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.

The National Medical Commission (NMC) has issued an advisory mandating strict adherence to safe injection practices. The directive aims to curb preventable outbreaks of HIV, Hepatitis B (HBV), and Hepatitis C (HCV) caused by the unsafe reuse of syringes, needles, and other single-use medical devices.

Despite decades of evidence and repeated warnings from the World Health Organization (WHO), unsafe injection practices continue in India, often under the guise of cost-saving. This has led to avoidable infections, lifelong treatment costs, and a loss of public trust in healthcare systems.

What the NMC Advisory Says

The advisory mandates:

• Single-use devices must never be reused:Reuse of syringes, dialyzers, or vials is a direct breach of patient safety.
• Progressive adoption of safety-engineered auto-disable syringes: These devices prevent reuse and help protect healthcare workers from needle-stick injuries.
• Strict enforcement of the Biomedical Waste Management Rules, 2016: Proper segregation and disposal of sharps is mandatory.
• Mandatory training and audits: Healthcare workers must undergo regular competency assessments, and institutions must conduct strict monitoring.

Why Action Is Important

“India has the manufacturing capacity to supply safety-engineered syringes at scale. The barrier is not technology, it is willpower. Procurement administrators must prioritize patient safety over short-term cost-cutting,” said Rajiv Nath, Forum Coordinator of the Association of Indian Medical Device Industry.

“Single-use devices like syringes, dialyzers, and AV (Arteriovenous) fistula needles must not be reused. Unsafe injection practices are entirely preventable, and continuing them is indefensible,” he added.

The expert urged policymakers to act now because it is affecting

• Public Health : Treating HIV, HBV, and HCV infections acquired through unsafe injections costs far more than investing in safe injection devices.

• Global Credibility: As one of the world’s largest users of injectable medicines and vaccines, India’s leadership in safe injection, drug delivery, and blood management practices is critical to global health security.

• Patient Trust: Every reused syringe erodes confidence in healthcare institutions and undermines national health programs.

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Call to Action

The AiMeD stated that the NMC's advisory must be treated as a binding mandate, not a suggestion. Procurement administrators, hospital authorities, and policymakers should:

• Enforce zero tolerance for device reuse across all healthcare facilities.
• Allocate budgets for safety-engineered syringes, including auto-disable syringes and sharps injury-prevention devices, as a public health investment rather than a discretionary expense.
• Establish accountability mechanisms through accreditation schemes, including audits, reporting of needle-stick injuries, and penalties for non-compliance.
• Launch patient awareness campaigns to empower communities to demand safe injection practices.

"Unsafe injection practices are not a matter of affordability but of accountability. India has the capacity, technology, and cost-effectiveness evidence through Health Technology Assessment (HTA). What is needed now is decisive action to protect patients and healthcare workers alike," the AiMeD said.

Survival rates among patients with high-grade gliomas — one of the most aggressive forms of brain cancer — have improved by up to 50 per cent in India, according to leading oncologists ahead of World Brain Tumour Day 2026.

Doctors say a growing number of patients are now living significantly longer after diagnosis, with some surviving for more than a decade.

Advances Boost Survival Outcomes

Dr. Tejinder Kataria, Chairperson of Radiation Oncology at Medanta, said median survival for many high-grade glioma patients has increased from around 9–12 months to 14–18 months.

She noted that some centers are "reporting nearly 40 per cent two-year survival rates among patients with Grade III and Grade IV gliomas. In addition, about 5 per cent of patients in certain high-grade glioma groups are now surviving for more than 10 years".

Experts attribute these improvements to advances in molecular diagnostics, comprehensive genomic profiling, neuronavigation-assisted surgery, precision radiation therapy, and targeted treatments.

“Radiation oncology has evolved from open beams in the cobalt era to highly precise beam configurations using modern technologies. We are now able to deliver tumoricidal doses more accurately while also preserving quality of life,” Dr. Kataria said.

Personalized Treatment Changing Care

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Dr. R. Ranga Rao, Chairman of Medical Oncology at Paras Health, said brain tumor treatment is no longer limited to surgery and radiation.

A deeper understanding of tumor biology is enabling doctors to tailor treatment according to the molecular profile of each patient’s cancer.

“Although high-grade gliomas remain challenging to treat, the combination of precision diagnostics, modern therapies, and multidisciplinary specialist care is helping more patients live longer and maintain a better quality of life than was possible even a few years ago,” Dr. Rao said.

