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.

Many people do not realise just how closely mental health and liver health are connected—especially when alcohol becomes a go-to coping strategy for stress, anxiety, or emotional overwhelm. What may seem like temporary relief can quietly evolve into a pattern that affects both the mind and the body in significant ways. Dhara Ghuntla, Psychologist affiliated with Sujay Hospital, 7 Hills Hospital, Criticare Hospital, in an interaction with Health and Me, spoke about the impact of stress, alcohol use and emotional eating on the liver.

In today’s fast-paced, high-pressure lifestyle, it is common for individuals to turn to alcohol to unwind or escape difficult emotions. In the short term, alcohol can create a sense of relaxation or numbness. However, over time, this reliance can shift into a habitual coping mechanism and eventually into dependence. While the psychological impact is often discussed, the physical consequences—particularly on the liver—are just as important.

The liver plays a critical role in detoxifying the body. Regular alcohol consumption places it under constant strain, impairing its ability to function effectively. Over time, this can lead to conditions such as fatty liver, inflammation, and even long-term liver damage. What makes this especially concerning is that early-stage liver issues often present with little to no obvious symptoms, allowing damage to progress unnoticed.

At the same time, liver health has a direct influence on mental well-being. When the liver is compromised, it can affect energy levels, mood regulation, and cognitive function. People may experience increased fatigue, irritability, anxiety, low mood, or emotional instability. This happens because the liver plays an indirect but essential role in brain health through metabolism and toxin clearance.

The Vicious Cycle

This creates a self-perpetuating loop. A person feeling stressed, low, or anxious may turn to alcohol for relief. While it may help temporarily, it simultaneously places stress on the liver. As liver function declines, mental health symptoms—such as fatigue, irritability, anxiety, or low mood—can worsen. This often leads the individual to consume more alcohol, reinforcing the cycle.

Adding another layer, many individuals who rely on alcohol are often dealing with underlying issues such as depression, anxiety, sleep disturbances, or chronic life stressors. Alcohol is frequently used as a form of self-medication. However, instead of addressing these root concerns, it masks them temporarily while deepening both psychological and physical harm. Over time, this pattern increases dependency and makes recovery more complex.

The Gut–Liver–Brain Connection

Liver health is also closely tied to gut function and brain health. When the liver is under stress, digestion can be affected, nutrient absorption may decline, and energy levels can drop. This interconnected system—the gut, liver, and brain—plays a key role in emotional regulation and overall well-being. Disruptions in one area can ripple across the others, influencing how a person thinks, feels, and functions daily.

Breaking the Pattern

Recognising this connection is the first step towards change. Instead of turning to alcohol, healthier coping strategies can help regulate stress and support both mental and physical health. Practices such as yoga, meditation, regular exercise, journalling, and maintaining a balanced diet can significantly improve resilience and emotional stability.

Prioritising mental well-being, addressing underlying psychological concerns, and protecting liver health are not separate goals—they are deeply interconnected. Seeking timely support, whether through therapy, lifestyle changes, or medical guidance, can help break the cycle.

Reducing or eliminating alcohol use is not just about avoiding physical harm; it is about creating space to heal the underlying causes of stress and emotional distress. Supporting the liver, nurturing the gut, and caring for mental health together can lead to more sustainable and meaningful well-being.

You pick up a jar on the kitchen shelf and shudder. You take a flight of stairs, and that old pain sinks into your hip. You get up in the morning, and your shoulder feels as though it has been wrung out. You attribute it to age, to a long day on your feet, to just how things are now. But what if your body is trying to tell you something very particular and you have been missing it?

Dr Apoorv Dua, Consultant, Orthopaedics, ISIC Multispeciality Hospital, in an interview with Health and Me, said that this may be a sign of bursitis—a condition that is much more widespread than most people realise, and much more treatable than most people are aware. The expert went on to answer common questions regarding extreme pain that comes with this condition.

What is bursitis?

Bursae are small, fluid-filled sacs located between your bones, muscles, and tendons. Imagine them as the natural cushioning system of the body—shock absorbers that ensure your joints move smoothly and painlessly. Under normal circumstances, you do not even think about them. However, when inflamed, due to repetitive motion, prolonged pressure, injury, or infection, they make their presence known in a very noticeable manner. This is bursitis. Although it most often appears in the shoulder, elbow, hip, and knee, it may occur in nearly any joint in the body.

Who gets bursitis—and why?

This is where the lifestyle connection cannot be overlooked. Bursitis does not discriminate, but it has definite patterns. The weekend warrior who runs ten kilometres on Saturday after sitting at a desk all week. The housewife who spends hours cleaning floors or squatting in the kitchen. The office worker who has been stooped over a computer. The gym enthusiast who does not warm up. The retired teacher who begins a walking routine too vigorously. All these individuals may be silently placing stress on their bursae, and in many cases, bursitis is the eventual outcome.

