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.

Rashes are common in children and can occur for many reasons. Most are harmless and settle on their own, but some may need medical attention. Knowing the warning signs can help parents decide when home care is enough and when to consult a doctor.

Why Do Rashes Happen?

Children’s skin is sensitive and can react to heat, friction, allergens, insect bites, irritants or infections. Common causes include heat rash, eczema, contact dermatitis, insect bites and viral infections such as chickenpox, hand-foot-and-mouth disease and roseola.

A rash can look worrying, but the child’s overall condition is often as important as the appearance of the rash itself.

When Home Care May Be Enough

If your child is active, reasonably comfortable, feeding and drinking well, and otherwise appears well, a mild rash can often be managed at home.

Home care may be appropriate when the rash:

• Is mild and limited to a small area
• Is not spreading quickly
• Causes only mild itching or discomfort
• Occurs without concerning symptoms
• Looks consistent with a known condition such as heat rash or eczema

Avoid applying multiple creams, powders, antiseptics or home remedies, as these may irritate the skin or make the rash harder to assess. Medicines or steroid creams should not be used without medical advice. Your paediatrician can recommend suitable treatment based on your child’s age, weight and the likely cause of the rash.

When Should You See a Doctor?

Seek medical advice if your child has:

• A rash with fever, particularly if the child appears unwell, unusually sleepy, less responsive or is becoming progressively worse
• A red or purple rash that does not fade or become lighter when pressed firmly with a clear glass, especially if the child has fever or appears unwell
• A rapidly spreading rash
• Large blisters, peeling skin or a painful/tender rash
• Signs of a secondary skin infection, such as increasing redness, warmth, swelling, pain or pus
• A new or unexplained rash in a newborn or young infant, especially if accompanied by fever, poor feeding or unusual sleepiness
• Unusual sleepiness, weakness, poor feeding or reduced drinking
• A rash that is getting worse, keeps recurring or does not improve with appropriate home care

Seek Emergency Care Immediately If

A rash is accompanied by:

• Difficulty breathing or swallowing
• Swelling of the lips, mouth, face or tongue
• Extreme sleepiness, marked weakness or a child who is difficult to wake
• Rapid deterioration in the child’s overall condition
• A concerning non-fading red or purple rash in a child who appears unwell

What Parents Should Remember

Most childhood rashes are temporary and harmless. However, it is important to look beyond the rash itself.

Note when the rash started, where it first appeared, whether it is spreading and whether your child has fever or other symptoms. A photo of the rash can also help your paediatrician understand how it has changed over time.

Trust your instincts. If your child seems unusually unwell, is getting worse or something simply does not feel right, it is always better to seek medical advice rather than waiting.

A Simple Rule for Parents

Home care may be enough if your child is well, active and comfortable. Seek medical attention if the rash is accompanied by significant illness, rapid worsening or any warning signs.

By Dr Navin Bhatia, Senior Consultant & HOD – Paediatrics & PICU, PB Health

India is facing a significant and growing cancer burden, with the latest National Cancer Registry Programme study estimating that the lifetime risk of developing cancer in the country is 11% — about one in nine people.

The 2025 study also found that India ranks second in Asia and third globally in cancer incidence.

SC Directs States To Notify Cancer

Around 17 states in India have already made cancer a notifiable disease, while the Supreme Court in August directed the remaining 19 states and Union Territories to comply with the requirement, aimed at enabling early detection and proper care of patients.

The petition before the court argued that the continued non-notification of cancer, despite its alarming and escalating burden in India, amounted to a grave abdication of the state's constitutional duty under Articles 14 and 21 of the Constitution. It said this denied uniform treatment to similarly situated citizens and undermined their fundamental right to health and a life of dignity.

The Supreme Court's order is legally binding on the remaining 19 states and Union Territories, which have until November 11, 2026, to comply with the directive.

By the deadline, the concerned administrations are required to transition cancer into a notifiable disease and formally submit their progress reports to the Supreme Court. States will also need to issue official Gazette notifications requiring public and private healthcare entities to report cancer cases and related data.

Why Cancer Notification Matters

Speaking to HealthandMe, experts said making cancer notifiable could strengthen cancer surveillance, improve data collection and support research and treatment planning.

Dr Karishma Kirti, Consultant Obstetrician & Gynaecologist, Jaslok Hospital, Mumbai, said cancer should be treated as a notifiable disease, but through a system different from the traditional notification process used for infectious diseases.

How Cancer Registration Can Help

Dr Kirti told HealthandMe that mandatory registration of cancer cases could help India understand cancer trends and generate more real-world data to guide research.

