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.

In a recent post, Dr Sudhir Kumar shared the case of a five-year-old Rishi, a seemingly healthy boy, who suddenly started showing symptoms of deafness and even vision loss. However, the problem wasn’t as surface level as it seemed, as the boy’s brain health was the root cause.

Dr Sudhir Kumar, a Bangalore-based neurologist, shared the rare neurological case of Landau-Kleffner syndrome, he encountered in a five-year-old on the social media platform X.

What is Landau-Kleffner Syndrome?

According to John Hopkins Medicine, Landau-Kleffner Syndrome is a rare nervous system disorder that can cause the loss of ability to understand and use language.

They explain that it can happen to a child who has been developing normally and can also cause seizures. It can happen over time or even suddenly.

But what causes it and is it treatable? The condition is treatable with speech therapy and medication; however, not much is known regarding what causes it.

Researchers say it could be caused by mutation in the genes or the immune system attacking its own tissues like an autoimmune disorder.

Can A Child Stop Hearing Out Of The Blue?

While the first 3 years of Rishi’s life was on track with the development of an average child, things quickly changed.

He stopped looking up when his name was called and acted as if he couldn't hear at all. His parents took him to ear specialists, but the tests showed his ears were perfectly healthy. Over the next year, Rishi stopped speaking entirely and was eventually labeled as "deaf and mute."

Dr Sudhir explained that the timeline of his symptoms didn't match typical deafness. Most children who can't hear are born that way; they don't usually start talking and then suddenly stop.

This suggested that Rishi hadn't lost his hearing, he had lost his ability to understand sound. To solve the mystery, the doctor ordered a sleep EEG to monitor Rishi’s brain waves overnight.

What Are The Symptoms Of Landau-Kleffner Syndrome?

The symptoms of Landau-Kleffner Syndrome can be confusing because they often look like hearing loss or autism. Based on Rishi’s experience, the main signs include:

• Word deafness, which means that the child might hear a sound (like a bell) but cannot understand spoken words.

• Loss of speech is one of the main symptoms of this condition. As the child stops understanding language, they eventually stop speaking the words they once knew.

• Behavioral changes like the children may become frustrated or seem unaware of their surroundings.

• Hidden seizures could also be a symptom. While some children have physical seizures, many (like Rishi) only have abnormal brain activity during sleep.

Is Landau-Kleffner Syndrome Treatable?

The most important takeaway for Rishi’s family was that LKS is treatable. Because it is caused by abnormal electrical activity, doctors can use anti-seizure medications to "calm" the brain. Once Rishi started his treatment, the results were life-changing.

After three months, he began responding to his name again. Within six months, he was talking, playing, and laughing just like any other child. The "silence" in his home was finally gone.

Rishi’s story is a reminder that when a child suddenly loses language skills, every second counts. If LKS is caught early, the brain has a much better chance of recovering and rewiring itself.

If left untreated for too long, the loss of speech could become permanent. By understanding that the problem was in the brain and not the ears, Rishi’s doctors were able to give him his future back.

Hearing is one of the most vital yet overlooked senses—and its impact extends far beyond the ears. It shapes how a child learns to speak, how a student performs in school, how adults stay socially connected, and even how the brain ages.

As Dr NVK Mohan, ENT and Cochlear Implant Surgeon at CK Birla Hospitals, CMRI, explains, “Hearing is one of the most vital yet overlooked senses, and its impact extends far beyond the ears.”

This World Hearing Day, the focus is clear: ignoring hearing loss doesn’t just affect sound—it affects development, confidence, learning, and long-term brain health.

What Is Hearing Loss?

Hearing loss can happen when any part of the ear is not working in the usual way. This includes:

• The outer ear
• The middle ear
• The inner ear
• The hearing (acoustic) nerve
• The auditory system in the brain

When sound cannot travel properly through these structures—or when the brain cannot process sound clearly—hearing becomes impaired. It may be partial or complete, temporary or permanent, and can occur at any stage of life, from before birth to adulthood.

In Children: The Impact Goes Beyond the Ears

In children, hearing plays a central role in speech and language development. Even mild hearing loss can cause a child to miss critical sounds needed to build vocabulary and clear speech.

