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.

A new study has revealed an alarming trend in stroke cases in the past three decades. Strokes have often been associated as an age-related disease. But according to a study published in Neurology, the rate of stroke among adults aged 20 to 54 has nearly doubled between 1993-94 and 2020.

Researchers examined data from the Greater Cincinnati and Northern Kentucky Stroke Study and identified 2,076 first-time strokes among people in this age group.

The rate of stroke rose from 33.9 cases per 100,000 person-years in 1993-94 to 62.2 in 2020. The increase was largely driven by ischemic stroke, which happens when a blood vessel in the brain becomes blocked.

The study points towards an alarming pattern, especially among younger age groups. It raises the question of why are strokes are occurring earlier in life?

High Blood Pressure, Diabetes And Other Risks

The researchers found that several risk factors of stroke became more common among younger people. These included lifestyle disorders like high blood pressure, diabetes and atrial fibrillation, an irregular heart rhythm that can increase the risk of blood clots.

Apart from lifestyle diseases, researchers also saw an increase in substance use. Among younger adults who had suffered a stroke, substance use rose from 4.6% in 1993-94 to 40.2% in 2020. Much of this increase was linked to marijuana use.

However, the study does not prove that these factors caused the overall rise in stroke rates. Researchers did not have comparable information from people who had not suffered a stroke, making it impossible to determine whether the changing risk factors directly explain the surge in cases.

According to the study, the increase was concentrated mainly in ischemic strokes. The rate of ischemic stroke among 20- to 54-year-olds rose from 23.8 to 47.3 cases per 100,000 person-years during the study period.

Researchers did not observe a similar increase in intracerebral haemorrhage, which involves bleeding within the brain, or subarachnoid haemorrhage, which involves bleeding around the brain.

Also read: Can A Roller Coaster Cause A Brain Bleed? What Sudden Acceleration And Deceleration Does To The Brain

What Is An Ischemic Stroke?

An ischemic stroke occurs when a blood vessel supplying part of the brain becomes blocked, cutting off oxygen and nutrients. Brain cells can start dying within minutes, which is why stroke treatment is highly time-sensitive.

The warning signs of stroke can appear suddenly. They include:

• Facial drooping
• Weakness
• Numbness in an arm or leg
• Difficulty speaking

The commonly used FAST acronym stands for Face, Arm, Speech and Time. If these symptoms appear, emergency medical care should be sought immediately.

Also read: UK Student Nearly Dies After Accidental Paracetamol Overdose: Why It Can Cause Liver Failure

More Young People Are Surviving Stroke

This is another interesting finding. Although stroke became more common among younger adults, the study found that the 30-day death rate declined modestly, from 11.7% in 1993-94 to 9.4% in 2020 after adjusting for age, race and sex.

That means more younger people may be surviving strokes but potentially living with their long-term consequences.

The researchers say the findings highlight the importance of identifying and managing stroke risk factors earlier in adulthood. More research is still required to understand what is behind the changing pattern and how it can be prevented.

A 20-year-old UK student nearly died after accidentally taking two over-the-counter medicines that both contained paracetamol.

Riley Lubas, a first-year University of Bath student, developed a bad cold in March 2025. Days later, he developed severe stomach pain and was found to have serious liver damage.

What Happened?

Doctors initially suspected hepatitis, but Riley's condition rapidly worsened. He became delirious and hallucinated as his liver began to fail. His lungs and kidneys also stopped working, leaving him in multiple organ failure.

He was placed on life support and dialysis before being transferred to King's College Hospital in London, where doctors identified the cause after asking about his paracetamol use.

"It didn't necessarily help with a solution, but it was good to know the cause at last," his father, Chris, said.

Also read: ‘Zombie’ Drug Medetomidine, Spotted In Heroin Supply, Raises Concern As It Could Evade Overdose Antidote

Riley Had To Learn To Walk And Talk Again

Riley was assessed for a liver transplant after his parents were warned that some of the damage could be "irreversible". But his liver began to recover.

"We watched Riley's situation closely for a couple of days, and he continued to improve, until he was taken off dialysis and life support just a week later."

Riley spent six weeks at King's College Hospital and later moved to an ICU in Newport. After a tracheostomy and multiple organ failure, he had to relearn how to speak and walk.

"But just seeing him up and alive again was unbelievable," his father said.

Riley has since recovered and returned to work as a bartender.

"It was mad how quickly it all escalated," he said.