“Mandatory registration of cancer cases will in the future help in understanding trends, generating real-world data early, and guiding research. Most of the evidence-based medicine and treatment that we recommend comes from Western data and mandating cancer registration will help India generate its own data and understand the inherent characteristics of Indian cancers better.”

Notifying Cancer Could Strengthen Cancer Care

Dr Harit K Chaturvedi, CEO & Clinical Head, Apollo Oncology Network, said making cancer a notifiable disease could help improve cancer care and research as the country's cancer burden rises.

“No two cancers are the same and the disease cannot be fought in silos. As the burden of cancer cases is increasing, wherein India is projected to record 1.5 million cases in 2026, declaring cancer as a notifiable disease can enable better cancer care and research across India,” he told HealthandMe.

Chaturvedi said notification of cancer would also give impetus to the decades-old National Cancer Registry Program and enable proper and mandatory record-keeping of cancer cases, as seen in many developed nations.

“By making cancer a notifiable disease, we can ensure that all cancer cases are reported and documented accurately, enabling us to track cancer incidence, mortality, and survival rates.”

Importantly, he said, notification would also enable policymakers, healthcare providers and researchers to work with real-time data, which could help bring more awareness, strengthen prevention and early detection, and improve treatment outcomes and quality of life.

Recurring abdominal pain is often dismissed as acidity or indigestion. This becomes a matter of concern when persistent pain reaches the back and causes vomiting and weight loss. These are symptoms of a more serious disease such as chronic pancreatitis.

A recent case highlights the importance of recognizing the condition early. A 35-year-old mother of two had been living with severe upper abdominal pain for nearly three years. She experienced episodes that required hospital admission. Upon detailed investigations, it was confirmed to be a case of chronic idiopathic calcific pancreatitis. Long-standing inflammation had caused stones to develop within the pancreatic duct, which blocked the normal flow of digestive juices and triggered repeated attacks of pain. The underlying problem remained unresolved. To the patient, the mental toll of being a daily-wage worker came with loss of income and disruption to family life.

Chronic pancreatitis is when repeated inflammation causes permanent damage to the pancreas. Gradually, the gland becomes scarred, the pancreatic duct narrows, and stones develop. Pressure within the pancreas increases, thereby causing recurrent abdominal pain. As the disease advances, patients may also develop difficulty digesting food, unintended weight loss, nutritional deficiencies, and diabetes due to loss of pancreatic function. There exist multiple causes of chronic pancreatitis such as alcohol, gallstones, smoking, genetic disorders, autoimmune diseases and certain metabolic conditions. In a proportion of patients, no definite cause can be identified despite extensive evaluation.

Diagnosis is made on clinical grounds and imaging modalities such as ultrasound, CT scan, or MRI, which are helpful in identifying changes in the pancreas and detecting ductal stones. Early diagnosis is essential to prevent further complications and long-term outcomes. Treatment is modified according to the severity of the illness and the patient's signs and symptoms. Initial management is done in the form of dietary modifications, enzyme supplementation, and avoidance of substances such as alcohol and tobacco. However, when pain persists despite medical treatment, surgery may be required to relieve the obstruction and restore pancreatic drainage. This also occurs when stones obstruct the pancreatic duct,

In this patient's case, the severity of the case warranted surgery in order to ensure the best chance of lasting relief. Prior to the surgery, the patient consulted multiple hospitals before treatment. She underwent a minimally invasive robotic-assisted procedure to remove the pancreatic duct stones and create a new drainage pathway for pancreatic secretions. She had been advised open surgery but delayed it because she feared the large incision and long recovery; before this, she was admitted every 2-3 months for severe pain. The surgery was performed through small incisions with reduced tissue trauma as compared to conventional open surgery. The recovery was unsuccessful, and the patient was discharged with pancreatic enzyme supplementation.

Three months later, she was free from the disabling pain that had dominated her life. She had returned to work and was able to resume her daily routine.

Available treatment options have increased due to minimally invasive and robotic techniques for selected patients, but they may not be suitable for everyone. The choice of treatment is dependent on multiple factors such as the stage of the disease, the anatomy of the pancreas, and the patient's overall condition.

The more important message, however, extends beyond surgery. Persistent pain should never be ignored or considered a common passing occurrence; neither should it be repeatedly treated with painkillers without identifying the cause.

Earlier diagnosis and timely referral can be encouraged by raising awareness amongst the general public to prevent recurring hospital visits. Awareness can make the difference between years of repeated hospitalizations and a return to a healthier, more productive life.

(Dr. Sreedhara V., Surgical Gastroenterologist, Apollo Hospitals Bannerghatta Road, Bengaluru)