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.

Preventive healthcare through early screening, healthier lifestyles and greater public awareness is crucial to reducing the burden of both communicable and chronic diseases, doctors said ahead of National Doctors' Day.

National Doctors' Day is observed in India on July 1 to honor the contributions of medical professionals.

Shift Focus On Prevention

Speaking at an event organized by the Illness to Wellness Foundation, Rajesh Bhushan, former Secretary, Ministry of Health and Family Welfare, said India has made significant strides in expanding access to healthcare and strengthening its treatment infrastructure.

"The next phase of our healthcare journey must focus equally on prevention," Bhushan said.

He stressed that preventive healthcare should become a national priority, supported by regular screening, early diagnosis, healthier lifestyles and greater public awareness.

"Preventive healthcare is not only a public health priority but also an economic imperative for building a healthier and more productive nation," he added.

India Faces A Double 9-0

Prof. (Dr.) Nirmal Kumar Ganguly, former Director General of the Indian Council of Medical Research (ICMR), said India is battling both infectious diseases and a rapidly growing burden of lifestyle-related illnesses.

"One of the biggest health challenges India faces today is the growing burden of obesity, which is the root cause of many major non-communicable diseases. Preventive healthcare is the most effective way to address both communicable and non-communicable diseases."

India continues to report a high burden of communicable diseases such as tuberculosis, malaria, dengue, cholera, typhoid, HIV/AIDS, hepatitis B and hepatitis C, which together account for about 27.5% of the country's disease burden.

At the same time, non-communicable diseases—including obesity, diabetes, hypertension and cancer—are rising rapidly. Around 60% of all deaths in India are caused by NCDs, with nearly 70% of their risk factors linked to unhealthy lifestyles.

Prevention Can Improve Quality Of Life

Prof. (Dr.) G. C. Khilnani, Chairman, PSRI Institute of Pulmonary, Critical Care & Sleep Medicine, said preventive healthcare should become part of everyday life through regular health check-ups, balanced nutrition, physical activity, vaccination, good hygiene and timely medical consultation.

Dr. Yash Gulati, Padma Shri awardee and Senior Consultant Orthopaedic and Joint Replacement Surgeon at Apollo Hospitals, New Delhi encouraged people to treat preventive healthcare as a lifelong commitment rather than an occasional health check-up.

"Every step taken towards prevention today reduces the burden of disease tomorrow."

How To Prevent Diseases

Doctors said adopting a prevention-first approach can significantly reduce the risk of both communicable and chronic diseases. They recommended:

• Going for regular health screenings to detect diseases early.
• Exercising regularly, including walking, yoga or other physical activities.
• Eating a balanced diet rich in fruits, vegetables, whole grains and fiber.
• Maintaining a healthy weight to reduce the risk of obesity, diabetes and heart disease.
• Getting adequate sleep and manage stress through meditation or relaxation techniques.
• Staying up to date with vaccinations to prevent infectious diseases.
• Maintaining good hygiene, including frequent handwashing and access to safe drinking water.
• Seeking timely medical advice instead of waiting for symptoms to worsen.

Aarogya Setu started as a contact-tracing and tracking app during the COVID-19 pandemic. But it underwent a significant transformation since its initial launch. Now, years after its launch, the Centre has launched Aarogya Setu 2.0.

Aarogya Setu 2.0 Aims To Solve Everyday Healthcare Problems

Instead of focusing only on infectious diseases, Aarogya Setu 2.0 now acts as a comprehensive healthcare app that provides a range of healthcare services. Its features are designed to change the way you obtain medical services in hospitals and other healthcare facilities.

It can help users store, retrieve, and manage their medical records, access various services, and simplify everyday healthcare tasks. Apart from data and records storage, the app can help users locate the nearest hospitals, manage their prescriptions, and track their insurance coverage seamlessly. The revamped platform is designed to address common challenges patients face while navigating India's healthcare system.

Here's a closer look:

Finding Closest Hospitals

One of the most useful features Aarogya Setu 2.0 provides is access to the locations of the closest hospitals and healthcare facilities. In times of emergencies, this feature could prove to be lifesaving as it could save valuable time when immediate medical attention is needed.

The app has also enabled searching for PM-JAY empanelled hospitals. This feature is integrated with Pradhan Mantri Jan Arogya Yojana, allowing users to search for empanelled hospitals offering cashless treatment. Users can easily find authorized hospitals and access free or subsidized care.

Read more: Ebola Outbreak Spreads To Fourth Province In DR Congo As Cases Rise To 1,274

Retrieving Medical History During Doctor Visits

Patients often struggle to recall their medical history, including details like previous illnesses, surgeries, allergies, medications, or vaccinations during a consultation. It often hinders the diagnostic process as the doctor does not have a comprehensive picture of the patient’s health.