"Because I was already sick, when my stomach hurt I just assumed I'd caught a stomach bug, so I didn't notice the pain in my liver specifically."

"I'm just so grateful that I was able to come out the other end alright."

Why Combining Cold And Flu Medicines Can Be Risky

Read More: Are GLP-1 Drugs Safe for Children? Study Finds Nutritional Deficiency in Nearly 17% Within a Year

Riley's case highlights the risk of taking multiple medicines without realizing they contain the same active ingredient.

Dr Will Mackintosh, a GP and chairman of RCGP Cymru Wales, said accidental paracetamol overdose in young people was "a fairly rare occurrence", but warned that people can inadvertently take two products containing paracetamol, BBC reported.

The Medicines and Healthcare products Regulatory Agency (MHRA) has warned that "simple misunderstandings" about medicines can have serious consequences, highlighting the importance of checking the ingredients beforehand.

The Royal College of General Practitioners Cymru Wales also advised people to "read the label carefully" before taking medicines.

How Much Paracetamol Is Safe?

For most adults, the usual dose is 500 mg to 1,000 mg at a time, with at least four hours between doses.

The usual maximum is 4,000 mg in 24 hours, although some people may need a lower dose because of their weight, liver or kidney problems, alcohol use or other health conditions.

The important point is to count paracetamol from all medicines, including cold and flu products.

How Can An Overdose Damage The Liver?

The liver breaks down paracetamol. When too much is taken, a toxic substance can build up and damage liver cells. Severe overdose can lead to liver failure and death.

Early symptoms may include nausea, vomiting and stomach pain, but serious poisoning may not cause obvious symptoms immediately. Later signs can include jaundice, confusion and extreme sleepiness.

What To Do After Taking Too Much

If you think you have taken too much paracetamol — including by combining medicines that contain it — seek urgent medical advice immediately.

Do not wait for symptoms. Early treatment can reduce the risk of serious liver damage.

Always check the active ingredients on painkillers and cold and flu medicines before taking them together.

Doctors at a Mumbai hospital successfully performed a complex coronary angioplasty on an elderly diabetic patient with severely calcified coronary arteries using an advanced technique called Intravascular Lithotripsy (IVL), helping restore blood flow to the heart despite multiple procedural challenges.

The patient, who had been experiencing symptoms suggestive of coronary artery disease, was found to have extensive calcium deposits in the coronary arteries. Further evaluation also revealed poor blood flow in the leg arteries, making conventional vascular access for the procedure difficult.

What Is Coronary Artery Calcification?

Coronary artery calcification is commonly seen in elderly individuals and people with long-standing diabetes. Excessive calcium makes the arteries rigid and narrow, often making routine angioplasty technically challenging and increasing the risk of incomplete stent expansion, which can affect long-term outcomes

Severely calcified coronary arteries remain one of the biggest challenges in interventional cardiology. The calcium makes the arteries extremely rigid, making it difficult to properly expand the stent. In such situations, conventional angioplasty alone may not be sufficient.

Despite the patient’s complex anatomy and poor peripheral vascular access, the team successfully performed the procedure through the radial artery in the wrist, avoiding access through the diseased leg vessels.

Also read: Stopping Ozempic, Wegovy, Mounjaro Linked To 22% Higher Heart Attack, Stroke Risk: Study

Breaking Deep Calcium Deposits In Artery Wall

To prepare the artery for stenting, doctors used Intravascular Lithotripsy (IVL), an advanced technology that delivers controlled sonic pressure waves to fracture deep calcium deposits within the artery wall. This allows the blood vessel to expand more effectively, enabling safe and optimal placement of the coronary stent.

IVL works on a principle similar to the technology used for breaking kidney stones, but it is specifically designed for heavily calcified coronary arteries. By modifying the calcium before placing the stent, we can achieve better stent expansion, reduce procedural complications and improve long-term outcomes in appropriately selected patients.

The procedure was completed successfully, with excellent blood flow restored to the affected coronary artery. The patient recovered well and was discharged in a stable condition.

Doctors say the case highlights how newer technologies are expanding treatment options for patients who were once considered extremely difficult to treat due to severe coronary calcification.

Advanced techniques such as IVL are transforming the management of complex coronary artery disease, particularly in elderly diabetic patients, allowing us to safely treat lesions that would have been significantly more challenging with conventional techniques alone.

The case underscores the growing role of advanced interventional cardiology in treating complex heart disease while minimising procedural risk and improving patient outcomes.