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.

Mothers who use minoxidil, a widely used hair loss treatment, may increase the risk of infantile hypertrichosis in babies, a condition marked by excessive hair growth across the body, including areas where hair does not usually grow, according to a large international analysis.

Minoxidil Use by Mothers Linked To Potential Health Risks In Infants

Researchers from the Ministry of Health and Family Welfare and the All India Institute of Medical Sciences (AIIMS), New Delhi, reviewed 2,664 worldwide reports of suspected infantile hypertrichosis linked to minoxidil. Of these, 45 cases involved children aged between birth and 23 months.

The analysis showed that 22.2 per cent of these infant cases were associated with maternal exposure to minoxidil. Accidental exposure accounted for 44.4 per cent, while the cause remained unclear in 33.3 per cent of cases. The findings were published in the Archives of Dermatological Research.

What Is Minoxidil?

Minoxidil is a drug most commonly used to treat pattern hair loss, known as androgenetic alopecia, in both men and women. In higher oral doses, it is also prescribed for severe high blood pressure. The medicine works as a vasodilator, meaning it helps widen blood vessels to improve blood flow.

What Is Infantile Hypertrichosis?

Infantile hypertrichosis (also called childhood hypertrichosis or werewolf syndrome) is a rare condition marked by excessive hair growth on the face, back, arms, and other areas, appearing from infancy, often with a genetic cause but sometimes triggered by medications (like minoxidil) or underlying conditions, leading to significant cosmetic and psychological distress despite being a generally harmless cosmetic issue

Minoxidil: Eye-Related Side Effects Also Reported

The study also highlighted concerns beyond infant cases. Researchers identified 1,669 global reports of eye-related adverse effects linked to minoxidil use in the general population, including 25 cases reported from India.

Commonly reported eye symptoms included swelling of the eyelids, blurred vision, and central serous chorioretinopathy, a condition in which fluid accumulates beneath the retina and can affect eyesight.

Background on Minoxidil

Minoxidil was originally developed to treat high blood pressure. It was later reformulated as a topical treatment for hair loss in both men and women after its hair growth–stimulating side effects were observed. The drug is typically applied directly to the scalp or affected skin areas, the researchers noted.

Minoxidil: Concerns Over Regulation and Use

Despite its proven effectiveness, the researchers raised concerns about the drug’s widespread over-the-counter availability and limited regulatory oversight. These factors, they said, increase the risk of misuse and unintended exposure.

Although minoxidil is generally advised against for use during pregnancy and breastfeeding, the analysis still identified cases of infantile hypertrichosis linked to maternal exposure during these periods.

The researchers noted that minoxidil has also been associated with eye-related side effects in the broader population, prompting renewed questions about its overall safety profile.

“This study aims to examine global reports of infantile hypertrichosis associated with maternal minoxidil exposure and to assess serious and non-serious eye disorder cases reported in India, with the aim of improving awareness about the risks of early-life or accidental exposure,” the authors wrote.

The study was based on data collected up to March 2025 from VigiBase, the World Health Organization’s global database of suspected adverse drug reactions.

This year had been a year of flu, fiver, bacterial illness and more. One of the over the counter medicine that many people often buy, or is prescribed, especially for bacterial infections is Amoxicillin.

What Is Amoxicillin?

It is a widely prescribed antibiotic that is used to treat bacterial infections in children and adults. It is part of the penicillin class of medications and it inhibits the growth of bacteria and allows the immune system to efficiently eliminate the infection. It is commonly used to treat bacterial infections affecting the respiratory tract, urinary tract, and skin.

However, about 5 to 10 per cent of children prescribed this may develop skin rashes as a common side effect. A rash can develop in two forms: allergic and non-allergic. A rash from the drug Amoxicillin could last up to a week.

What Kind Of Rashes Are Caused By Amoxicillin?

A Maculopapular rash is a flat rash that occurs like red patches, raised bumps and spreads over the body.

Hives are itchy, raised red or skin-colored welts that can change shape and location.

Erythema Multiforme are more severe, featuring target-like lesions or bull's-eye shapes with central red spot, pale ring, and red outer ring.

Anaphylactic Reaction is a rare but severe allergic reaction that includes symptoms like difficulty in breathing, swelling of the face, lips, or tongue, hives and rapid drop in blood pressure.

Non-Allergic Amoxicillin Rash are flat, red spots that may be slightly raised, but not harmful. These usually appear o the 5th to 7th day after the start of amoxicillin and can appear on the chest, abdomen, back, face, arms, and legs. It may get worse before it starts to get better.

What Signs Should You Look Out For?

