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.

New health data has prompted the NHS to once again encourage certain groups to get their flu vaccination. Recent figures from NHS England show that cases of winter viruses are climbing again.

For example, as per Mirror, hospital admissions due to flu have risen by 9% over the past two weeks, after the previous fortnight had suggested a decline in cases. At the same time, daily numbers of patients admitted with norovirus and Covid have increased compared with the previous week.

Despite these rising cases, the NHS confirmed that it has administered over 18.6 million flu vaccines this winter, an increase of more than half a million compared with the same period last year. With the surge in winter viruses putting extra strain on hospitals and ambulance services, the NHS emphasised that thousands of flu vaccination appointments are still available.

NHS Issues New Flu Jab Alert

Posting on X, the NHS said: "Flu can be serious, especially for older people and those at higher risk. Millions have already been vaccinated this season, and there are still thousands of appointments available.

"If you're eligible, it’s not too late to get yours." Many people, particularly those in vulnerable groups, may qualify for a free flu vaccine.

Who Is Eligible For The Free Flu Jab?

According to NHS guidance, there are six main categories of people eligible for a free flu jab. You might qualify if you need additional protection or if someone in your household does.

This includes people who:

• Are pregnant
• Have certain long-term health conditions
• Live in a care home
• Are aged 65 or over, or will turn 65 by March 31, 2026
• Are the main carer for an older or disabled person, or receive a carer's allowance
• Live with someone with a weakened immune system (for example, someone undergoing chemotherapy)

NHS national medical director Professor Meghana Pandit said: "It’s clear that the worst is far from over for the NHS this winter. Hospitals have seen another rise in admissions from flu and other respiratory viruses last week. The cold weather is also contributing to an increase in vulnerable patients visiting A&E with respiratory issues and more injuries from slips and falls due to icy conditions, so it remains an extremely busy period."

How To Get The Flu Vaccine For Free?

If you qualify for a free flu jab, there are several ways to access it. As per Mirror, you can call your GP surgery directly to book an appointment, or arrange one at a pharmacy either online or through the NHS app, as long as you are 18 or older.

Some pharmacies also offer the NHS vaccine at no cost and accept walk-ins without prior booking. This service isn’t available at every pharmacy, but you can locate the nearest pharmacy offering the complimentary vaccine here.

Itchy skin is something most of us deal with occasionally, and in many cases, it is harmless. Everyday triggers such as rough clothing, insect bites, or dry winter air can all leave the skin irritated. Itching is also commonly linked to skin conditions like eczema or psoriasis.

That said, an oncologist has pointed out that persistent itching can, in some cases, be linked to certain cancers. In a TikTok video, Dr Amit Garg, a cancer specialist based in California, explained that itching can appear as a symptom in four specific types of cancer. While itching alone is not usually a cause for concern, it may become more meaningful when it occurs alongside other symptoms that should be checked by a GP.

1. Hodgkin Lymphoma

Hodgkin lymphoma is a relatively rare cancer that affects lymphocytes, the white blood cells that help the body fight infection. Dr Garg explained that this cancer can cause “severe, widespread itching,” which often becomes worse at night. The NHS also lists itchy skin as a possible symptom, along with:

• A painless lump or swelling, usually in the neck, armpit, or groin, which is the most common sign
• Pain in the glands of the neck, armpit, or groin after drinking alcohol
• A high temperature
• Night sweats
• Shortness of breath
• Sudden, unexplained weight loss

The NHS advises seeing a GP if you notice any of these symptoms. Although they are common and do not always point to Hodgkin lymphoma, it is important to rule it out. Early diagnosis improves the chances of successful treatment, so symptoms should not be ignored.

2. Polycythemia Vera

Polycythemia vera is a rare, slow-developing blood cancer. According to the NHS, it is most often caused by a change in the JAK2 gene, which leads the bone marrow to produce too many red blood cells. An increased concentration of red blood cells is known as erythrocytosis, although having this condition does not automatically mean cancer.

