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.

For all major diseases, early detection is key to improving treatment outcomes. However, when it comes to rare diseases, it is unpredictable, making it more challenging to diagnose. In such a scenario, Artificial Intelligence (AI) is playing a major role -- from early diagnosis to treatment, said health experts on Rare Disease Day.

Rare Disease Day is annually observed on February 28 to raise awareness about the lesser-known conditions and the underlying challenges for people suffering from them.

While many of the rare disorders are genetic, they often also surface without any prior family history. In some cases, they are diagnosed in infancy, while in others the manifestation is years late.

The advanced AI technology is, however, now enabling clinicians to better understand the patients’ genetic profiles and patterns that were not clearer earlier. The technology is also paving the way for earlier and more accurate diagnoses, bringing hope to thousands of patients worldwide.

“AI is revolutionizing the fight against rare diseases by speeding up diagnosis, research, and development of treatments. Rare diseases often take years to diagnose because of the lack of data, overlapping symptoms, and unclear diagnosis,” Dr. Vinit Banga, Director, Neurology, Fortis Escorts Hospital, Faridabad, told HealthandMe.

“AI algorithms can process medical records, genetic information, and images to identify patterns that may escape human detection, allowing for earlier and more accurate diagnoses,” he added.

AI Simplifying Rare Disease Diagnoses, Drug development

In a February paper published in the journal Nature, researchers from the Shanghai Jiao Tong University in China presented an AI system called DeepRare -- a multi-agent system for rare disease differential diagnosis decision support, powered by large language models, integrating more than 40 specialized tools.

Using the specialized tools and knowledge sources, the agentic AI system generates ranked diagnostic hypotheses for rare diseases. Each of the tools was also accompanied by reasoning that links the conclusions to verifiable medical evidence.

Similarly, Harvard University-based researchers in a paper also published in the Nature journal in 2025 described an AI tool called PopEVE, which can identify genetic variants most likely to cause severe disease or death.

The model was able to identify more than 100 novel alterations responsible for undiagnosed, rare genetic diseases.

"AI is cutting short the diagnostic odyssey from years to weeks. Large-scale genomic projects help create a vital reference architecture for India and the global community,” Dr. Sudheendra Rao N R, MBBS, PhD, Scientific Advisor, Organization for Rare Diseases India, told HealthandMe.

By integrating deep phenotyping with AI, clinicians can decipher unknown genetic variants and accelerate the development of both repurposed and next-generation precision-therapies, the expert added.

AI can also help researchers identify new drug targets for the treatment of rare conditions.

Dr. Banga said that AI is also instrumental in accelerating drug development by processing enormous amounts of biomedical data to discover new targets for drugs and repurpose existing ones. Importantly, AI is cutting down on time and expenses.

“Machine learning algorithms enable the prediction of patient responses to particular treatments, making it possible to develop personalized treatment strategies,” the expert said.

Further, AI-enabled infrastructure is helping to achieve geographic neutrality, delivering the same caliber of healthcare screening to rural villages and Tier-3 cities as to Tier-1 hubs, ensuring a high-quality healthcare gateway that is no longer defined by where the patient lives.

Moreover, AI-based platforms bring together researchers from across the globe, making it easier to share data.

What Is A Rare Disease

The World Health Organization (WHO) defines a rare disease as an often debilitating, chronic, or degenerative condition affecting 1 or fewer per 1,000 population.

Rare diseases do not have epidemiological data, are at high risk of misdiagnosis, and often also lack effective treatments.

According to the WHO ICD-11 (International Classification of Diseases), there are over 5,500 rare diseases. It also assigns unique identifiers (URIs) to them for better tracking.

There are estimated to be over 7,000 distinct rare diseases affecting more than 300 million people globally.

Do you know that congenital hypothyroidism, a rare disability, affects about 1 in 2,500–3,000 newborns globally, but in India, the incidence is higher -- approximately 1 in 1,000 births.

India records nearly 26 million births annually, with an estimated 10,000 babies born each year with Congenital Hypothyroidism.

This means 27 babies are born every day in India, with the condition that more than one is born every hour. Early treatment within the first 2 weeks of life can ensure normal brain development, while delayed treatment can reduce IQ by 30–50 points.

Congenital Hypothyroidism (CH) is a condition present at birth in which a baby’s thyroid gland does not produce enough thyroid hormone.

The thyroid is a small gland located in the neck. It produces a hormone called thyroxine (T4), which is essential for brain development, growth, and overall body metabolism. The thyroid hormone is especially important in the first few weeks of life.

The thyroid hormone helps in:

• Brain development
• Physical growth
• Bone development
• Muscle strength
• Energy regulation

If a baby does not receive enough thyroid hormones soon after birth, it can lead to permanent intellectual disability and growth problems.

The good news is that congenital hypothyroidism is easily detectable and completely treatable if identified early.

What Causes Congenital Hypothyroidism? What Are The Symptoms?

Congenital Hypothyroidism may occur because:

• The thyroid gland is completely absent
• The thyroid gland is underdeveloped
• The gland is present but does not function properly
• Rarely, the baby cannot produce or use the thyroid hormone correctly

One of the biggest challenges with Congenital Hypothyroidism is that most babies look completely normal at birth.

However, over time, some signs may appear:

• Excessive sleepiness
• Poor feeding
• Constipation
• Prolonged jaundice (yellowing of skin and eyes)
• Hoarse cry
• Large tongue
• Puffy face
• Cold or dry skin
• Slow growth

How Is Congenital Hypothyroidism Detected?

