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.

California-based Dr. Salvador Plasencia, who supplied 20 vials of ketamine to Matthew Perry, the Friends (1994–2004) star, has been sentenced to 30 months in prison. Perry, 54, was discovered dead in his luxurious Los Angeles home on October 28, 2023. The actor had a history of depression and substance use but was reportedly on the path to recovery. His final on-screen appearance was playing himself in the 2021 feature-length special, *Friends: The Reunion*.

Perry accidentally drowned due to the acute effects of a ketamine overdose. Five individuals faced charges in the case, all of whom eventually pleaded guilty. Dr. Plasencia is the first person to be sentenced in connection with Perry’s death. In addition to his 30-month prison term, he was ordered to pay a fine of $5,600. But what exactly is ketamine, and how can an overdose affect the body?

Doctor Who Supplied Matthew Perry Ketamine Pleads Guilty

Perry was found dead in his hot tub on October 28, 2023, at age 54. The LA County Medical Examiner determined that his death resulted from the “acute effects of ketamine,” with contributing factors including drowning and coronary artery disease. In July 2025, Dr. Plasencia pleaded guilty to felony charges for distributing ketamine to four individuals. He also confirmed that Perry had received multiple doses of the drug prior to his death. Perry’s death in Los Angeles, California, was officially attributed to the “acute effects of ketamine,” which caused him to lose consciousness and drown in his hot tub. He had struggled with substance abuse for years and had been receiving ketamine treatment for anxiety and depression at an accredited clinic, according to the BBC.

What Is Ketamine?

Ketamine is a medication used by doctors as an anesthetic to induce temporary loss of consciousness. Under the Controlled Substances Act, it is classified as a Schedule III non-narcotic substance. The FDA has approved ketamine for use only as a general anesthetic. However, in some cases, doctors prescribe it “off-label” for conditions such as depression. “Off-label” refers to using a drug for a condition that the FDA has not specifically approved.

How Does Ketamine Overdose Harm Your Body?

Certain medical conditions can make ketamine overdose riskier. People with heart disease or high blood pressure may experience increased intracranial pressure, raising the chance of stroke. Blood flow to the heart can be reduced. As a relaxant, excessive ketamine can interfere with breathing, causing it to become shallow. High doses can also be toxic to the liver and urinary bladder. Unregulated or repeated use may lead to dependence and increase the risk of developing schizophrenia.

Side Effects Of Ketamine

At prescribed doses, common side effects of ketamine, according to Medical News Today, include:

• Drowsiness
• Double vision
• Confusion
• Nausea
• Vomiting
• Dizziness
• A general feeling of unease

Ketamine can also cause a wide range of other symptoms affecting different parts of the body, though these are less frequent.

Ketamine As A Drug Of Abuse

Ketamine can produce sensations of detachment from the environment, pain relief, and hallucinations, which has led to its misuse. Recreational users often describe feelings of being separated from their body or a floating sensation. Some report near-total sensory detachment, which they compare to a near-death experience.

The drug is particularly popular among teens and young adults in club settings. Many users prefer ketamine trips to PCP or LSD because the hallucinations are shorter—lasting 30 minutes to an hour—rather than several hours.

Always consult a healthcare professional before starting, stopping, or changing any medication.

As December rolls in, familiar melodies float through malls, train stations and sometimes right outside your front door. Carol groups wrapped in tinsel bring a warm sense of nostalgia. Their voices rise in unison, cheerful and bright, filling cold evenings with a comfort that feels almost instinctive. What most people do not realize is that this seasonal tradition may be giving the singers themselves a genuine health lift.

Researchers have been exploring this for years, and their findings suggest that singing is far more than a joyful holiday hobby. It strengthens social bonds, supports emotional wellbeing and even offers physical benefits that reach deep into the brain and lungs.

Why Singing Feels So Good

Alex Street, a researcher at the Cambridge Institute for Music Therapy Research, describes singing as a cognitive, physical, emotional and social act, as reported by BBC. When people sing, especially in groups, the brain lights up in ways few other activities can replicate. Regions responsible for language, movement and emotion get activated at the same time. The steady breathing that singing requires also prompts the release of endorphins, which brings on feelings of pleasure and reduces pain.

Psychologists have long noted how even strangers can develop a sense of togetherness after singing side by side for just an hour. This may explain why community choirs often feel like extended families.

