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.

Annabelle Gurwitch, an American author, actress, and television host, has opened up about her lung cancer diagnosis in her new memoir.

In her sixth book, ‘The End of My Life Is Killing Me’, Annabelle Gurwitch offers a satirical take on her journey with stage 4 lung cancer. The best-selling author found out about her cancer status in 2020, when she went for a COVID-19 test.

In the book, Annabelle Gurwitch writes about her life as a "cancer slacker", her divorce, treatment with a targeted therapy that turns off the gene that has gone rogue, radiation, and chemotherapy, all with a humorous take.

Lung Cancer: A Stealthy Disease, Says Annabelle Gurwitch

Notably, the American actress had no symptoms and was not a smoker. She went to get her “persistent little cough” tested for COVID, when a doctor told her that there was something suspicious on her lungs.

Soon after, an X-ray and a biopsy confirmed her diagnosis of stage 4 cancer.

Annabelle Gurwitch called lung cancer a “stealthy disease" as, other than her little cough, she exercised every day and felt like she was in really good health.

“You know, you can be asymptomatic with Stage 4 lung cancer because lung cancer is a really stealthy disease, and this is why it's such a big killer, still the No. 1 cause of cancer deaths, because some lung cancers, like the one I have, are not recognized by the immune system," Annabelle Gurwitch told NPR.

"So my body didn't know that it was - anything was happening, which is, I mean, I was going to regular doctor's appointments. And this is why it's often diagnosed at a late stage, and such a big killer because it's not diagnosed at an earlier stage,” she added.

Also read: Early-Stage Lung Cancer Surgery Safe, Effective Even After 80, Reveals Lancet Study

Can Non-Smokers Get Lung Cancer?

Contrary to long-held assumptions, a significant proportion of lung cancer cases now occur in people with no history of smoking. The American Cancer Society reports that approximately 10-20 percent of lung cancers in the U.S are found in non-smokers, often attributed to genetic mutations like EGFR, environmental exposures, or radon gas.

These cases are more common in women, younger adults, and individuals of East Asian descent, but they can affect anyone.

Also read: New AIIMS Study To Probe How PM2.5 Is Surging Lung Cancer Risk In India

Early Signs and Symptoms to Look Out For

Lung cancer symptoms can mimic less serious conditions, which is why they’re often dismissed or misdiagnosed. If you experience the following symptoms persistently, don’t ignore them—regardless of your age or smoking history:

• Chest pain or discomfort
• Unexplained shortness of breath
• Persistent cough or wheezing
• Shoulder, back, or rib pain
• Fatigue or sudden weight loss
• Blood in sputum (though not always present).

A visit to the emergency ward (ER) of a hospital can definitely feel scary, and you want every reason to avoid ending up there as a patient. From broken bones to life-threatening emergencies, it’s a place filled with urgency, uncertainty, and intense emotions. Imagine what doctors and other health workers face every day.

However, while many cases are unavoidable, there are several that can be completely prevented, said doctors, while sharing a few. These include:

• Symptoms ignored for long

However, ignoring symptoms like a persistent stomachache or a nagging cough can allow a condition to worsen over time, eventually leading to an emergency.

“People say, ‘It’s pretty mild. I’m not worried about it,’” Dr. Evelyn Huang, an emergency-room physician with Orlando Health, was quoted as saying to Time.

“Days become weeks, weeks become months, and months can even become years, and by the time they're seeing me, these things have progressed so far that they’re now something dangerous.”

Seeking timely medical advice and not delaying checkups can help prevent complications and avoid unnecessary ER visits, the expert said.

• Drowning

Dr. Cheyenne Falat, assistant medical director of the adult emergency department at University of Maryland Medical Center stated that every time a patient comes ER with a drowning case, he hears the same story.

“I would have been watching them, but I thought the babysitter was watching them. I thought my spouse was watching them. I thought their grandparents were watching them.”

The doctor recommended instead starting swimming lessons as early as possible. She also urged for fences with childproof gates near pools.

• Falling

• Frostbite and hypothermia

People often don’t realize how quickly conditions can turn.

“They think, ‘I won’t be at risk for hypothermia because it's a little warmer during the day,’” said Falat. “Then they sweat,” which can leave their clothing damp and their bodies more vulnerable once temperatures drop.

Heat-related illnesses include mild dehydration to heat exhaustion and, in the most extreme cases, heat stroke, which can be deadly.

• Choking during sex

Recently, for example, he treated a young woman who came to the ER with neck pain, a hoarse voice, and bruising; she assured Yoo that she had wanted her partner to choke her. “I’m not judging anyone who enjoys this, but it's way more dangerous than people think,” he said.

• Party drug

A harmless party drug -- gamma-hydroxybutyric acid, or GHB -- can also turn life-threatening. It is a clear, odorless substance sometimes called “liquid ecstasy.”

While in small amounts, it can make people feel relaxed or euphoric, but when taken in overdose, it can lead to unconscious and breathing difficulties. “It’s one of the most awful sights,” Yoo said , adding that in severe cases, some patients need to be put on a ventilator to survive.

In today’s hyper-connected world, access to health information has never been easier. Yet, ironically, the ability to understand and apply that information remains one of the biggest barriers to better health outcomes.

This is where health literacy comes in, not just the ability to read a pamphlet or follow a doctor’s prescription, but the broader skill of accessing, comprehending, and using health information to make informed decisions for oneself, one’s family, and one’s community.

While definitions vary, there is consensus that health literacy is multi-dimensional. It involves confidence, critical thinking, and practical skills, knowing when to seek care, how to evaluate health claims, and how to follow treatment correctly. In essence, health literacy is the foundation of preventive care and treatment adherence, and its absence can be devastating.

The Challenge of Low Health Literacy in India

The scale of the problem in India is stark: nearly 90 percent of Indians have low health literacy. This gap directly affects patient outcomes, from delayed diagnoses and poor compliance with treatment to preventable complications and higher healthcare costs.

Several factors explain this reality:

• Low literacy levels: A significant proportion of the population cannot read or interpret basic medical instructions, leading to mismanagement of conditions.

• Poverty and affordability: For millions living on less than INR 100 a day, awareness alone is not enough when healthy choices remain unaffordable.

• Gender and cultural barriers: Women often have lower access to information and autonomy in health decisions, particularly around reproductive and maternal health.

• Distrust in healthcare systems: Overcrowded facilities and inconsistent care erode confidence, driving many to informal or unverified sources.

Low health literacy doesn’t just harm individuals; it amplifies inequities and strains the entire healthcare ecosystem. It also worsens misinformation, as people turn to social media or word-of-mouth for guidance, often encountering unverified or unsafe advice.