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.

World Asthma Day is observed globally every year on the first Tuesday of May to raise awareness about the most common chronic non-communicable disease in the world.

The condition affects over 260 million people. It is also responsible for over 450,000 deaths each year worldwide. However, most of these deaths are preventable.

As per the Global Burden of Disease Report (GBDR) 2019, India has the highest and growing burden of asthma in the world in terms of deaths and disability-adjusted life years, and over 3.4 crores of people in India have asthma, despite accounting for only 13 per cent of the world's asthma population, and 42 per cent of global asthma mortality.

World Asthma Day: History

World Asthma Day began in 1998 during the first World Asthma Meeting in Barcelona, Spain.

Coordinated by the Global Initiative for Asthma (GINA), with over 35 countries initially participating, it has grown into a global awareness event held annually on the first Tuesday of May.

GINA is a World Health Organization collaborative organization founded in 1993.

World Asthma Day: Theme

This year, the theme is: “Access to anti-inflammatory inhalers for everyone with asthma – still an urgent need”.

The theme reinforces that every person with asthma, including most pre-school children with asthma, should receive inhaled corticosteroids.

These inhalers reduce the person’s risk of asthma attacks and preventable asthma deaths.

GINA continues to emphasize the need to ensure that all people with asthma can access inhaled medications that are essential for controlling the underlying disease and treating attacks.

Preferably, the inhaler should be a combination 2‑in‑1 inhaler containing both an inhaled corticosteroid and a quick-acting reliever. Together, they treat the asthma symptoms, prevent asthma attacks, and reduce hospital admissions.

Also read: Exposure To Traffic Emissions Before Birth May Delay Speech Development In Children: Study

What is Asthma? Signs and Symptoms

Asthma attacks are mainly caused by the obstruction of the air passages in the lungs, which reduces the ability of the person to inhale life-sustaining oxygen into the body.

The airway obstruction is caused by spasm and tightening of the airway muscles, and inflammation, which causes both swelling of the walls of the air passages and mucus or phlegm blocking the airways.

Common symptoms include

• shortness of breath,
• wheezing (a whistling sound on exhaling),
• chest tightness or pain,
• coughing—often worse at night, early morning, or during triggers like colds, exercise, allergens, or smoke.

How To Treat Asthma

According to GINA, inhaled corticosteroids are essential for treating and controlling asthma.

The short-acting bronchodilator relievers (salbutamol, albuterol, terbutaline, SABAs) only relieve the spasm and tightening of the muscles in the air passages, but inhaled corticosteroid-containing medications prevent asthma attacks by treating the underlying inflammation that causes asthma.

The inhaled corticosteroid-containing medication should be prescribed in addition to, or in combination with, reliever medication, to prevent the continuing avoidable morbidity and mortality from asthma.

In low-middle-income countries, lack of availability or high cost of inhaled medicines, especially inhaled corticosteroid-containing inhalers, are major contributors to the fact that many attacks and 96 per cent of global asthma deaths occur in these countries.

How To Prevent Asthma

Asthma can be prevented by:

• Avoiding exposure to environmental triggers such as air pollution, cold air, fragrances, etc.
• Avoiding contact with allergens.
• Avoiding smoke from cigarettes, candles, incense, and fireworks. Staying away from sick people (cold or the flu)
• Keeping the surroundings dust-free
• Taking vaccinations on time to prevent pneumonia, diphtheria, tetanus, the zoster vaccine, and whooping cough
• Adhering to asthma medications.

If you speak to doctors today, one pattern is becoming very common—women in their 30s are often being diagnosed with both thyroid problems and PCOS together. Earlier, these conditions were seen separately. Now, they frequently show up side by side.

At first, this can feel confusing. The thyroid is a gland in your neck that controls how your body uses energy, while PCOS affects the ovaries, periods, and hormones. They seem unrelated—but inside the body, they are more connected than we think.

Hormonal Imbalance

A big reason behind this overlap is hormonal imbalance. PCOS already disturbs the balance of female hormones and can lead to irregular periods. If the thyroid is underactive, it slows the body’s metabolism and also interferes with hormone levels. When both happen together, symptoms tend to become more noticeable and sometimes more difficult to manage.

Insulin resistance

Another important link is insulin resistance. Many women with PCOS have it, even if they are not diabetic. This means the body struggles to use sugar properly, leading to higher insulin levels. Over time, this doesn’t just affect weight—it also impacts hormones and can indirectly influence thyroid function. That’s why the two conditions often overlap.