He also highlighted the growing role of whole genomic sequencing, which helps clinicians understand a tumor’s genetic makeup and select more personalized treatment strategies that may improve survival.

Patients Should Not Lose Hope

Dr. Shyam Agarwal, Senior Consultant in Medical Oncology at Sir Ganga Ram Hospital, said many patients fear the worst when diagnosed with a brain tumor.

“People often feel that nothing can be done once they hear the word tumor in the brain. But brain tumors are of many different types — benign and malignant — and even malignant tumors vary widely in behavior,” he said.

According to Dr. Agarwal, modern treatment options, including surgery, radiation, targeted therapies, and newer drugs, can control many brain cancers for extended periods and may even offer a cure in selected cases.

He also stressed the importance of molecular testing and comprehensive genomic profiling to identify patients who may benefit from precision medicines.

Late Diagnosis Remains a Major Challenge

Despite advances in treatment, experts say delayed diagnosis remains a significant problem in India.

“The biggest blind spot in our country is that many patients reach specialists at a late stage. Symptoms may masquerade as routine headaches, hearing deficits, or visual disturbances. We need greater awareness,” Dr. Kataria said.

Dr. Agarwal added that delayed diagnosis is due to symptoms such as persistent headaches, hearing problems, or vision disturbances which are often mistaken for stress, migraine, or other common conditions, leading to late referrals.

What Is Glioma?

As per the Johns Hopkins Medicine, glioma is a common type of tumor originating in the brain. About 33 per cent of all brain tumors are gliomas, which originate n the glial cells that surround and support neurons in the brains, including astrocytes, oligodendrocytes and ependymal cells.

Gliomas are called intra-axial brain tumors because they grow within the substance of the brain and often mix with normal brain tissue. Symptoms include

• Headaches
• Seizures
• Personality changes
• Weakness in the arms, face or legs
• Numbness
• Problems with speech
• Nausea and vomiting
• Vision loss
• Dizziness.

Canada has had a shortage of doctors, nurses, and other medical staff for many years, whereas just south of it, the United States does not have this kind of problem. It is not that no one wants to go and work in the Maple Leaf Country, but its strict regulations put a barrier between foreign professionals.

This complex issue has been addressed by the new report by the Institute for Canadian Citizenship (ICC), authored by Kareem El-Assal. This report, named Ready to Contribute, finds that the Canadian foreign qualification recognition (FQR) challenges are leaving nearly 640,000 immigrant degree-holders outside.

The report also said that these restrictions are causing harm to the medical industry in Canada, and it's not getting labour market success as their counterparts in the United States. The study also mentions that if the restrictions are lifted, then thousands of medical professionals will be able to contribute.

The study also states, “This translates into a disproportionate number of immigrant physicians working as security guards, engineers driving for ride-share apps, and nurses sorting packages in warehouses. This waste of talent hurts all Canadians, not just immigrants.”

The ICC report highlights that this strict policy has impacted Canada adversely. They reported that only 41 per cent of internationally trained physicians and 37 per cent of internationally trained nurses are working in their professions.

They said, “Lowering the immigrant overqualification rate to match the national rate has the potential to add 27,000 nurses and related professionals and nearly 16,000 medical doctors to Canada’s workforce. This illustrative example underscores the way in which immigrant underemployment impacts all Canadians, considering that 6.5 million Canadians do not have access to a family doctor.”

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How Patients Are Suffering Due To Different Diseases?

Canadian healthcare facilities' shortcomings have also become a problem for citizens, as the nation has approximately 4 million people with diabetes, or 9.7 percent of its population. Cancer and cardiovascular diseases are also issues, among others. There are also issues of having infectious and vector-borne diseases like Lyme disease and West Nile virus.

Also Read: New Study Warns Smog Is Rising Across the US: The Hidden Health Risks

What Is Diabetes?

Diabetes is a condition characterized by high blood sugar (glucose) levels. It develops when the pancreas either doesn't produce enough insulin, doesn't produce any insulin at all, or when the body doesn't respond properly to insulin, a condition known as insulin resistance.

Diabetes Occurs Under The Following circumstances:

• The pancreas does not produce any insulin.
• The pancreas produces very little insulin.
• The body does not respond appropriately to insulin (insulin resistance)

What Is Lyme Disease?

Lyme disease is caused by a bacterium called Borrelia burgdorferi. The most common cause of these diseases in humans is blacklegged ticks, though other variants can also be carriers. The Harvard Health says that most patients do not remember being bitten by a tick.