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.

Mental health struggles among young children and teens are most likely to get overlooked due to many reasons. That is one of the glaring problems that prompted 16-year-old Imaan Zara Khan to write and direct Unspoken, a movie that follows four teenagers from different social, cultural, and economic backgrounds who navigate their mental health struggles.

Imaan told HealthandMe, "We constantly tell young people to speak up, but what happens when they don’t have the words for what they’re feeling? And even when they do, there’s the fear of being judged, misunderstood or simply not taken seriously. The social visibility cost is simply too high. So, they choose silence instead. I wanted to explore that silence, because sometimes the biggest barrier to seeking help comes long before someone actually asks for it."

The Ministry of Education, Government of India, recently reviewed the draft school mental health policy to foster students' mental wellbeing. The landmark move aims at ensuring adequate resources to protect students' mental well-being by strengthening school systems. Scaling up proven best practices to promote student mental health and psychosocial well-being is one of the primary objectives of the policy.

On World Mental Health Day, we review the government's initiative to comprehend its importance and urgency amid expanding mental health crisis in India's young population.

School Mental Health Policy Aims To Reshape Mental Care For Young Children

Also read: Childhood Fitness Linked To Lower Risk Of Depression In Adulthood: 30-Year Study

The policy entails several key measures to reshape mental healthcare in educational institutions. From identifying early signs of academic stress to proactive screening, it says that schools must routine mental wellness checkups into their academic calendars.

Nandita Bhatla, Vice President and Country Director, WorldBeing India, an international non-profit that works towards integrating mental health wellbeing programs into education systems, told HealthandMe, "India has done well to break the silence. Yet the loss of young lives to suicide tells us that too many children still feel they have nowhere to turn, and that listening cannot wait for a crisis."

She added, "The harder, more important work is making care a routine part of a school day, owned and led by governments, and not dependent on a single programme or a single champion. Schools are the lived reality of millions of our children. When they become spaces to build resilient, hopeful individuals and not mere academic achievers, we know we are on the right path."

The draft also stresses upon building an inclusive and supportive school culture built on a strong foundation of empathy, care, and mutual trust.

The policy also moves away from emergency crisis management. Instead, it aims to create robust, long-term support systems that could help children thrive and stay motivated towards building their future.

Imaan said mental health problems should not be treated as emergencies. She said, "Just as we build physical health through everyday habits, schools should be building emotional resilience, coping skills and mental-health literacy from an early age. But equally important is having a clear, transparent, end-to-end framework that everyone, whether it’s a student, teacher or parent, can understand and navigate."

Also read: Over 2 Hours of Daily Screen Time Linked to Depression, Obesity In Young People: Lancet

Turning Teachers Into Mentors

The policy also focuses on training teachers to be primary mentors for students who could interact with them every day and recognise early signs of conditions like stress, anxiety, and depression. According to the policy, teachers will be trained to identify changes in behaviours and academic burnout.

This does not mean that teachers will replace professional counselors. Additionally, this effort also urges parents to monitor domestic environments.

The policy also plans to channel traditional Indian Knowledge Systems to promote mental wellness among students. It urges schools to integrate mindfulness practices into everyday student activities.

It promotes that these ancient practices can equip students to handle academic pressure, especially during stressful board examinations. The updated curriculum will now support both cognitive growth and development and psychological well-being.

Spending hours sitting at a desk, gaming or binge-watching shows without moving may increase the risk of blood clots, including deep vein thrombosis (DVT), vascular experts have warned.

Prolonged sitting slows blood flow from the legs, potentially increasing the risk of clot formation. Experts from the Vascular Society of India (VSI) highlighted the concern at the VSI-ASVS 2026 Conference, noting that sedentary screen habits warrant attention even among young, otherwise healthy people.

“In our OPD, we are seeing patients where lifestyle history has become an important part of the vascular evaluation. Earlier, when we thought about prolonged immobility, we primarily discussed long-distance travel, hospitalization or being bedridden. Today, we also need to ask young patients how many hours they spend continuously sitting in front of a gaming console, computer or OTT screen,” said Dr. Tarun Grover, Senior Director of Peripheral Vascular and Endovascular Sciences at Medanta.

What Is DVT?

Deep vein thrombosis (DVT) occurs when a blood clot forms in a deep vein, usually in the legs. If the clot travels to the lungs, it can cause a potentially life-threatening pulmonary embolism.

Although prolonged immobility has traditionally been associated with long-distance travel, hospitalization and bed rest, experts say extended screen time can also contribute to inactivity.

Gaming and binge-watching do not automatically cause DVT. However, prolonged sitting may add to the risk, particularly in people with obesity, dehydration, smoking habits, hormonal risk factors, inherited clotting disorders or a previous history of thrombosis.

Also read: Richard Branson’s Wife’s Death Highlights Blood Clot Risk After Fractures

What Does Science Say?

A 2024 systematic review and dose-response meta-analysis published in Scientific Reports, covering 25 articles and 31 studies, found that people with the highest levels of sedentary behavior had approximately 24% higher risk of venous thromboembolism (VTE) than those with the lowest levels.

