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.

The NHS will not be automatically inviting all men above a certain age to check for prostate cancer, unlike the approach for some other cancers. The UK National Screening Committee has suggested that the prostate-specific antigen (PSA) test should only be actively offered to men carrying the BRCA gene mutation, which increases their risk. Still, men can request a PSA test from their GP in certain situations.

Olympic cycling hero Sir Chris Hoy, who has received a terminal diagnosis, is among those campaigning for men with known risk factors to be invited for a PSA test at a certain age, even if they do not have any symptoms.

Prostate Cancer Screening: What Is The PSA Test?

A prostate-specific antigen (PSA) test checks the level of PSA in your blood. PSA is a protein produced by the prostate, a small gland in the male reproductive system located just below the bladder. The prostate produces the fluid part of semen.

The NHS says the test might be suggested if you notice symptoms that could point to prostate cancer, such as:

• urinating more often than usual, feeling a sudden urge to pee, or waking up frequently at night to urinate
• blood in your urine
• difficulty getting or maintaining an erection

However, for most men, urinary symptoms are caused by something other than cancer.

A PSA test is usually carried out at a hospital or GP surgery by a nurse or other healthcare professional. Men are asked to avoid certain activities for 48 hours before the test, as these can temporarily raise PSA levels and affect the result. Activities to avoid include anything that leaves you out of breath, like strenuous exercise.

If a man’s PSA level comes back high, they may be offered a repeat test to see if the levels remain raised. If they do, the GP may refer them to a specialist for further investigations, such as a biopsy or an MRI scan.

Prostate Cancer Screening: Why Is The PSA Screening So Controversial?

PSA levels can rise for many reasons, including minor infections, and around 75% of men with a raised PSA do not have prostate cancer. A high reading can lead to referrals for unnecessary biopsies or MRI scans, or treatment for tumours that might never have caused harm.

The PSA test can also miss aggressive cancers. Research has shown that roughly 15% of men with a normal PSA result may actually have prostate cancer.

Prostate Cancer Screening: Who Can Currently Get The PSA Test?

Routine PSA testing is not offered as standard on the NHS. You might be offered a test if a doctor suspects symptoms that could indicate prostate cancer. Men undergoing treatment for a prostate condition may be offered regular PSA checks to monitor how treatment is progressing.

Men aged 50 and over can request a PSA test from their GP, even without symptoms. Campaigners say many men are unaware that they are at higher risk of prostate cancer and should be actively encouraged to think about having a PSA check.

Prostate Cancer Screening: Who Else Could Get It?

If the UK National Screening Committee’s recommendation is approved by the Government next year, men with the BRCA gene mutation could also be invited for a PSA test. Men who think a family member might have had the BRCA gene mutation can request a genetic test on the NHS to find out.

Alzheimer's disease is the most common cause of dementia. As you may know, It is a physical illness that causes the brain to gradually stop functioning correctly, leading to a decline in memory and thinking skills. Alzheimer’s is not just a condition that affects not only memory but also many aspects of daily life, including behavior patterns, routines, and speech.

According to Alzheimer’s Society, the disease is affecting more people than ever: roughly one million people in the UK currently have dementia, a figure expected to rise significantly by 2050.

Catching Alzheimer's early is key to ensuring patients and caregivers receive the right medical care and support. One of the best ways to spot the beginning of mental decline is by noticing changes in how a person uses language and speaks.

5 Speech Clues That May Signal Early Alzheimer's

New speech problems are often one of the first indicators of the disease. Here are five subtle signs to watch out for:

Pauses, Hesitations, and Vagueness

People often have trouble finding the exact word they want to use. This causes them to stop frequently, leading to long pauses and hesitations while speaking. When they can't remember the word, they might use very general words like "thing," or they will try to describe what the forgotten word is, they will describe the forgotten word instead of saying it directly.

Using Incorrect but Related Words

A person might replace the correct word with one that is somehow connected to it. For instance, if they mean to say "fork," they might mistakenly say "spoon" because both are common eating tools. In the very early stages, they might use a general category word, like saying "animal" instead of the specific word, "cat."

