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 a bizarre medical case, a 28-year-old US man began seeing his pet cat Luna’s features on human faces after brain surgery. These included almond-shaped eye sockets enlarged pupils and stripes.

If Karl sees Luna first thing in the morning, he continues to see her features on human faces throughout the day, whether in person or online.

However, if he wakes up looking at a human face, he may see that person’s pupils and eye shape on other people’s faces and even on his cat.

According to a case report published in the journal Cortex, Karl experiences a form of palinopsia, in which something seen earlier persists or reappears in subsequent perception. In his case, this causes facial distortions known as prosopometamorphopsia (PMO).

How Did The Condition Begin?

Also read: Rare Canine Tooth Found In Indian Teen’s Eyelid: What Is An Ectopic Tooth?

Karl, who lives in the northeastern US, has experienced the condition for two years. It began after surgery to remove part of his right temporal lobe to treat an arteriovenous malformation (AVM), an abnormal tangle of blood vessels connecting arteries and veins that can cause bleeding in the brain.

The right temporal lobe plays an important role in face processing.

"This case of Karl seeing his cat's features in human faces and vice versa demonstrates that individual features can be pulled from memory and influence our ongoing perception," said lead author Brad Duchaine, professor and chair of psychological and brain sciences and principal investigator of the Social Perception Lab at Dartmouth.

More Than 250 People Experience Facial Distortions

Karl is not alone. According to Duchaine's lab, more than 250 people experience facial distortions. Many are mistakenly diagnosed with psychiatric problems.

"We have heard from people who have been told that they had a psychiatric problem and, in some cases, have even been put on antipsychotics, when they are in fact just having visual problems," Duchaine said.

Duchaine also cited a 1986 study published in Cortex. It described a woman who saw a poodle sitting on a passenger's lap while riding a bus. She then began seeing the poodle's face on every passenger. The woman had experienced a stroke nine months earlier.

Unlike that case, Karl sees individual facial features transferred between faces rather than entire faces.

How AI Can Help

Also read: Hours Of Sitting, Gaming And Binge-Watching OTT? Doctors Warn Of Blood Clot Risk In Young People

Duchaine used a large language model to turn a line drawing of Karl’s experience into a photorealistic image. He then worked with Karl to refine the visuals featured in the report.

AI-generated images can help researchers understand visual distortions and help patients explain their experiences to doctors, friends and family, Duchaine said, adding that he will continue working with Karl to decode more about the condition.

What Is Prosopometamorphopsia?

Prosopometamorphopsia (PMO) is a rare visual condition in which faces or facial features appear distorted due to changes in the brain's face-processing network. The term combines prosopo (Greek for face) and metamorphopsia (perceptual distortion).

People with PMO may see facial features as:

• Droopy or stretched

• Larger or smaller than normal

• Displaced or out of position

• Distorted in specific parts of the face

Two prominent subtypes are:

• Full-face PMO: The entire face appears distorted

• Hemi-PMO: One half of the face appears distorted

Most cases last days or weeks, although some persist for years. Around 75 case reports have so far been published.

Rubbing your eyes is a common habit, often triggered by itching, dryness or tiredness. However, frequent and vigorous rubbing can damage the cornea and increase the risk of keratoconus, a progressive condition that causes it to thin and bulge outward, experts warn.

World Keratoconus Day is observed every year on November 10 to raise awareness about the condition.

Early diagnosis is important to slow its progression. Frequent changes in spectacle prescriptions or deteriorating vision should prompt an eye examination.

Why Should You Avoid Rubbing Your Eyes?

Frequent or aggressive eye rubbing can put mechanical stress on the cornea, potentially weakening its structure and worsening existing eye conditions.

Speaking to HealthandMe, Dr Janhvi Mehta, Consultant Ophthalmologist, Jaslok Hospital and Research Centre, Mumbai, said, "Frequent or vigorous eye rubbing can damage the cornea, particularly by contributing to keratoconus. It can also cause corneal epithelial injury and worsen existing ocular allergy."

Repeated rubbing can:

• Contribute to corneal thinning and biomechanical weakening.
• Accelerate keratoconus in susceptible individuals.
• Cause corneal abrasions and increase the risk of infection.

Also read: Ozempic, Zepbound: US FDA Orders New Warning Over Rare Eye Risk

Dr Mahipal Singh Sachdev, Chairman and Managing Director, Centre for Sight Group of Hospitals, explained that excessive rubbing puts pressure on the cornea and can damage its collagen structure.

"The cornea might become thinner than usual or its shape may become uneven, leading to impaired vision. Hence, people should avoid the habit of rubbing their eyes," he told HealthandMe.

Why Are Children More At Risk?

Children with allergies, especially allergic conjunctivitis, may be more vulnerable to keratoconus because of frequent eye rubbing.

Allergies can cause persistent itching, redness, watering, and discomfort, encouraging children to rub their eyes repeatedly. The resulting mechanical stress may contribute to the development or progression of keratoconus in susceptible individuals.

The experts urged parents to watch for excessive rubbing and changes in their children's vision. Timely allergy treatment and regular eye examinations can help identify potential problems early.

Other risk factors for keratoconus include:

• Vernal keratoconjunctivitis (VKC)
• Atopic eye disease
• Family history of keratoconus
• Genetic predisposition
• Certain connective tissue disorders

However, not everyone who frequently rubs their eyes develops keratoconus.

