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.

The monsoon season brings a respite from scorching heat, but it also increases the risk of contracting various diseases and infections. Apart from common illnesses like dengue, malaria, and typhoid fever, states and cities in India also face the risk of specific infections based on climate, geography, infrastructure, parasites, and sanitation.

Prevention Of Gut Infections During Monsoon

In a conversation with Health and Me, Dr Aabha Nagral, Director of Gastroenterology, Chief Hepatologist and Liver Transplant Physician at Jaslok Hospital and Research Centre, explained how rains can lead to contamination of water sources, increasing the spread of fecal-oral infections.

As the monsoon has set in, several states in India, including Maharashtra, Kerala, Karnataka, and Tamil Nadu are facing an alarming rise of gastrointestinal infections. Heavy rains are one of the reasons behind contamination of drinking water and food supplies.

Bacteria, viruses, and parasites in food and drinking water often result in a spike in diarrhea, vomiting, food poisoning, and gastroenteritis. Increased bacterial growth in warm and humid conditions, combined with poor food hygiene and subpar sanitation facilities, contributes to the rise of gut infections in urban areas like Mumbai.

Recent research and seasonal trends also support the increase in these infections. A 2025 review published in Frontiers in Tropical Diseases found that tropical infections like cholera, giardiasis, and enterotoxigenic E. coli infections disrupt the gut microbiome by reducing beneficial bacteria and increasing harmful microbes.

Faecal-oral diseases and infections like hepatitis A and E mainly cause jaundice, whereas gastroenteritis presents with diarrhea. On the other hand, typhoid can present with high fevers.

Dr Nagral says, “You can have various other diseases during the rains by what we call faecal-oral contamination of water. So, we know that during the rainy season, the water gets contaminated more easily. So, make sure that you are boiling your water for at least 10 minutes, or if you are using RO or any other means of sterilising the water. Also, make sure your systems are well serviced regularly so that the water you drink is well filtered and sterile.”

The water source is among the first to get contaminated during the monsoon. Dr Nagral suggests these tips to prevent gut infections.

• Avoid foods and drinks that contain water in different forms

• Avoid street-side juices during monsoons to prevent gut infections

• Avoid any drink that contains ice or that has been sitting out for a long time

Dr Aabha Nagral also spoke about avoiding consuming street foods as they are more likely to be contaminated during the monsoon.

She explains, “Also, I would say avoid all street food because that’s how diseases spread. They spread through flies which sit on the faeces, which are often unfortunately there on our roadside, and then onto your food or drinks.”

Common Monsoon Diseases

Monsoon diseases can vary across India depending on rainfall, flooding situation, sanitation, and local mosquito populations. Some of the most common ones include dengue, malaria, typhoid, and diarrheal diseases. These infections affect nearly every state during the rainy season.

Specifically, Kerala, Maharashtra, Karnataka, and Tamil Nadu have seen a higher likelihood of leptospirosis following floods.

Odisha, Chhattisgarh, and Jharkhand continue to record high malaria cases, while flood-prone states like Odisha, Assam, and Bihar are vulnerable to water-borne illnesses, including cholera and gastroenteritis.

A recent study has found proof that an autoimmune reaction is triggering certain neurological symptoms seen in some long COVID patients. The study, conducted in healthy mice, found that the mice exhibited symptoms mirroring those of affected patients to some extent.

What is Long COVID?

While it has been a long time since the end of the COVID pandemic, its effects continue to linger even today. Several patients who contracted COVID continue to suffer.

Autoantibodies Behind Long COVID Symptoms?

A US NIH-funded research group, directed by Drs. Akiko Iwasaki and Tamas L. Horvath of the Yale University School of Medicine and Dr. David Putrino of the Icahn School of Medicine at Mount Sinai recently found that autoantibodies could be triggering these neurological symptoms in some long COVID patients.

Antibodies, in a healthy person, help fight infections. In patients with autoimmune diseases, these antibodies target the body’s own tissues. They are called autoantibodies.

The study also discovered that patients who had these autoantibodies are more likely to experience similar symptoms. For example, people with autoantibodies are more likely to face symptoms like loss of taste and smell. They are also more likely to experience nausea and joint pain.