Talking About a Task Instead of Doing It

When someone needs to start a task, they may struggle to begin or complete it. Instead of discussing the actual steps needed, they talk about their feelings. They might say, "I used to be able to do this easily," or "I don't think I can manage it now," showing worry or doubt instead of focusing on the job at hand.

Less Word Variety

The person's language starts to sound much simpler and less colourful. They tend to stick to basic, common words and may repeat the same verbs and adjectives over and over again. They also use connecting words like "the," "and," or "but" very often to link their basic sentences, making their speech sound repetitive.

Trouble Finding Words in Groups (Categorization)

It becomes difficult for them to quickly name things that belong to a specific category. For example, if asked to name five types of food, different parts of the body, or words starting with the letter 'P,' they struggle. This challenge becomes noticeably harder and more frustrating as the disease progresses.

Why Early Detection Matters

While everyone forgets a word now and then, Persistent and worsening problems with memory, fluency, and varied language could be an early sign of Alzheimer's.

Age is the biggest factor for Alzheimer's risk, with the chance doubling every five years after age 65. However, the disease can affect people under 65 (early-onset Alzheimer's). Spotting these speech changes early is especially crucial for people who are already at a higher risk, such as those with Down Syndrome.

Usually, when your muscle hurts, it's just from working out too hard, pulling a muscle, or getting a bruise. The pain is normal and goes away after a while. However, the National Health Service (NHS) wants people to know that some types of muscle pain are not normal and could be a medical emergency.

Muscle cramps and pain are considered normal; you may have hurt your leg by a fall, stretched your muscles wrong etc. However, not all pain is harmless and it can lead to more serious consequences. Here is how you identify whether your muscle pain is in dangerous territory or not.

Signs You Should See A Doctor Immediately

NHS explains that one should get help right away if your muscle pain feels like:

• A "burning pain" (like something hot is inside your leg or arm).
• A "deep ache" that feels very intense and goes deep into the muscle.

It's a major red flag if this pain gets much worse when you try to move the sore body part. If you have these symptoms, doctors worry it could be a serious problem called Compartment Syndrome.

What is Compartment Syndrome?

The strong, thin layer of tissue which holds your muscles is called fascia. A compartment is just one of these tight bundles of muscle, blood vessels, and nerves.

Compartment syndrome happens when something causes a lot of swelling or bleeding inside that bundle. Because the fascia around the muscle doesn't stretch easily, the pressure inside the compartment goes up very fast.

This high pressure squeezes the blood vessels and nerves, stopping blood from flowing properly. When blood can't get in to bring oxygen or out to remove waste, the muscle tissue starts to die. That's what causes the severe pain.

What Are The Symptoms of Compartment Syndrome?

It's important to watch out for these symptoms, especially if they follow an injury or intense activity:

Intense Pain: The pain is severe, much worse than normal soreness. It might feel like a deep, burning ache inside the muscle.

Worse with Movement: If you try to move the sore arm or leg, the pain gets instantly and much worse.

Swelling: The muscle might look puffy, or it might feel rock-hard or tight to the touch.

Odd Sensations: You might feel numbness, a pins-and-needles feeling, or feel weak in your hand or foot.

Tightness: The area feels so tight you have trouble moving it normally.

How is Compartment Syndrome Treated?

If the problem is sudden and severe (Acute Compartment Syndrome), it is an emergency, and doctors must act right away.

The Surgery (Fasciotomy)

The surgeon makes a long cut through the tough skin (the muscle cover) that is squeezing the muscle. This immediately releases the pressure, allowing blood to flow normally again to the muscle and nerves.

Recovery

Afterward, you'll need pain medication, and sometimes a skin graft (taking skin from another part of your body) to cover the large wound. You will also need physiotherapy to help the muscle get back its full movement and strength. Since the pain here is linked to exercise, treatment usually starts with changes to your routine:

• Stop activities that trigger the pain. For example, if running hurts, try riding a bike or swimming instead.
• Use anti-inflammatory medicines (like ibuprofen) to ease the discomfort.
• A physical therapist will teach you special stretches and strengthening moves.
• If you run, wearing special shoe inserts might help.
• If these easy changes don't work after a few months, your doctor might then suggest a small surgery.