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 today’s digital age, screens have become almost inseparable from daily life—even for very young children. While technology offers convenience and learning opportunities, increasing clinical observations have raised concerns about a phenomenon often referred to as “virtual autism." In an interview with Health and Me, Dr Aarti Javeri Manek, Paediatric Neurologist at Sir HN Reliance Foundation Hospital, explained what virtual autism is and the impact of screen time on children's brain health.

What is “virtual autism”?

Virtual autism is not a formally recognised medical diagnosis but rather a descriptive term used for children—typically toddlers—who exhibit autism-like features in the context of excessive screen exposure, particularly during critical periods of brain development. These children may show reduced eye contact, delayed speech, poor social interaction, and limited responsiveness to their environment.

Also Read: Cancer Is The 10th Leading Cause Of Death In Indian Children: Study

However, it is crucial to distinguish this entity from clinical Autism Spectrum Disorder (ASD). ASD is a neurodevelopmental condition, often with a strong underlying genetic and biological basis, present in addition to exogenous influences. External stimulus exposure may not even be apparent. In contrast, children with virtual autism often demonstrate significant improvement when screen time is reduced and replaced with real-world, interactive experiences. This reversibility is a key differentiating factor.

Read more: Is My Child Shy Or Autistic? Psychiatrist Shares Tips To Help Parents Spot Early Signs

What early signs should parents watch for?

From a neurological perspective, early childhood is a period of rapid synaptic growth, heavily influenced by sensory and social input. When screens replace human interaction, this can impact language acquisition, attention, and social interaction.

Some red flags that may suggest screen-related developmental delays include:

1. Limited or absent eye contact
2. Reduced response to name
3. Delayed speech or loss of previously acquired words
4. Preference for screens over people
5. Decreased or limited gestures (not pointing, showing, or sharing interest)
6. Repetitive behaviours such as watching the same videos excessively or viewing the same rhyme persistently
7. Irritability or meltdowns when screens are removed

While these signs overlap with autism, the context is important. A history of prolonged, unsupervised screen exposure, often exceeding 3–4 hours per day in toddlers, should prompt consideration of environmental impact.

Read more: Can Cell Therapy Be The Future Of Autism Treatment?

Are toddlers at greater risk compared to older children?

Yes, significantly so. The first three years of life are critical for brain development, particularly for language, social bonding, and emotional regulation. During this period, the brain relies heavily on serve-and-return interactions—a child babbles, a caregiver responds; a child points, and a parent names the object. These exchanges build neural circuits essential for communication and cognition.

Screens, even educational ones, are inherently passive. They do not adapt in real time to a child’s cues in the same way a human does. Excessive exposure during this sensitive window can therefore displace meaningful interactions, leading to significant developmental delays.

Older children, while not immune, are generally more resilient, as they have already established foundational social and language skills. However, excessive screen time in this group may still contribute to attention difficulties, behavioural issues, and reduced social engagement.

What can parents do?

The encouraging aspect of virtual autism is its potential reversibility if it is identified early. Reducing screen exposure, especially in children under 2 years, and reintroducing interactive play, storytelling, and face-to-face communication may lead to noticeable improvements. Ultimately, screens are tools and not substitutes for relationships. In early childhood, it is these relationships that shape the developing brain most profoundly.

For some people, getting inked is more than a passion—it is a form of self-expression. And tattoos are nothing short of an addiction; it is not easy to stop at one. Despite being a painful procedure that requires a great deal of caution—using fresh needles and safe ink, for instance—several incidents come to light where getting a tattoo goes wrong in irreversible ways. In a recent case, a man developed a weeping, black ulcer of dead flesh on his neck months after getting a tattoo. In this case, doctors blamed this reaction on the colour of the tattoo ink—it may have triggered inflammation that caused the skin to blacken and die.

A reaction from the tattoo ink

A 20-year-old man had a red cross tattoo on the base of his neck. After three months, it faded away spontaneously and was replaced by scars and bumps on either side of the neck, accompanied by a necrotic ulcer. In this case, when the tissue blackens and dies, it results in a painful wound. The unnamed man was hospitalised five months after getting his first tattoo. Doctors examining the patient found that the lymph nodes, which help fight infections, were swollen and hard. Doctors also examined a large crusted ulcer, which had spread across the base of the neck and had seeped into deeper layers of skin.