The Mouse Experiment

The researchers conducted the study by transferring purified antibodies from long COVID patients into healthy mice. It was discovered that the mice developed the following changes that resembled the donors' symptoms:

• Antibodies from patients with chronic pain caused increased pain sensitivity

• Antibodies from patients with dizziness caused balance problems

• Antibodies from fatigued patients reduced treadmill endurance

The recent breakthrough in long COVID research has brought the healthcare industry one step closer to personalizing care for those affected.

Dr. Putrino says, “Our study now shows that if you are in a subgroup of Long COVID patients who have autoantibodies circulating in your body, this is a quantifiable sign that you may be a good candidate for these drugs.”

Long COVID Patients More Likely To Develop Heart Diseases

The study finds that cardiovascular diseases were more common among long COVID patients. It concluded that 11.9% of those with long COVID have CVD compared to 6.8% without this condition.

Specifically, it further revealed that long COVID was associated with a higher risk of chest pain and heart attack, but not coronary heart disease and stroke.

There is a growing belief that ‘sugar feeds cancer.’ Because of this, many people think that stopping sugar and carbohydrates completely can starve cancer cells and help defeat the disease. However, the trend may have side effects. This half-truth is becoming dangerous for many patients. This trend is making it even more difficult for patients to cope with the side effects of chemotherapy.

This fact is not entirely unscientific, but it is incomplete. In 1924, the German scientist Otto Warburg found that cancer cells consume more glucose than normal cells. This phenomenon is known as the Warburg Effect.

This finding has subsequently been validated in numerous studies. This is also the reason why cancer cells appear clearly in PET-CT scans. They absorb glucose-like substances more aggressively than normal cells. But this does not mean cancer can be “starved” by reducing sugar in food.

Why The Body Still Needs Glucose?

Glucose is an essential fuel for the human body. The brain, heart, red blood cells, and immune system all depend on it.

If a person completely stops eating carbohydrates, the body starts producing glucose on its own. It breaks down muscles and proteins to make energy. This process is known as gluconeogenesis. This means the cancer cells still receive fuel, but the patient’s body becomes weaker day by day. This condition is described as ‘cancer cachexia.’

In this condition, body weight and muscle mass reduce rapidly. Such patients often cannot tolerate chemotherapy and surgery properly. In some cases, their protein levels and white blood cell counts had dropped too much.

As a result, doctors had to delay treatment, reduce medicine doses, or even stop some treatment cycles. Irony is painful. In trying to starve cancer, patients sometimes end up weakening their own bodies so much that proper treatment becomes difficult.

In my clinic, I see it almost every week. In such a case, a cancer patient walks in visibly frail. She almost had lost several kilograms over the past month. When I asked about her diet, her IT professional son said that she has cut out sugar entirely. The reason behind this was the same reel-based knowledge about sugar and cancer cells. His son strictly follows this half-truth. Due to her weakness, we had to push back her treatment for a few weeks.

What Cancer Patients Should Eat

We simply suggest avoiding foods that rapidly increase blood sugar levels. These include refined sugar, sweets, soft drinks, maida, and highly processed foods. We advise cancer patients to eat complex carbohydrates, whole grains, pulses, vegetables, healthy fats, and enough protein. The best way is not to cut sugar entirely, but to lower the glycemic load.

Will Fasting help?

Some animal studies have shown the benefits of fasting during cancer treatment. However, there is still not enough evidence in humans. For patients who are already weak or losing weight rapidly, long fasting can become harmful.

The Goal Is to Stay Strong During Treatment

Cancer cells use more glucose, but starving the body cannot stop cancer. If you want to help your body, then avoid refined sugar and junk food, but continue eating balanced meals. Because sufficient protein and calories are extremely important. Practising long fasting without medical advice is harmful. The goal should be to keep the body stable and strong, not weak.

The purpose of cancer nutrition is to nourish the patient, not to starve them. Proper nutrition helps the body tolerate treatment and fight disease more effectively. What is needed is to reduce the intake of refined sugar and foods with a high glycemic index, not to declare every carbohydrate an enemy. After all, one cannot win the battle against disease by weakening the body.