Lifestyle

Lifestyle plays a bigger role than we usually admit. In your 30s, life tends to get busy—work pressure, family responsibilities, irregular sleep, and constant stress. Meals are often rushed or skipped, exercise takes a backseat, and screen time goes up. All of this affects the body’s internal balance. Stress hormones, in particular, can disrupt both thyroid function and reproductive hormones.

Weight Gain

Weight gain is another common thread. Many women notice gradual weight gain that doesn’t seem to respond easily to diet or exercise. Thyroid problems can slow metabolism, while PCOS can increase fat storage, especially around the abdomen. This, in turn, worsens insulin resistance—creating a loop that’s hard to break without proper guidance.

It’s also worth noting that we are simply diagnosing more cases now. Women today are more aware of their health and are more likely to seek help for symptoms like irregular periods, fatigue, hair fall, or acne. Earlier, these were often ignored or brushed off as “normal.”

When both thyroid issues and PCOS are present, you may notice:

• Periods are becoming irregular or stopping altogether
• Constant tiredness, even after rest
• Hair thinning or excessive hair fall
• Acne that doesn’t settle easily
• Unexplained weight gain
• Difficulty getting pregnant

How To Manage

The encouraging part is that both conditions can be managed well. The approach is not just about medicines—it’s about small, consistent lifestyle changes. Eating balanced meals, staying physically active, managing stress, and getting proper sleep can make a real difference over time.

The key is to listen to your body. If something feels off and continues for months, don’t ignore it. Getting checked early can save a lot of trouble later.

In the end, this rise in combined thyroid and PCOS cases isn’t random. It reflects how modern lifestyles are affecting women’s health. The good news is—with the right care and awareness, it’s absolutely possible to manage both and stay healthy.

The concept of self-medication in the case of a trivial ailment such as a headache or a small cut is generally considered responsible self-care. Nevertheless, it becomes a matter of public health concern when the process goes through two particular stages. The first of these stages is the “masking of chronic disease." When one uses over-the-counter (OTC) drugs to cover up symptoms of fatigue, acidity, or thirst, he or she ends up masking the symptoms of underlying chronic diseases, which could be type 2 diabetes or high blood pressure, for instance. By the time these symptoms are diagnosed, the condition may have caused irreparable damage to organs. Another health problem created due to self-medication is antimicrobial resistance, which poses a danger not only to the individual but also to society as a whole.

What are the risks of making a self-diagnosis?

Dr Vimal Pahuja, MD, Associate Director, Internal Medicine & Metabolic Physician, Diabetes & Weight Management Clinic, Dr LH Hiranandani Hospital, Powai, Mumbai, said, “The most serious complications include those that have no immediate effects and do not trigger pain signals. DILI is a growing concern in India and is a consequence of the persistent abuse of painkillers (NSAIDs) or even some of the herbal supplements available in the market. In the same way, ‘kidney compromise’ results from prolonged consumption of analgesics. Looking at things from the viewpoint of the endocrine system, the frequent consumption of over-the-counter steroids, which are also included in some ‘miracle’ skin creams and supplements, can affect hormones and lead to the development of secondary diabetes.”

Does it help to ‘Google’ symptoms?

Internet searches usually generate confirmation bias, where patients only seek answers that align with what they want to hear. Health-related social media sites and influencers tend to oversimplify medical issues by encouraging bio-hacking. This results in unsafe practices, such as people prescribing themselves advanced metabolic and hormonal treatments without being aware of the contraindications or the need for clinical testing.

Dr Kirti Sabnis, Infectious Diseases Specialist, Fortis Hospital, Mulund & Kalyan, Mumbai, said, “With the growing emphasis on early and accessible diagnosis, more individuals are becoming proactive about understanding their symptoms and lab reports. This has led to a noticeable rise in what clinicians often refer to as ‘Google diagnosis,' where patients arrive with self-researched conclusions based on online information or AI-enabled report analyses.”

Why is accurate diagnosis important?

The expert went on to say that interpreting symptoms and investigations is rarely straightforward. Fever, for instance, is merely a symptom and can stem from a wide range of causes, from infections to non-infectious conditions such as thyroid disorders. While digital tools and AI platforms can analyse reports and suggest possible conditions, they typically rely on common algorithm-based differentials. In some cases, this may lead to alarming or misleading possibilities such as tuberculosis or even cancer, when the underlying issue could be far less serious.

Accurate diagnosis requires more than data interpretation; it demands clinical expertise, physical examination, and years of medical experience to connect symptoms, history, and test results. Over-reliance on online searches can sometimes lead to unnecessary anxiety, delayed diagnosis, or even self-medication, which may complicate the condition further.

The importance of taking time to explain the reasoning behind prescribed medication is essential, especially when informing a patient that an antibiotic cannot cure their flu.