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.

One in four or 25 percent of adults with type-2 diabetes in India also suffer from liver fibrosis, according to an alarming study published in The Lancet Regional Health Southeast Asia journal today.

With data from more than 9,000 patients across the country, it is the largest ever real-world survey of liver fibrosis in type 2 diabetes from any low- or middle-income country.

While fatty liver disease has been touted as the most common liver condition among diabetes patients, the new study established liver fibrosis as the real danger among people with high blood sugar.

“Type 2 diabetes is closely linked to fatty liver disease (also known as MASLD). But how common is liver Fibrosis — the real danger — in Indian diabetics? Our answer: 1 in 4 has clinically significant liver fibrosis. One in 20 already has probable cirrhosis. Most had no symptoms. We propose liver fibrosis as the ‘4th major complication’ of diabetes,” said Ashish Kumar, from Ganga Ram Postgraduate Institute of Medical Education and Research (GRIPMER), from Sir Ganga Ram Hospital, in a post on social media platform X.

Also read: About 84% IT Employees Are Suffering With Fatty Liver Disease - Why Screenings Are Necessary For Corporate Workers

What Did The Study Find?

Fatty liver is typically the first and reversible stage of liver disease, where excess fat builds up in liver cells. Left untreated, it progresses to liver fibrosis, which is the excessive accumulation of scar tissue (collagen) in the liver resulting from chronic inflammation. The condition then progresses to the third and late stage, irreversible scarring (fibrosis) of the liver. The final stage is liver cancer.

The DiaFib-Liver Study included a total of 9,202 adults with type-2 diabetes patients who underwent FibroScan (VCTE) to assess liver fibrosis in routine diabetes care.

Of these:

• 26 percent had clinically significant fibrosis,
• 14 percent had advanced fibrosis,
• 5 percent had probable cirrhosis
• 65 percent had fatty liver disease.

• obesity
• dyslipidaemia
• kidney problems
• diabetes duration ≥10 years.

Fibrosis: The Screening Target

The study suggested the urgent need to integrate fibrosis screening into national diabetes programs.

“One in four adults with type 2 diabetes in India has clinically significant liver fibrosis and one in twenty already has probable cirrhosis, establishing advanced liver disease as a 'fourth major complication' of diabetes,” said the researchers.

“The DiaFibLiver Study calls for: Fibrosis — not steatosis — as the screening target. FibroScan integration into routine diabetes care. Moving beyond ultrasound-based referral,” Jha said.

“We hope this data from India adds to the global conversation on diabetes and liver disease,” he added.

Also read: The Silent Rise of Fatty Liver Disease: How India-Specific Guidelines Can Help

The findings highlight the urgent need to:

• move beyond steatosis
• systematically integrate fibrosis assessment into routine diabetes care,
• deploy non-invasive tools such as vibration-controlled transient elastography (VCTE) in community practice
• define screening strategies,
• evaluate therapeutic interventions.

Everyday Habits That Harm the Liver

Certain lifestyle choices can accelerate liver damage, such as:

Overeating processed or fried foods

High sugar intake (soft drinks, sweets, desserts)

Physical inactivity or prolonged sitting

Ignoring health issues like diabetes or hypertension

Crash dieting or taking unprescribed supplements.

How To Improve Liver Health?

Early screening and detection are key to prevent irreversible stages. Yet liver disease can be prevented with lifestyle changes such as:

• Eating a balanced diet with vegetables, fruits, whole grains, and lean protein
• Engaging in at least 30 minutes of exercise daily
• Staying hydrated to help the liver flush out toxins
• Avoiding alcohol and smoking
• Avoiding self-medication and unnecessary pills
• Getting routine health screenings.

New Delhi: Every day, the brain processes hundreds of choices. Most pass unnoticed: what to wear, which route to take, what to eat. But accumulated over hours and across competing demands, this constant decision-making exacts a cost. Decision fatigue is the gradual erosion of the brain’s capacity to make good choices, and over time it affects both mental functioning and physical health. Dr Shivi Kataria, Consultant – Psychiatry, CK Birla Hospitals, Jaipur, addressed the problem of plenty and said that it could take a toll on mental health in certain circumstances.

Read more: India Launches 1st Repository Of Data On Major Psychiatric Disorders

What are the signs?

The earliest signs tend to be emotional. Simple decisions start to feel disproportionately heavy. Choosing between two options takes longer than it should. Irritability surfaces. Tasks that once felt manageable begin to pile up as the mental energy required to engage with them thins. Procrastination, self-doubt, and a general withdrawal from decisions are common responses, with the brain essentially rationing what little capacity remains.

