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.

Bacterial vaginosis (BV) is among the most common vaginal conditions and develops when the natural balance of bacteria in the vagina is disrupted. If you have experienced it before, the symptoms are likely familiar: a strong fish-like smell, changes in vaginal discharge, and persistent discomfort. Because BV is usually framed as a condition affecting people with vaginas, it raises an important question many people still ask: can men get bacterial vaginosis too?

What Is Bacterial Vaginosis (BV)?

Bacterial vaginosis occurs when healthy lactobacilli bacteria in the vagina decline, allowing other bacteria, such as Gardnerella, to multiply. This imbalance typically causes thin grey or white discharge with a noticeable fishy odor, which often becomes stronger after sex.

Although BV is not classified as a sexually transmitted infection, it does raise the risk of acquiring STIs and can lead to pregnancy complications, including preterm birth. Diagnosis is made by a healthcare professional, and treatment usually involves antibiotics like metronidazole or clindamycin. Even after treatment, BV is known to return in many cases.

Bacterial Vaginosis Symptoms And Causes

• Vaginal discharge that looks off-white, grey, or slightly green
• A fishy-smelling discharge, especially after intercourse
• Itching or irritation in the vaginal area
• A burning sensation while urinating

Can Men Get Bacterial Vaginosis?

A major study published in The New England Journal of Medicine has challenged long-held beliefs about BV. The research showed that BV can be passed through sexual contact and that treating male partners significantly lowers the chance of the infection coming back. These findings have already influenced medical guidelines in the United States, ending years of treating BV as a condition affecting only women, despite frequent recurrence.

The study suggests that persistent BV was not due to poor treatment adherence but rather incorrect assumptions about transmission. While BV is not a traditional STI caused by a single organism, it does spread through sex and thrives when the vaginal environment is disturbed. This has highlighted the limitations of strict STI definitions and the consequences of excluding partner treatment.

For both patients and clinicians, this shift matters. It reframes BV as a shared health concern rather than a problem limited to the vagina, helping reduce stigma and improve outcomes. It also exposes how narrow thinking in women’s health delayed better research, treatment strategies, and shared responsibility.

Bacterial Vaginosis: What Causes Similar Symptoms In Men?

Men cannot develop BV itself, but they can experience symptoms that resemble it, such as itching, unusual discharge, or unpleasant odors. Several conditions may be responsible.

Thrush

STIs

Several sexually transmitted infections caused by bacteria can mimic BV-like symptoms in men. These include:

• Gonorrhea
• Chlamydia
• Trichomoniasis
• Genital herpes
• Human immunodeficiency virus (HIV)

STIs are typically spread through unprotected sexual contact.

Urinary Tract Infection

Although UTIs are more commonly associated with women, men can develop them too. This happens when bacteria multiply in the bladder or urinary tract. Symptoms may include:

• Inflammation
• Pain or burning during urination
• Blood in the urine

UTIs often occur when Escherichia coli bacteria enter the urinary tract through the urethra and move upward.

Balanitis

Balanitis refers to inflammation of the skin at the tip of the penis. It is more common in men who are uncircumcised and may make it difficult to retract the foreskin due to swelling. Possible causes include:

• Overwashing or poor hygiene
• Use of scented or irritating products
• Sexually transmitted infections
• Reactive arthritis
• Poorly controlled diabetes

People can end up in hospital if they take too much vitamin D, doctors have warned. Health experts say excessive intake can be harmful, with cases of hypervitaminosis D rising and linked to a range of serious health problems. Women, children, and people with existing illnesses are considered more vulnerable to the condition.

Doctors Warn Vitamin D Overdose Can Lead To Hospitalisation

The warning follows the case of a middle-aged man in the UK who was admitted to hospital after first visiting his family doctor. He complained of persistent vomiting, nausea, chest pain, leg cramps, ringing in his ears, dry mouth, intense thirst, diarrhoea, and unexplained weight loss.

His symptoms had lasted for nearly three months and began after he started seeing a nutritional therapist who recommended multiple vitamin and dietary supplements.

The patient already had several underlying health conditions, including tuberculosis, an inner ear tumour that had caused hearing loss in one ear, a build-up of fluid in the brain, bacterial meningitis, and chronic sinusitis.

What Is Hypervitaminosis D?

Vitamin D toxicity, also known as hypervitaminosis D, occurs when vitamin D levels build up excessively in the body. It is uncommon and usually results from taking doses that exceed medical advice, either through high-strength prescription vitamin D or excessive use of over-the-counter supplements taken without guidance.

Daily Intake Exceeded Recommended Vitamin D Levels

Doctors found that he had been taking more than 20 over-the-counter supplements every day. Together, they contained more than 80 times the recommended daily amount of vitamin D. He was consuming around 50,000 micrograms daily, despite the advised dose being just 600 micrograms. The mix of supplements also included excessive vitamin B9 and omega-3, alongside other vitamins, minerals, nutrients, and probiotics.

Although he stopped taking the supplements once symptoms appeared, his condition did not improve. Blood tests later showed his vitamin D levels were seven times higher than what is considered healthy. He also had dangerously high calcium levels and slightly raised magnesium levels.

Doctors found that his kidneys were not functioning properly, though scans ruled out cancer.