The analysis also found a 2% increase in VTE risk for every additional hour of sedentary behavior per day. The association persisted after accounting for physical activity, suggesting that exercise may not fully offset the potential risks of prolonged sitting.

The experts explained that when people sit for hours, their calf muscles—which help pump blood back toward the heart—remain relatively inactive, slowing venous circulation.

A separate study of 11 adolescents with thrombosis found that all reported at least four hours of daily screen exposure, averaging approximately six hours. Eight had DVT in the legs, two had pulmonary embolism and one had subclavian vein thrombosis.

Many also had inherited thrombophilia, a predisposition to blood clots. Researchers noted that prolonged screen-related inactivity may act as an additional trigger rather than the sole cause of thrombosis.

“The evidence showing a 24% higher VTE risk with higher sedentary exposure should make us take this issue seriously. A young age should not create a false sense of security, particularly when prolonged sitting is combined with other risk factors,” Dr. Grover said.

How Can You Reduce The Risk?

Experts recommend taking regular movement breaks during work, gaming and streaming sessions to avoid prolonged uninterrupted sitting.

“Just as smoking increases vascular and clotting risks, prolonged sitting can also increase the risk of blood clots. When a person remains seated for hours, the calf-muscle pump becomes inactive, venous blood flow from the legs slows down and blood can stagnate in the deep veins," said Dr. Bhupesh Garg, Senior Vascular and Endovascular Surgeon, Vascular Society of India.

The message should be simple: if you are going to spend hours on a screen, do not spend those hours completely still, the experts said.

The Black Death swept across Eurasia and North Africa between 1346 and 1353, killing an estimated 30% to 60% of Europe's population.

Plague continued to recur in Europe over subsequent centuries, causing millions of deaths. Caused by Yersinia pestis, the same bacterium responsible for plague today, the Black Death was primarily associated with bubonic plague, although pneumonic plague also occurred.

Bubonic plague typically spreads through infected flea bites, while pneumonic plague affects the lungs and can spread between people through infectious respiratory particles during close contact. All forms can be fatal without prompt treatment, but antibiotics are effective when administered early.

India's 1994 Plague Outbreak

Although often associated with medieval history, plague continues to occur in parts of the world.

In 1994, India experienced an outbreak involving both bubonic and pneumonic plague, following heavy flooding and reports of exposure to dead rats.

“When the plague outbreak happened in India, I was one of the people who investigated it. The outbreak involved bubonic plague, which can be treated with antibiotics, and Surat also saw 64 to 68 cases of pneumonic plague. We identified the plague bacillus and traced its cycle in the surrounding wildlife. Plague surveillance in rats and other animals is essential to detect outbreaks early and take preventive measures,” Dr. N.K. Ganguly, former Director General of the Indian Council of Medical Research (ICMR), told HealthandMe.

There were 693 suspected cases that tested positive for Yersinia pestis antibodies and 56 deaths nationwide.

Surveillance, hygiene and timely treatment were essential to controlling the disease, said Dr. Amitabh Banerjee, an epidemiologist and former member of the Indian Armed Forces’ mobile epidemic investigation team. He investigated the 2002 pneumonic plague outbreak in Himachal Pradesh, which caused 16 cases and four deaths.

Plague Still Exists In Africa And The US

In the US, an average of about seven human plague cases are reported annually, mostly in rural areas of the American West, according to the Centers for Disease Control and Prevention (CDC).

The continued presence of Yersinia pestis in animal populations means the disease has not been eradicated.

“People think the plague is gone, it was something that occurred 500 years ago. It's not. It's here amongst us,” Simon Clarke of the University of Reading in the UK told the Associated Press. “Unless you get rid of those wild animals, which of course is not possible, then you're not going to get rid of the bacteria.”

Russia's Plague Scare: What We Know

Russia has completed checks following the October 2 death of 28-year-old laboratory worker Darya Shipilova in Siberia. Authorities have not confirmed plague as the cause, describing her illness as pneumonia of unknown origin. Nearly 5,000 samples reportedly showed no dangerous pathogens.

Reports of a second death linked to the plague was called "fake news" by Russia, and no plague outbreak has been confirmed in Russia. The WHO and US have requested Russia for more transparency regarding the cases.

Can Plague Be Eradicated?

Plague persists because Yersinia pestis circulates naturally among wild and domestic animals, including rodents, and their fleas. Eliminating human cases in one location does not remove the bacterium from these animal reservoirs.

Dr. Banerjee said plague can be deadly, particularly when it affects the lungs, but modern antibiotics are highly effective when treatment begins early.

“Plague cannot be eradicated because it is in wildlife, it is in rodents and all. So the only thing is hygiene and, with modern antibiotics, there should not be any panic,” he told HealthandMe.

Bubonic plague does not typically spread directly between people, while pneumonic plague can spread through infectious respiratory particles during close contact. Pneumonic plague can progress rapidly and requires urgent treatment.

Dr. Banerjee cautioned against assuming that a suspected case automatically signals a wider outbreak, noting that early diagnosis and appropriate antibiotic treatment are crucial.