Warning signs include rashes within two hours of the first amoxicillin dose, difficulty breathing or swallowing, or very itchy hives.

The allergic reaction is caused by one's immune system reacting to that medication as if it were a foreign invader in the body.

More girls than boys develop these rashes, and in children this is even more common. In fact, the rash by amoxicillin was first noted in 1960s, in children who were being treated with ampicillin, recorded the Journal of Pediatrics.

What Can You Do If You Get Amoxicillin Rashes?

Among treatment, the first step should be to see your physician and immediately stop taking the medication. Drinking water and enough fluids can also help. Your doctor too would prescribe you medications and lotions to soothe your itching.

Hives can also be treated with the over the counter drug Benadryl. However, you must go see your doctor or GP, and not self medicate.

A doctor may treat the rash in various ways, including stopping the medication as the first line of defense. Then the doctor may give oral antihistamines (e.g., cetirizine) for the itch. Some doctors may use topical steroids to help with the itch and redness.

Before visiting your doctor, take photos of your rash, send it to your GP, as if it is contagious. Even after you start the treatment, stay in touch with your healthcare provider for any development.

The World Health Organization (WHO), notes that 36% of world's rabies deaths come from India, and a 2024 Lancet study notes that the country accounts for over one-third of global rabies deaths. When we spoke to Dr Aniket Mule, Consultant Internal Medicine at KIMS Hospital, Thane, he said that it is not just dog bites that lead to rabies, but it could happen from any rabies-susceptible animal. The first line of defense after you clear your wound immediately is to get the rabies vaccine. "Rabies vaccination is required for bites or scratches from any rabies-susceptible animal, including cats, monkeys, bats, foxes, and other wild mammals," he pointed out. As the country's apex court ruled and issued directives on stray dogs, focusing on public safety by ordering their removal, global health organizations, including WHO point out that this is not the right way to deal with rabies issue. Comprehensive methods including evidence=based strategies that center on mass dog vaccination is the key to the problem.

However, before this could be implemented, here's what you should know about dog bites and rabies.

What To Do After A Dog Bites Or Scratches You?

Dr Mule points out that even when there are minor scratches, without bleeding, you must get a rabies shot. "Rabies can be contracted through broken skin. Such exposures still require medical evaluation and, in most cases, rabies vaccination."

Read: In An 'Exceptionally Rare' Case, Man Dies Of Rabies After Kidney Transplant

What Should One Do Immediately After Being Bitten Or Scratched?

• Wash the wound immediately for at least 15 minutes with soap and running water
• Apply an antiseptic such as povidone-iodine
• Do not apply home remedies like turmeric, chili or oil
• Seek medical care promptly for rabies vaccination and possible immunoglobin

Dr Mule points out that the rabies vaccine should be started as soon as possible. "Ideally within 24 hours of a bite or scratch. However, even if there is a delay of days or weeks, vaccination should still be started immediately as rabies has a variable incubation period," he says.

After the bite, the immediate medical attention involves rabies post-exposure prophylaxis or PEP, and with a tetanus booster. Some rabies vaccines also use saline water as the diluent to reconstitute the freeze-dried powder before injection.

Read: Australia Issues Advisory Warning Travelers Of Counterfeit Rabies Vaccines Found In India

The temperature of the vaccine matters. "Rabies vaccines are temperature-sensitive and must be stored between 2°C and 8°C. Exposure to heat or freezing can reduce vaccine potency. Poor cold-chain maintenance is a known reason for vaccine failure in rare cases," points out the doctor.

Cases Of Rabies Coming Back After Vaccination Course Has Been Done

Dr Mule points out that in order to avoid such things happening, one must ensure immediate wound washing, timely vaccination, and correct use of Rabies Immunoglobulin or RIG. Rabies can come back if these following things occur:

• Delay in starting vaccination
• Failure to administer Rabies Immunoglobulin (RIG) in severe (Category III) exposures
• Improper wound cleaning
• Incorrect injection site (gluteal region)
• Poor vaccine storage (cold-chain failure)

Dr Mule points out that the vaccine should be given intramuscularly in the deltoid or upper arms for adults, as gluteal or buttock injections could lead to inadequate absorption and reduce effectiveness.

How Many Doses Should One Get?

• For someone not previously vaccinated, the current standard is 4 doses on days 0, 3, 7, and 14 (intramuscular schedule).
• In some government programs or intradermal schedules, 3–4 doses may be advised.
• Previously vaccinated individuals require only 2 booster doses (days 0 and 3).

The exact schedule depends on vaccination history and the protocol followed.