Patient Treated In Hospital For Eight Days With Fluids And Medication

The man remained in hospital for eight days, where he was treated with intravenous fluids to flush excess substances from his body. He was also given medications typically used to strengthen bones and reduce calcium levels in the blood.

Two months after leaving hospital, his calcium levels had returned to normal, but his vitamin D levels were still above the healthy range. NHS advises sticking to recommended vitamin D doses, especially in winter

Vitamin D can be obtained naturally from sunlight, oily fish, and wild mushrooms. The NHS advises people to follow recommended doses, particularly during autumn and winter when sunlight exposure is limited. It recommends that everyone over the age of one consider taking a daily supplement of 10 micrograms, or 400 IU, from October to March.

Hypervitaminosis D Is Rising Globally

Researchers involved in the case said there is a growing global trend of hypervitaminosis D, a condition marked by unusually high vitamin D levels in the blood. Symptoms can last for several weeks.

The researchers noted that symptoms vary widely and can include drowsiness, confusion, apathy, psychosis, depression, stupor, coma, loss of appetite, chest pain, vomiting, constipation, stomach ulcers, pancreatitis, high blood pressure, irregular heart rhythms, and kidney problems. Inflammatory eye disease, joint stiffness, hearing loss, and deafness have also been reported.

While the condition remains relatively rare, experts stress that it is possible to overdose on vitamin D. They warned that supplements often seen as harmless can become toxic when taken in unsafe amounts or combined improperly. The findings were published in the journal BMJ Case Reports.

Anyone who takes aspirin daily is being warned that the medication can cause serious side effects, and for many people, the risks may outweigh the benefits. First developed in the 1890s and commonly sold as an over-the-counter painkiller, aspirin was prescribed for years as a preventive treatment for heart disease.

Taking Aspirin Every Day Long Term Can Be Dangerous

According to MailOnline, more than two million people in the UK take aspirin every day to protect their heart. The drug works as a blood thinner, helping to reduce the risk of heart attacks and strokes. However, newer research suggests that aspirin offers little benefit for people who do not already have heart or circulation-related conditions.

More serious side effects that require immediate medical attention include coughing up blood, blood in the stool or urine, yellowing of the skin or eyes which may signal liver problems, painful joints linked to high uric acid levels, and swelling of the hands or feet caused by fluid retention.

Aspirin can also lead to stomach ulcers, and some people may develop allergic reactions. The Mail reports that during the early 2000s, when aspirin use was at its peak, the drug may have contributed to around 7,000 deaths a year in the UK. There are also concerns that it could increase the risk of bleeding in the brain.

In 2021, official guidelines were updated to say that people should only take daily aspirin if advised by a doctor. In 2023, GPs were instructed not to routinely prescribe aspirin to patients who have never had a heart attack.

Aspirin: NHS Recommendations

The NHS still recommends daily aspirin for people who have previously had a heart attack or stroke. Anyone who has been advised by a doctor to take aspirin should not stop without seeking medical guidance.

A 2019 study by the UK’s National Heart and Lung Institute found that daily aspirin provides only limited benefit for people without underlying heart disease, while significantly increasing the risk of serious internal bleeding.

Professor Malcolm Finlay, a consultant cardiologist at Barts Heart Centre in central London, told the Mail: “For patients who have suffered a heart attack or stroke, there is still a strong case for taking daily aspirin. But for everyone else, the benefit is very small.”

He added that aspirin’s side effects should not be underestimated. “You could have a bleed in the stomach, which can cause several days of severe pain. If bleeding occurs in the brain, it can be life-threatening,” he said.

Professor Finlay also revealed that he personally experienced a major stomach bleed while taking aspirin for a back injury.

Doctors who prescribe aspirin often also prescribe medications such as omeprazole or lansoprazole to help protect the stomach. However, Prof Finlay warned that these drugs should not be used long term either. He said this is why the NHS no longer recommends routine aspirin use, adding that there are now better cardiovascular treatments available that do not carry the same risks.

Aspirin Common Side Effects

These affect more than one in 100 people. The NHS advises taking aspirin with food to help reduce stomach-related issues.

• Indigestion and stomach pain: This is the most common complaint.
• Bleeding more easily: People may notice more frequent nosebleeds, bruising, or cuts that take longer to stop bleeding.
• Nausea or vomiting: Feeling sick or being sick after taking aspirin.

Aspirin Serious Side Effects

• Signs of internal bleeding: Coughing up blood or noticing blood in urine, vomit, or stools, which may appear black or tar-like.
• Liver problems: Yellowing of the skin or the whites of the eyes.
• Joint pain: Especially in the hands or feet, which may indicate high uric acid levels and possible gout.
• Swollen hands or feet: This may be a sign of fluid retention.

Immediate Emergency Symptoms

Call 999 or go to A&E immediately if you experience:

• Anaphylaxis (severe allergic reaction): Swelling of the lips, mouth, throat, or tongue, difficulty breathing, or a widespread itchy or blistering rash.
• Severe wheezing: Particularly in people with asthma, as aspirin can trigger serious attacks.

NHS Important Safety Warning

Under 16s: The NHS strongly advises against giving aspirin to children under 16 unless prescribed by a doctor, due to the risk of Reye’s syndrome, a rare but life-threatening condition that causes severe liver and brain damage.