Cognitive symptoms follow. Concentration narrows. Judgement becomes less reliable. Small errors accumulate. People in this state often describe feeling mentally stuck, present in the room but unable to engage with any clarity or momentum.

The physical dimension is frequently overlooked. Headaches, low energy, disrupted sleep, and difficulty sustaining attention are all associated with sustained decision overload. These symptoms register what prolonged mental strain produces in the body and are worth taking seriously.

Who is most at risk?

Decision fatigue affects most people at some point, but the load is not evenly distributed. Professionals in high-responsibility roles, caregivers, and anyone managing multiple competing demands make a disproportionately high number of decisions each day. By the end of a long day, the quality of choices made about food, purchases, relationships, or work often reflects exhaustion more than intention.

Read more: Smartphone Overuse Linked To Rising Risk Of Eating Disorders Among Youth, Study Finds

Is there a solution?

Reducing the number of decisions that require active thought each day is the most direct intervention. Fixed routines for meals, schedules, and recurring tasks remove the need to deliberate repeatedly over the same ground. This is conservation of mental energy, and it compounds over time.

Important decisions are better made earlier in the day, when the brain is rested and cognitive resources are intact. Short breaks during sustained work periods allow partial recovery. Even brief physical activity or deliberate rest between decision-heavy tasks restores some capacity.

The brain has a finite decision-making budget each day. Spending it on low-stakes choices leaves less available for the ones that carry real consequence.

While fevers are often overlooked and brushed aside or even managed with antibiotics — a dangerous trend — an alarmingly nationwide study linked it to infectious diseases with far-reaching consequences.

The report, based on data of over one lakh individuals in India with fever, between 2023 and 2025, showed that these were not vague or self-limiting, but in more than 30 percent or one-third cases had clear links to serious infections, such as dengue, and typhoid.

According to the report by healthcare diagnostics company Thyrocare, the fevers were mostly linked with

• typhoid – in over 18 percent cases
• dengue -- over 14 percent cases.
• Other diseases include malaria, chikungunya, and leptospirosis.

Presence Of Multiple Infections

Importantly, the findings highlighted the presence of co-infections in 10 per cent cases. The most common was a combination of dengue and typhoid.

Dr Preet Kaur, Chief Scientific Officer, Thyrocare, said that a significant number of patients carry serious infections, sometimes more than one at a time, revealing patterns that simple assumptions cannot capture.

"Beyond the visible rise in temperature, laboratory markers highlight hidden stress on organs, from drops in platelet counts to elevated liver enzymes, underscoring that fever is a systemic signal, not an isolated event," she added.

Also read: ‘Breakbone Fever’: US CDC Warns Of Dengue Surge Across 17 Countries

Further, the report noted that dengue positivity declined significantly over the three-year report period, malaria increased despite its lower overall base.

Typhoid and chikungunya rose in 2024 before easing in 2025 but remained present across the testing population.

Also read: Drug Resistance Driving Severe Typhoid Disease, Death Among Children Under-5s in India: Lancet Study

Fever: Men Vs Women

The report noted that more women were affected with typhoid than men. On the contrary, men reported more malaria cases.

More than 32 percent of females had fevers compared to 29 percent of men. Fevers in women was largely driven by higher typhoid detection (21 percent vs 15 percent).

Malaria affected men more than twice as often as women (1.1 percent vs 0.5 percent).

The lab reports also revealed key physiological markers such as platelet counts and liver function among people with fever, dengue, and malaria.

Low platelet levels were seen in

• 27 percent of patients with fever
• 80 percent malaria positive patients
• 37 percent dengue-positive patients

• All fever patients (56 percent) showed elevated SGOT levels and 37 percent SGPT
• Liver stress was seen across patients with dengue, malaria and leptospirosis.

Dengue cases rose throughout the year and typically peaked around October.

Typhoid positivity steadily fell from 2023 to its lowest in 2025. Despite a mild monsoon spike each year, 2025 remained consistently lower overall.

Chikungunya cases rose gradually from lower, volatile levels in 2023, peaked sharply in 2024, and moderated to a softer trend in 2025.

Malaria positivity remained relatively low overall but increased during the monsoon months, with transmission peaking between May and September.

Over the three-year period, malaria positivity rose from 0.5 percent to 1.1 percent, indicating a gradual increase despite its lower overall base.