Read More: 6 Million People In Delhi Living With Poor Vision: AIIMS Study

Why Is Keratoconus Often Diagnosed Late?

Dr Janhvi noted that keratoconus commonly begins during adolescence or early adulthood but may remain undiagnosed until vision deteriorates.

Its early symptoms can resemble common refractive errors such as myopia. Children and young adults may experience mild blurring or require frequent changes in their spectacle prescriptions, which can be mistaken for routine vision changes.

The condition can also progress gradually and initially affect only one eye, making changes harder to recognise. Routine eye examinations may not always detect early keratoconus without specialised corneal assessment, Dr. Mahipal said.

Warning signs to watch for include:

• Increasing myopia
• Progressive or irregular astigmatism
• Frequent changes in spectacle prescriptions
• Reduced visual clarity despite corrective lenses
• Ghosting, glare or double vision in one eye
• Difficulty driving at night

Increasing astigmatism despite repeated spectacle corrections is an important warning sign that warrants further evaluation.

Read More: Sudden Floaters, Flashes Or Blurred Vision? When Should You Seek Emergency Care For Retinal Changes

How Can You Prevent Corneal Damage?

Preventing excessive eye rubbing and managing its underlying causes can help reduce avoidable stress on the cornea.

1. Break the eye-rubbing habit

• Avoid pressing or massaging closed eyelids.
• Use a cold compress when your eyes itch.
• Avoid rubbing your eyes even through a towel or handkerchief.
• Keep children's fingernails short to minimise accidental injury.

2. Treat underlying allergies

If itching triggers eye rubbing, consult an ophthalmologist about appropriate treatment. Options may include topical antihistamine or mast-cell stabiliser drops, such as olopatadine or ketotifen.

Other measures include:

• Using preservative-free artificial tears for irritation
• Treating associated blepharitis or dry eye
• Avoiding prolonged use of topical steroid drops without medical supervision

3. Reduce exposure to environmental triggers

• Avoid dust, smoke and known allergens
• Wear protective glasses outdoors
• Avoid direct airflow from air conditioners.

Come Saturday morning, many people have just one thing on their mind: catching up on sleep. After a week of early mornings, office deadlines, late-night screen time and household responsibilities, the weekend feels like the perfect opportunity to stay in bed for a few extra hours. Some people even sleep until noon, believing that the extra rest will make up for all those late nights. But is it really possible to undo five days of poor sleep in just two days?

Unfortunately, the brain doesn't work that way. Sleeping longer over the weekend can certainly help you feel less tired, but it cannot completely compensate for a week of inadequate sleep.

Sleep is much more than physical rest. It is when the brain gets down to some of its most important work. Memories are processed, information gathered during the day is organised, and the brain gets an opportunity to recover from constant activity. When we repeatedly cut short our sleep, these processes can suffer.

Why Do We Feel Better After Sleeping In?

Think about how you feel after several nights of going to bed late. You may find yourself forgetting small things, struggling to concentrate during meetings or becoming unusually irritable over minor issues. These are some of the ways sleep deprivation can affect everyday functioning.

Sleeping for a few extra hours over the weekend can ease some of this fatigue. You may feel more alert and find it easier to concentrate. However, feeling refreshed is not necessarily the same as being fully recovered. Certain effects of repeated sleep restriction, particularly on attention and reaction time, can take longer to resolve.

Can Weekend Lie-ins Disturb Your Sleep Cycle?

There is another side to this weekend habit that people rarely consider. If you sleep at 11 pm during the week but stay awake until 2 or 3 am on Friday and Saturday, your body's internal clock can get disrupted.

This internal timing system, called the circadian rhythm, helps regulate when you feel sleepy and when you wake up. Large changes in sleep timings can make it harder to fall asleep on Sunday night. Before you know it, Monday morning arrives and you are back to feeling exhausted.

It becomes a familiar cycle: insufficient sleep during the week, prolonged sleep on weekends and difficulty getting back into a routine.

What Does Repeated Sleep Deprivation Do To The Brain?

One of the biggest areas affected is memory. Sleep plays an important role in consolidating information, which is why a poor night's sleep can make it harder to remember things or absorb new information the following day.

It can also affect emotional regulation. People who regularly sleep less may become more impatient, anxious or sensitive to everyday stress. Their ability to focus and make decisions may also take a hit.

Persistent sleep deprivation has also been associated with metabolic and cardiovascular problems. It is therefore important not to treat poor sleep as an unavoidable part of a demanding work schedule.

What Is A Healthier Way To Catch Up On Sleep?

Rather than depending on Saturday and Sunday to recover, try making small changes to your routine throughout the week.

• Keep a consistent schedule: Try to go to bed and wake up at roughly the same time every day.
• Don't compromise on sleep duration: Most adults need around seven to nine hours of sleep each night.
• Put your phone away before bedtime: Late-night scrolling can keep the mind stimulated and delay sleep.
• Be mindful of caffeine: That evening cup of coffee may be affecting your ability to fall asleep.
• Step outdoors in the morning: Natural daylight helps regulate the body's sleep-wake cycle.
• Pay attention to persistent tiredness: If you wake up exhausted despite getting enough sleep, speak to a doctor. Sleep disorders such as obstructive sleep apnoea may need to be ruled out.

Your brain needs rest every day, not just when the calendar says it is the weekend. Instead of treating sleep as something you can postpone and recover later, make it a non-negotiable part of your daily routine.