Read more: Tattoos May Increase Cancer Risk, Study Suggests

Doctors also performed an MRI and found large lumps around the ulcer that measured up to 5 cm. There were two blood clots in the jugular vein as well. Two biopsies were taken of the necrotic ulcer, but they did not reveal what may have triggered the necrosis. The team was then concerned about the scan results and how fast the patient's condition was progressing. He was then rushed into surgery, where doctors removed the ulcer along with masses on the neck. His neck was then reconstructed using fat from the thighs. The patient was then diagnosed with necrotising granulomatous lymphadenitis.

What is necrotising granulomatous lymphadenitis?

Necrotising granulomatous lymphadenitis is an inflammatory condition wherein the lymph node tissues die and form clumps of immune cells known as granulomas. This can develop in response to an injury, and in this case, doctors said that the tattoo was to blame.

Doctors said that heavy metals like cadmium and mercury in organic tattoo ink can result in an immune response. From surgery to recovery, the patient's case is published in the journal JAMA Otolaryngology. Experts say that this is only the second known case of necrosis after a tattoo.

What are the riskiest spots for a tattoo?

Getting a tattoo can be painful, but for some people, the pain is worth it. However, according to experts, there are some spots that are not ideal for getting a tattoo. These are:

1. Eyes—can lead to partial or complete blindness
2. Genitals – heightened risk of contracting sexually transmitted diseases and infections
3. Spine – a tattoo on the spine is extremely painful, and if it goes wrong, there could be irreversible repercussions

As winter transitions into warmer summer months, many people notice a sudden worsening of dandruff. During colder months, dandruff often appears as dry, fine flakes due to scalp dryness. However, as temperatures rise and humidity increases, dandruff can become oily and sticky because of increased sweating and sebum production. This seasonal shift highlights that dandruff is not limited to a particular time of year; rather, changes in climate can disrupt scalp balance and trigger flare-ups. Dr. Anupriya Goel, MBBS, MD, DPD (UK) – Dermatology, answered this for us.

Why does dandruff recur?

Many people struggle to understand why dandruff keeps recurring. It is often treated as a temporary cosmetic concern, but in reality, dandruff is a chronic scalp condition that requires consistent care and appropriate treatment. The primary cause of dandruff is a yeast called Malassezia globosa, which naturally resides on the scalp. This microorganism feeds on sebum (the natural oils produced by the scalp). As it breaks down these oils, it releases by-products that can irritate the scalp, leading to inflammation, itching, and visible flaking.

Seasonal factors further aggravate this process. In winter, cold air, low humidity, indoor heating, and frequent hot showers can strip the scalp of its natural moisture and weaken the skin barrier, resulting in dryness and flaking. In contrast, summer brings increased sweat and oil production. The combination of humidity, sweat, and sebum creates an ideal environment for Malassezia to multiply, which can worsen dandruff symptoms.

Read here: Simple Secrets To Establishing The Right Winter Hair Care Routine

What are the external factors responsible for dandruff?

Environmental factors such as pollution can also settle on the scalp and contribute to irritation. In addition, daily habits like wearing helmets for long hours, tying up damp hair, or not cleansing the scalp regularly can further disrupt scalp health. The transition period between seasons is often the most challenging, as the scalp has limited time to adapt to changing environmental conditions.

Because dandruff is often mistaken for a temporary issue, many people rely on occasional treatments or home remedies. However, effective management typically requires regular scalp-focused care using clinically proven active ingredients.

Treating dandruff

One such ingredient commonly used in anti-dandruff formulations is Piroctone Olamine, an antifungal agent that helps control the growth of Malassezia on the scalp. By reducing fungal proliferation, it helps address the underlying cause of dandruff and can assist in decreasing flaking, itching, and scalp irritation. It also helps cleanse the scalp by removing excess oil and buildup while being relatively gentle on the hair and scalp.

Read more: 7 Ayurvedic Hair Health Tips You Should Try For Healthy Locks

For optimal results, individuals experiencing recurrent dandruff may benefit from incorporating an anti-dandruff shampoo containing Piroctone Olamine into their regular hair care routine. Consistent use is important for maintaining scalp balance. During periods of increased sweating, such as in hot and humid weather, washing frequency may be increased as needed. Maintaining hygiene practices such as regularly cleaning helmets, pillowcases, and hair accessories can also help minimise recurrence.

In addition to controlling dandruff, well-formulated shampoos containing Piroctone Olamine are often combined with conditioning and moisturising ingredients that help maintain hair softness and scalp comfort while supporting long-term scalp balance.