One symptom of erythrocytosis can be itchy skin, particularly after bathing or showering. You should speak to a GP if symptoms persist. Other signs may include:

• Headaches
• Blurred vision
• Reddened skin, especially on the face, hands, and feet
• Tiredness
• High blood pressure
• Dizziness
• Discomfort in the abdomen
• Confusion
• Bleeding issues such as nosebleeds or bruising
• Gout, which can cause joint pain, stiffness, and swelling

3. Gallbladder And Pancreatic Cancer

Gallbladder cancer and pancreatic cancer often share similar symptoms. These can include a reduced appetite, unintentional weight loss, fever, nausea, and changes in bowel habits such as diarrhoea or constipation.

Dr Garg explained that both cancers can cause “intense itching,” which happens when bile salts build up under the skin. The NHS also lists itching as a symptom for both conditions, noting it may occur alongside darker urine, paler stools, and jaundice, which can cause yellowing of the skin or the whites of the eyes.

One key difference between the two cancers is the type of pain experienced. Gallbladder cancer may cause a dull ache on the right side of the abdomen, while pancreatic cancer more commonly causes pain in the upper abdomen and back, which can worsen after eating or when lying down.

In both cases, you should see a GP if symptoms last longer than two weeks or if you have lost weight without trying. You should call 111 if vomiting lasts more than two days, diarrhoea continues for more than seven days, or if your skin turns yellow.

4. Cutaneous T-cell Lymphoma

Cutaneous T-cell lymphoma is a form of skin lymphoma and a rare type of non-Hodgkin lymphoma. It begins in the T cells of the skin and often appears as flat, red patches that may be itchy.

In its early stages, these patches can resemble common skin conditions such as eczema or psoriasis. Seeing a GP is important if symptoms develop, as they can assess whether it is a common skin issue or something more serious.

Cancer Research UK states that around 150 people in the UK are diagnosed with cutaneous T-cell lymphoma each year, making it a rare cancer. As with many cancers, early diagnosis can play a key role in improving treatment outcomes.

A GP has advised women to make three simple health checks part of their monthly routine, saying the start of the month can act as a helpful prompt to stay consistent. The advice comes from Dr Carys Sonnenberg, an NHS women’s health GP and the founder of the Rowena Health Menopause Clinic. Speaking to her large audience on TikTok through her account @Rowenahealth_menopause, the doctor, author, and public speaker suggested setting aside the first day of every month for these routine checks.

Even if the date has already passed this month, she noted it can still serve as a timely nudge for those who have not yet done them, and a useful habit to follow going forward.

Three Health Checks Doctor Recommends

In her video, Dr Carys explained to viewers: “It’s the first of the month, so it’s a really good day to do your chest check, to do your vulva check, and also to examine any moles that you have on your body, not forgetting your head.” She added that becoming familiar with your own body is key. “When you’re checking yourself, it really helps to understand what’s normal for you. I’m Dr Carys Sonnenberg.

“I’m a GP and a menopause specialist. There is some excellent guidance online that shows you how to check your chest properly, what changes to be mindful of, and which symptoms should be discussed with your GP.

How To Do Health Checks Properly

“For the rest of your body, you’ll need a mirror. You might also want someone to help check areas you cannot easily see, such as your back, in case there are skin moles that look different or have changed. Don’t forget to part your hair and look at your scalp as well, in case there’s anything unusual that needs attention. I hope that’s helpful.”

Breast Changes To Watch For

Health experts stress the importance of staying alert to changes in your breasts or chest that could signal a problem. Making monthly checks a habit is a simple way to stay aware, while also remembering that some changes can occur naturally, such as during different phases of your menstrual cycle.

Possible signs of breast cancer can include:

• Skin changes like puckering or dimpling
• An unusual lump or swelling in the armpit or near the collarbone
• New lumps or areas of thickened tissue
• Fluid leaking from the nipple
• Crusting or a rash on or around the nipple
• A nipple that turns inward or changes direction
• A sudden change in breast size or shape
• Ongoing, unexplained pain in the breast, chest, or armpit

Secondary symptoms may include trouble sleeping, feeling generally unwell or sick, a loss of appetite, unexpected weight loss, and ongoing tiredness or low energy. While these signs do not always point to breast cancer, doctors advise contacting your GP if you notice anything unusual. Always speak to your GP if you have concerns about your health.