1. Newborn Screening Test (Heel-Prick Test)

• This is the most important test.
• A few drops of blood are taken from the baby’s heel.
• It is usually done 48–72 hours after birth, but can be done soon after birth on the cord blood, too.
• Test measures Thyroid Stimulating Hormone (TSH).
• If TSH levels are high, it suggests that the thyroid is not functioning properly.
• This test is simple, safe, quick, and affordable

2. Confirmatory Blood Tests

If the screening test is abnormal, the doctor will order:

• Serum TSH test
• Free T4 (thyroxine) level
• High TSH and low T4 confirm the diagnosis

3. Thyroid Scan

In some cases, imaging tests are needed. The ultrasound of the neck (less accurate) and Nuclear Medicine Thyroid scan (more accurate) may be done to check whether the gland is absent, small, or misplaced. However, treatment should not be delayed while waiting for imaging.

When Should Treatment Start?

Treatment should begin as early as possible -- ideally within the first 14 days of life. Starting treatment within the first two weeks allows normal brain development.

Delaying treatment increases the risk of permanent intellectual disability.

Doctors will monitor:

• TSH levels
• T4 levels
• Baby’s growth and development

Initially, blood tests are done every 2–4 weeks, then less frequently as the child grows. Proper follow-up ensures the dose remains correct. Some babies may need treatment for life.

In certain cases, doctors may reassess thyroid function after 3 years of age to see whether the condition is temporary or permanent. Most children who receive early and proper treatment grow up with completely normal intelligence and physical development.

Can Congenital Hypothyroidism Be Prevented? Why Early Screening Is So Important

Most cases cannot be prevented. However:

• Universal newborn screening can prevent intellectual disability
• Ensuring adequate iodine intake during pregnancy helps reduce risk
• The key is early detection—not prevention

A baby with Congenital Hypothyroidism may look perfectly healthy. Without screening, diagnosis may be delayed until symptoms appear—by then, brain development may already be affected.

With early testing the diagnosis is simple; treatment is affordable; and outcome is excellent. But without testing:

• Intellectual disability can occur
• Growth may be affected
• The child may require lifelong support

Congenital Hypothyroidism is one of the most preventable causes of intellectual disability in children. A small heel-prick test in the first few days of life can protect your baby’s brain forever.

If you are expecting a baby or have a newborn, speak to your doctor about newborn thyroid screening.

Early diagnosis. Simple treatment. Normal life.

Prime Minister Narendra Modi today launched the nationwide Human Papillomavirus (HPV) vaccination campaign for girls aged 14 years from Rajasthan's Ajmer.

The initiative marks a decisive step towards eliminating cervical cancer through timely HPV vaccination. Cervical cancer remains the second most common cancer among women in India. Nearly 80,000 new cases and over 42,000 deaths are reported annually in the country.

"Today, I have had the opportunity to launch the HPV vaccine campaign from Ajmer. This campaign is an important step towards empowering women and daughters of this country,” PM Modi said.

“For us, this was a sensitive issue tied to the insult of our sisters and daughters, one that made them ill. That is why we resolved it at a crucial turning point in their mission,” he added.

The World Health Organization has also lauded India's mission to launch the HPV vaccine and prevent the risk of cervical cancer.

“We are leaving no stone unturned to ensure that the daughters of the country are healthy and prosperous. The objective of this initiative is the prevention of cervical cancer," the Prime Minister, earlier wrote in a post on social media platform X.

The HPV Vaccination Campaign

The nationwide program, based on expert recommendations of the National Technical Advisory Group on Immunization (NTAGI), will target girls aged 14 years.

At 14, the HPV vaccine offers maximum preventive benefit, well before potential exposure to the virus.

"By prioritizing prevention at the right age, the program is expected to provide lifelong protection and significantly reduce the future burden of cervical cancer in the country," the government said.

“The HPV vaccine works best at 9-14 years, before exposure, and when the immune response is strongest. Studies show effectiveness is highest in younger age groups and decreases with age,” Dr. Parmod Kumar, Associate Professor in Medical Oncology, AIIMS Jodhpur, shared on X.

Vaccination under the national program will be voluntary and free of cost.

The HPV vaccination will be conducted exclusively at designated government health facilities, including Ayushman Arogya Mandirs (Primary Health Centers), Community Health Centers, Sub-District and District Hospitals, and Government Medical Colleges.

Cervical Cancer Burden In South East Asia

Despite being preventable, cervical cancer continues to claim the life of a woman every two minutes globally, and the WHO South-East Asia Region bears nearly one-quarter of the global burden.

Dr. Catharina Boehme, Officer-in-Charge, WHO South-East Asia, stated that the introduction of HPV vaccination at a national scale in India "will have a far-reaching impact". It will accelerate progress not only for the country, but for the region and the world, she said.

“This landmark step, led at the highest level of government, reflects India’s strong commitment to protecting adolescent girls from cervical cancer," said Dr. Boehme.

With today’s milestone, nine of the 10 countries in the Region now include HPV vaccination in their national immunization programs.

The WHO global targets for 2030 include vaccinating 90 percent of girls by age 15, screening 70 percent of women by ages 35 and 45, and ensuring 90 percent of women with pre-cancer and invasive cancer receive appropriate treatment.