The platform provides users with easy access to their health records, making it simpler to share relevant information with their healthcare providers whenever needed.

Read more: Leptospirosis In Monsoon: Expert Explains Why Early Detection & Prevention Is A Must

Avoiding Repetitive Diagnostic Tests

Patients are often compelled to undergo the same diagnostic tests and scans simply because their previous reports get misplaced. This not only increases healthcare costs but also causes inconvenience. Easy access to past laboratory reports can help patients avoid unnecessary repeat tests.

Simplifying Insurance And Cashless Treatment

Medical insurance paperwork often involves submitting hospital documents, prescriptions, diagnostic reports, and discharge summaries. Since many of these records are scattered across different hospitals or stored as paper documents, patients may spend considerable time collecting them.

With digital health records stored in one place, users may find it easier to retrieve documents required for insurance claims or cashless hospitalization, potentially reducing paperwork and delays.

Making Healthcare More Portable

Aarogya Setu 2.0 allows users to securely store and access digital health records through integration with India's digital health ecosystem. Having previous prescriptions and reports readily available can help both patients and healthcare providers make informed decisions.

This is particularly useful for individuals who relocate frequently and suffer from chronic conditions such as diabetes, hypertension, asthma, thyroid disorders, or kidney disease that need long-term monitoring.

Changing cities usually means changing doctors and hospitals. In the absence of a complete medical history, one is more likely to incur additional healthcare costs of retaking the tests.

As heatwaves have become more frequent and intense across the globe, health experts are increasingly warning that soaring temperatures affect far more than physical health. While dehydration, heat exhaustion, and heatstroke are common physiological effects of heatwaves, extreme heat can also take a significant toll on mental wellbeing.

Mental Health Toll Of Extreme Heat

HealthandMe spoke to Dr. Samant Darshi, Consultant - Psychiatrist & Neuromodulation Expert, Psymate Healthcare, Noida, about the psychological impact of extreme heat.

In hot weather, the human body constantly works to maintain a stable internal temperature. During periods of extreme heat, this process becomes increasingly challenging, placing considerable strain on both the body and brain.

Dr Darshi explains, “The high temperatures during heat waves can have a strong influence on not only physical but also the psychological state of people. The hot weather causes irritation, nervousness, stress, and frustration. Sleep disturbance associated with the hot weather only complicates the process of keeping a good mood.”

Living in higher temperatures is slowly becoming the new norm in several countries. With climate change driving longer and more intense heat events, understanding the psychological impact of extreme heat has become more important than ever.

Extreme Heat Can Worsen Serious Mental Health Issues

Additionally, research has shown that prolonged exposure to heat can worsen stress, anxiety, irritability, and even increase the risk of severe mental health crises. Moreover, people's ability to think logically is affected by heat; memory, attention, and overall productivity decrease in extreme temperatures.

Dr Darshi says, “People with some pre-existing mental health conditions (depression, anxiety disorders, schizophrenia, etc.) can suffer from worsening their symptoms during prolonged heatwaves. The side effects of some medications that are used for the treatment of mental illnesses include the disturbance of the processes of thermoregulation in the organism.”

High temperatures can also disrupt sleep, hamper hormone levels, and affect neurotransmitters like serotonin and dopamine, which play a key role in regulating mood. Sleep deprivation, a common consequence of hot nights, can further intensify emotional distress, making people feel more anxious, irritable, or overwhelmed.

Heatwaves Drives Isolation

As temperatures soar, people generally avoid stepping out, becoming increasingly secluded. Lack of social interactions triggers the brain’s primal ‘survival threat’ alarm, which can lead to excessive stress, poor emotional regulation, and increased risk of anxiety and depression.

It especially affects older people and other vulnerable groups. Social isolation can cause psychological problems in terms of loneliness and depression. In extreme cases, prolonged exposure to heat causes aggression, self-harm, and other mental health crises.

How To Protect Your Mental Wellbeing During A Heatwave

While one has little to no control over the weather, certain measures can help reduce the mental strain caused by extreme heat:

• Staying hydrated throughout the day.

• Keeping indoor spaces cool using fans, curtains, or air conditioning where possible.

• Avoiding strenuous activities during the hottest hours.

• Prioritizing good sleep hygiene and keep bedrooms as cool as possible.

• Checking in regularly with family members, friends, and neighbours, particularly those living alone.

• Seek professional support if feelings of anxiety, depression, or distress become overwhelming.