreatic cancer. Screening is generally considered for selected high-risk individuals, such as those with significant family histories or certain inherited genetic risks.

The new findings therefore represent a promising research direction, rather than a test people should independently seek out today. A useful early-detection test must work reliably in much larger, diverse populations and demonstrate that detecting cancer earlier actually improves outcomes.

For patients and doctors, however, the concept is important. Instead of waiting for a tumour to become large enough to produce obvious symptoms or visible changes on imaging, researchers are increasingly asking whether the molecular footprints of cancer can be detected in a simple blood sample. PANXEON is one more step towards answering that question.

I have often heard a familiar bedtime story: “I picked up my phone for five minutes, and suddenly it was 1 a.m.” The person is exhausted, yet continues scrolling through upsetting news, frightening predictions or other people’s lives.

Doomscrolling is not simply a lack of discipline. Our brains are naturally drawn towards possible threats because noticing danger has always supported survival. Each alarming headline tells the nervous system that there may be something important it must understand. The next post promises more information and perhaps a sense of control, so we continue scrolling.

How Stress And Anxiety Fuel Doomscrolling

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For someone already carrying stress or past trauma, uncertainty can feel especially difficult. Scanning for information may become the brain’s way of asking, “Am I safe? Is there something I need to prepare for?” Unfortunately, the answer rarely arrives. Instead, every new story introduces another concern.

Consider someone who goes to bed after a demanding day. Their body is tired, but their mind has had no opportunity to process what happened. They open social media for relief and encounter distressing content. Their heart rate increases, their thoughts become faster and sleep moves further away. The phone may distract them from uncomfortable feelings temporarily, while also keeping their system alert.

Screens can delay sleep by displacing bedtime and exposing us to light, but the emotional content matters too. Anger, fear and comparison create cognitive arousal, the opposite of the slowing down that sleep requires.

Simple Ways To Break The Doomscrolling Cycle

Rather than imposing a harsh digital ban, begin with a realistic boundary.

- Choose a time to stop reading news, charge the phone away from the bed or replace the final 20 minutes of scrolling with something less stimulating.

- Dim the lights, stretch gently, listen to familiar music or write down tomorrow’s worries so the brain does not have to keep rehearsing them.

- If you slip, respond with curiosity rather than criticism: “What was I trying not to feel, or hoping to find?”

When doomscrolling repeatedly disrupts sleep or becomes the main way you manage anxiety, therapy can help explore the need beneath the habit. The aim is not merely to take away the phone, but to help the nervous system discover safer ways to settle.

Sometimes, switching off the screen begins with helping the mind believe that it is safe to stop watching.

By Ms Arouba Kabir, Psychologist, Founder Enso wellness