Dr Mohan notes, “In children, undetected hearing loss can interfere with speech development, learning ability, and social interaction, often affecting confidence and academic performance well into adulthood.”

Many parents assume that if a child responds to loud sounds, their hearing must be normal. But hearing is more complex than that.

“Healthy hearing requires the ability to perceive sounds across all frequencies, especially those essential for speech and language development,” he explains. “Delayed identification can mean missed developmental milestones that are difficult to recover later.”

Signs of Hearing Loss in Babies

Even if a baby has previously passed a hearing screening, parents should continue to look for warning signs:

• Does not startle at loud noises
• Does not turn to the source of a sound after 6 months of age
• Does not say single words like “mama” or “dada” by 1 year
• Turns head when seeing you but not when you call their name
• Seems to hear some sounds but not others

What may look like inattention can sometimes be partial or complete hearing loss.

Signs of Hearing Loss in Children

As children grow, signs may include:

• Delayed speech
• Unclear speech
• Difficulty following directions
• Frequently saying “Huh?”
• Turning the TV or radio volume up too high

Babies and children are expected to reach developmental milestones in how they play, learn, communicate, and behave. A delay in these areas could indicate hearing loss or another developmental concern—and should prompt a hearing evaluation.

What Causes Hearing Loss?

Hearing loss can occur at any time during life.

Genetic Causes

About 1 in 2 cases of hearing loss in babies are due to genetic factors. Some babies may have family members with hearing loss. Around 1 in 3 babies with genetic hearing loss have a syndrome, meaning they have additional conditions such as Down syndrome or Usher syndrome.

Other Risk Factors

Around 1 in 4 cases are linked to:

• Maternal infections during pregnancy
• Complications after birth
• Spending 5 days or more in a neonatal intensive care unit (NICU)
• Severe jaundice requiring blood transfusion
• Structural differences in the head, face, or ears
• Neurological disorders
• Meningitis
• Severe head injuries requiring hospitalization

Recognizing these risks allows for closer monitoring and earlier diagnosis.

In Adults: When Hearing Loss Affects the Brain

The consequences of untreated hearing loss do not stop in childhood. In adults and older individuals, the risks shift from speech delays to brain health.

Dr Mohan highlights, “In adults and the elderly, untreated hearing loss is increasingly being linked to social withdrawal, memory problems, and cognitive decline.”

When the brain does not receive clear sound input, it must work harder to interpret speech.

“When the brain is deprived of clear sound input, it has to work harder to interpret speech, diverting cognitive resources away from memory and higher mental functions,” he explains. “Over time, this reduced auditory stimulation and social disengagement can increase the risk of accelerated cognitive ageing.”

In simple terms, when hearing decreases, conversations become exhausting. People may begin to withdraw socially. The brain receives less stimulation. Over time, this combination can affect cognitive resilience.

Hearing health, therefore, is closely linked to brain health.

Prevention: What Can Be Done?

While not all hearing loss can be prevented, certain measures reduce risk:

• Maintain a healthy pregnancy
• Ensure children receive recommended vaccinations
• Protect children from high noise levels
• Seek prompt treatment for ear infections

Noise-induced hearing loss, in particular, is preventable with awareness and protection.

Screening and Early Diagnosis: The Most Important Step

The most important message, experts say, is that hearing loss is both detectable and manageable—especially when addressed early.

“Hearing screening is easy and not painful. Babies are often asleep during the test, and it usually takes only a few minutes,” Dr Mohan says.

For Babies

• All babies should undergo hearing screening by 1 month of age.
• If a baby does not pass, a full hearing test should ideally be completed by 3 months.

For Children

• Hearing should be tested before school entry.
• Testing should also be done whenever there are concerns about speech delay, learning difficulties, or recurrent ear infections.
• Routine hearing checks are equally important for adults, particularly as they age.

Vaccinated for human papillomavirus (HPV)? Now, take that Pap smear test. This is the most common advice women hear to prevent the risk of cervical cancer that annually causes around 6,60,000 new cases and around 350,000 deaths worldwide.

However, it's easier said than done for most of the fairer sex.

A Pap smear is typically a gynecological examination where a speculum is inserted to collect cells from the cervix.

Although the procedure is brief and generally safe, the discomfort discourages many from getting screened. Fear of pain, anxiety of the results, form the common psychological barriers worldwide, and is followed by shame, cultural attitudes, and concerns with male clinicians.