A Simple Workout with Surprising Benefits

Beyond the emotional high, singing demands more from the body than many expect. Studies have shown that it can improve heart rate, circulation and blood pressure. The controlled breathing and longer exhalations strengthen the lungs in ways similar to moderate physical activity. Some researchers even compare a singing session with a brisk walk.

BBC reports that Adam Lewis, an associate professor of respiratory physiotherapy at the University of Southampton, notes that singing encourages people to use their respiratory muscles more efficiently. This is one reason why it has become a useful complementary tool for people living with chronic lung conditions.

Healing Through Harmony

One of the most profound uses of singing is in therapy for people recovering from brain injuries or neurological illnesses. Music therapists often rely on songs from childhood to help patients regain speech or movement. The story of former US congresswoman Gabrielle Giffords is one of the most well known examples, reports BBC. After surviving a severe brain injury, she regained her speech partly through singing familiar melodies during therapy sessions.

Similar approaches have been used with stroke survivors, patients with Parkinson’s disease and people living with dementia. Singing provides repeated vocal practice, encourages focus, and stimulates both sides of the brain. Experts also believe that it may help slow cognitive decline in older adults, although long term studies are still needed.

A Gentle Way Back to Community

For many people living with chronic illness, joining a choir brings something even more meaningful than physical gains. It offers a space where patients, caregivers and professionals participate as equals. Street describes these shared moments as a rare kind of unity that dissolves labels and replaces them with a sense of belonging.

As researchers learn more about the power of song, the message becomes clearer. Singing is not just entertainment. It is a tool for connection, a low cost therapy and a way to strengthen both mind and body. So this festive season, joining a group around the Christmas tree might be more beneficial than you think.

Delhi's Air Quality Index today recorded 'severe' in several location. The Central Pollution Control Board (CPCB) data from 40 monitoring stations from across the city showed AQI above 401 at 7.05 am on Wednesday morning. City's average AQI stood at 376.

While it has only been three days into December, the AQI levels have undergone severe changes. On November 30, Delhi's AQI was recorded at 279, on December 1, it was recorded at 304, while on December 2, the AQI went up to 372.

Amid all this, Dr Ritu Singh, Director Professor and HOD, Department of Biochemistry at Lady Hardinge Medical College posted on her Instagram, what she calls the 'only steps to save your lungs in Delhi".

What Does the Doctor Say?

"If you’re living in Delhi right now, the first line of protection is simple: avoid breathing unfiltered air. If you can’t leave the city, wear an N95 mask every time you step outside or move away from a HEPA-filtered space," says Dr Ritu Singh.

The doctor points out that keeping a high quality HEPA filter at home and at your workplace is essential. She points out that though it may be expensive, but one should know that their "lungs are not replaceable". She says, "Yes, spend all your hard earned money on HEPA filters because the lung is not replaceable."

What Is HEPA Filter? How Does It Help?

As per the US Environmental Protection Agency (EPA), HEPA or also known as the high efficiency particulate air is a type of filter that can theoretically remove at least 99.97% of dust, pollen, mold, bacteria, and any airborne particles with a size of 0.3 microns (µm). The diameter specification of 0.3 microns corresponds to the worst case; the most penetrating particle size (MPPS). Particles that are larger or smaller are trapped with even higher efficiency. Using the worst case particle size results in the worst case efficiency rating (i.e. 99.97% or better for all particle sizes).

What Else Can Be Done To Stay Safe From Air Pollution?

Dr Singh suggests that indoor plants could be added, though it could only offer a "small but meaningful improvement in air quality".

One famous NASA experiment, published in 1989, found that indoor plants can scrub the air of cancer-causing volatile organic compounds like formaldehyde and benzene.

These plants are:

• Spider Plant
• Snake Plant
• Peace Lilly
• Aloe Vera
• Boston Fern
• English Ivy
• Rubber Plant
• Golden Photos
• Bamboo Palm
• Dracaena

The doctor also recommends that one should increase their intakes of antioxidant foods. "Increase your antioxidant intake—turmeric, amla, oranges—these won’t fix pollution, but they help your body cope with oxidative stress.”

Antioxidants strengthen the immune system by fighting oxidative stress, which is caused by unstable molecules called reactive oxygen species (ROS). The body's normal processes, like breathing and metabolism, create free radicals (ROS). Antioxidants donate electrons to these unstable molecules, which neutralizes them and stops them from damaging healthy cells.

"Right now, the goal is extremely clear: prevent inhalation of polluted air. Delhi’s current levels are dangerous for the lungs, the heart, and the entire respiratory system," the doctor says.