Age also plays a role—the bursae, like most of our connective tissue, grow weaker with age. Certain medical conditions such as rheumatoid arthritis, gout, and diabetes can increase the risk. However, in many instances, the cause is simply the way we move—or do not move—in our day-to-day lives.

What does bursitis feel like?

A key characteristic of bursitis is pain that is disproportionate to the activity causing it. Reaching overhead, sitting on a hard surface, pressing on your elbow, or walking downhill—these are not dramatic movements, yet with bursitis, they may trigger a sharp, deep, or burning pain that interrupts you mid-action. The affected joint is usually swollen and tender. The area may feel warm to the touch. Movement becomes guarded. Sleep, particularly in cases of shoulder bursitis, can be difficult, as lying on the affected side aggravates the pain.

The challenge with bursitis is that its symptoms can resemble other conditions—tendinitis, arthritis, a muscle strain, or even a ligament tear. Many individuals self-diagnose, self-treat with painkillers, and hope it will go away. Sometimes it does. However, chronic, untreated bursitis may persist for months and, in some cases, lead to complications.

Bursitis diagnosis

A thorough clinical examination is usually the first step. A skilled orthopaedic specialist can identify the affected bursa through specific physical assessments. Imaging, such as ultrasound or MRI, may be recommended depending on the case to confirm the diagnosis, rule out structural damage, or guide treatment.

If infection is suspected—indicated by increased redness, fever, and rapidly worsening pain—fluid may be aspirated from the bursa and tested. Septic bursitis is a serious condition that requires immediate medical attention and is treated differently from the more common non-infectious type.

Bursitis treatment

The encouraging fact about bursitis is that it responds well to treatment, particularly when detected early. Most cases are managed with a combination of rest, activity modification, ice application, and anti-inflammatory medication. Physiotherapy also plays an important role, helping to correct movement patterns, strengthen supporting muscles, and restore the full range of motion.

In more persistent cases, a corticosteroid injection into the bursa may provide rapid and significant relief by reducing inflammation at its source. Surgery is rare and is typically considered only in chronic, recurrent cases that do not respond to conservative treatment.

Prevention is better

In many instances, bursitis is linked to lifestyle—and that presents an opportunity for prevention. Even small changes can help: warming up before exercise, avoiding excessive strain on joints, maintaining a healthy weight to reduce pressure on hips and knees, and ensuring workstations are ergonomically designed.

Pain often becomes background noise—something we get used to, work around, and push through. However, bursitis reminds us that the body communicates with precision. That pain when you pick up a jar, that discomfort on the stairs—it is not simply ageing. It is a signal worth discussing with your doctor.

The bulge that appears when an internal organ pushes through a weakened muscle wall will not recede with rest or medication—it will, in most cases, grow larger and more uncomfortable over time. Surgery is the only definitive treatment. What has changed significantly in recent years is what that surgery looks like and what recovery from it requires.

Dr Rajesh Sharma, Director – General Surgery, Minimal Access & Bariatric Surgery, CK Birla Hospitals, Jaipur, in an interview with Health and Me, spoke about the introduction of robotics in hernia treatment and how it can benefit patients.

How hernia surgeries are becoming less painful

With advances in surgical technology, minimally invasive approaches have significantly improved patient outcomes. One of the most important developments in recent years is robotic-assisted hernia surgery using the da Vinci Surgical System. In robotic surgery, the surgeon operates from a console equipped with a high-definition, three-dimensional, magnified view of the surgical field. The robotic system translates the surgeon’s hand movements into extremely precise movements of miniaturised instruments inserted through small incisions. The system also filters natural hand tremors and provides a greater range of motion than the human wrist, enabling meticulous dissection and suturing.

For hernia repair, these capabilities allow surgeons to perform delicate steps such as accurate defect closure and optimal mesh placement, which are important for the long-term durability of the repair.

Benefits for patients

Robotic hernia repair offers several advantages for patients:

1. Smaller incisions and minimal scarring
2. Reduced postoperative pain
3. Lower risk of wound complications
4. Shorter hospital stay
5. Faster return to normal activities

Because the procedure is minimally invasive, most patients experience earlier mobilisation and quicker overall recovery compared with traditional open surgery. Robotic surgery is particularly useful in complex, recurrent, or large ventral hernias, where precise reconstruction of the abdominal wall is important. While not every hernia requires a robotic approach, the technology expands the surgeon’s ability to perform advanced minimally invasive repairs with improved ergonomics and visualisation.

The future of hernia surgery

The integration of robotic platforms such as the da Vinci system represents a major step forward in modern general surgery. By combining surgical precision with minimally invasive techniques, robotic hernia repair aims to enhance patient comfort, improve recovery, and deliver durable surgical outcomes.