A study in Iran, published in the BMJ Open journal in January 2024, showed that psychological stress, cultural issues, and fear, along with limited information and health services, were the biggest hindrances to getting Pap tests.

Another research published in the BMC Women's Health in December 2022, focusing on Africa, Asia, and South America, reported that many women avoided or delayed Pap smears because they are afraid the procedure will hurt. Many also reported being embarrassed about the pelvic exam or fear of having a stranger see their private areas. Some also worried that the test could damage the uterus.

A Pap Smear test, however, is proven to be safe and is recommended for every woman above the age of 21 years.

“A Pap smear is a rapid, safe, and painless screening procedure that detects irregular cellular changes well before they become malignant. The ability to treat at this pre-cancerous stage of disease provides an excellent outcome,” Dr. Tirathram Kaushik, Senior Consultant GI, HPB, Gastrointestinal & Thoracic Oncology and Robotic Surgery, HCG Cancer Centre, Borivali, told HealthandMe.

A 2025 study, published in the Journal of Contemporary Clinical Practice, showed that pap smears are excellent at ruling out precancerous risks. It also remains a valuable screening tool where molecular testing is limited.

There are many myths about Pap smears that make people anxious or avoid screening. Let’s clear up the most common ones:

Pap Smears Are Painful

The Pap smear procedure, which takes only a few minutes, is often described as uncomfortable. While some feel like a quick pinch, others experience slight discomfort or spotting. Severe pain is not considered normal.

“From an oncology perspective, this myth results in a delay in diagnosis. Cervical cancer often occurs silently in its early stages, without any noticeable symptoms,” Kaushik said.

I Am Healthy, So I Don’t Need A Pap Smear

While individuals may feel completely well, they still have abnormal cells developing silently. As a result, regular Pap smear screening is important because it detects these changes early -- before they turn into cervical cancer.

“The HPV infection and subsequent changes that lead to cervical cancer happen slowly over many years. HPV infection is also very common, and one in two women is likely to get infected. Regular screening by a Pap smear will help to catch infection early before it can convert into cancer,” Dr. Deepak Jha, Chief - Breast Surgery & Sr. Consultant Surgical Oncology, Artemis Hospitals, told HealthandMe.

I Have Only One Partner, So I Don’t Need Screening

“HPV doesn’t need penetrative sex for infection. It can be transferred if there is any contact of bodily fluid. It’s always safe to test and be assured rather than repent later,” Dr. Jha said.

Testing Means Cervical Cancer

“Even if HPV is detected, it usually indicates a pre-cancerous stage that is highly treatable,” Dr. Parminder Kaur, Consultant Gynecologic Oncologist at CK Birla Hospital, Delhi, told HealthandMe.

Moreover, a Pap smear only screens for cervical cancer; it can’t detect other gynecological cancers such as cervical, ovarian, uterine (endometrial), vaginal, and vulvar cancers. So, screening and appropriate tests for those will be required, irrespective of the Pap smear.

I Am Old, So I Don’t Need A Pap Smear

I Got Vaccinated, So I Do Not Need A Pap Smear

Irrespective of vaccinated status, a woman should go for regular screening between the ages of 25 and 79. Also, if a woman already had HPV exposure before being vaccinated, she would not benefit, the experts said.

“Screening is not just a routine procedure - it is a preventive measure. In the treatment of cancer, early detection alters the disease course, whereas waiting for symptoms to develop means the disease is likely to be already advanced,” Dr. Kaushik said.

Dr Kaur called for more awareness and stated that open discussion are key to help more women take the important screening test.

When To Get Screened

The United States Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS) recommend getting your first Pap test at age 21, followed by Pap testing every 3 years. Even if you are sexually active, you do not need a Pap test before age 21.

• Individuals must start getting Pap tests at age 21. If the result is normal, repeat the test after three years.
• For individuals aged between 30 and 65 years old, doctors are likely to recommend an HPV test along with a Pap test. If both are normal, repeat after five years.

In women older than 65, you don't need to be screened anymore if:

• You have had at least three Pap tests or two HPV tests in the past 10 years, and the test results were normal or negative, and
• You have not had a cervical precancer in the past, or
• You have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids.