If your migraines suddenly feel more frequent, intense, or unpredictable in midlife, hormonal instability may be playing a bigger role than you realize.

In this episode, you’ll learn:

💡 Why fluctuating estrogen during perimenopause can make the migraine brain more reactive

💡 How poor sleep, hot flashes, anxiety, irregular periods, and migraine can reinforce one another

💡 How to track your personal patterns and create more stability during this hormonal transition

Perimenopause may feel unpredictable, but understanding your changing rhythm can help you respond with more clarity and confidence.

Ask Diane Anything — Live Q&A

Have a migraine question? Join Diane live on September 24, 2026 to ask your questions or simply listen.

👉 Register here: migraineheroes.com/live

🎧 New episodes every Monday and Wednesday

🔗 Discover our work on migraineheroes.com

References:

• Migraine Across the Menopausal Transition and Beyond: A Narrative Review (Korn & Bernstein, 2026): This review covers migraine changes and management across menopause. Read more here.
• Menstrual and Perimenopausal Migraine: A Narrative Review (MacGregor, 2020): This review examines hormonal changes affecting menstrual and perimenopausal migraine. Read more here.
• Menstrual Migraine Is Caused by Estrogen Withdrawal: Revisiting the Evidence (Raffaelli et al., 2023): This review reassesses the evidence for estrogen withdrawal as a migraine trigger. Read more here.
• Perimenopause and Menopause Are Associated With High Frequency Headache in Women With Migraine (Martin et al., 2016): This study found increased high-frequency headache during perimenopause. Read more here.
• Executive Summary of the Stages of Reproductive Aging Workshop + 10 (Harlow et al., 2012): This paper defines stages of reproductive aging and the menopausal transition. Read more here.
• Migraine Management During Menstruation and Menopause (MacGregor, 2015): This review covers migraine treatment during menstruation and menopause. Read more here.
• Migraine and Menopause: A Narrative Review (Bernstein & O’Neal, 2020): This review examines migraine patterns and treatment around menopause. Read more here.
• Hormonal Influences in Migraine, Interactions of Oestrogen, Oxytocin and CGRP (Krause et al., 2021): This review explores how reproductive hormones and CGRP interact in migraine. Read more here.
• Acupuncture for the Prevention of Episodic Migraine (Linde et al., 2016): This Cochrane review evaluates acupuncture for migraine prevention. Read more here.
• Acupuncture for Migraine: A Systematic Review and Meta-Regression of Randomized Controlled Trials (Yang et al., 2024): This review examines the dose-response relationship between acupuncture and migraine frequency. Read more here.

Disclaimer: This podcast is for informational purposes only and does not substitute for providing medical advice. Always consult your healthcare professional before making any health-related decisions.

For women, men, and children who suffer from migraine disease, Migraine Heroes is your go-to resource for understanding, managing, and overcoming migraine attacks.

We cover all types of migraines and related headaches, including primary and secondary migraines, chronic migraines, and cluster migraines. We dive deep into the complexities of migraine with aura and migraine without aura, as well as rarer forms like hemiplegic migraine, retinal migraine, and acephalgic migraine (silent migraine). Our discussions also extend to cervicogenic headaches, ice pick headaches, and pressure headaches, which often mimic migraine or contribute to overall migraine burden.

Could fatigue, dizziness, brain fog, feeling cold, and migraine be pointing to something deeper, like low iron stores?

In this episode of Migraine Heroes Podcast, Diane Ducarme explores the connection between iron, energy, oxygen delivery, brain function, and migraine and why low iron can sometimes be missed when we look only at hemoglobin.

You’ll learn:

💡 Why low iron may affect much more than your energy — and potentially make a migraine-prone nervous system more vulnerable

💡 Why ferritin can reveal depleted iron stores even when your blood count appears normal

💡 Simple ways to support iron intake, plus why finding the reason behind low iron matters just as much as replacing it

You’ll also discover how heavy periods, blood loss, diet, and absorption can contribute to depletion and why symptoms are often clues worth investigating rather than problems to look at in isolation.

🎧 New episodes every Monday and Wednesday

🔗 Discover our work on migraineheroes.com

References:

• The Bidirectional Relationship Between Iron Deficiency Anemia and Chronic Headache Disorders (Rohilla et al., 2025): This meta-analysis found a significant association between iron-deficiency anemia and chronic headache disorders. Read more here.
• Association Between Dietary Iron Intake and Serum Ferritin and Severe Headache or Migraine (Meng et al., 2021): This study links iron intake and ferritin levels with migraine or severe headache in some women. Read more here.
• Association Between Anemia Severity and Migraine in Iron Deficiency Anemia (Sari & Kama Başci, 2024): Lower ferritin was associated with greater migraine pain and headache impact. Read more here.
• Is There Any Correlation Between Migraine Attacks and Iron Deficiency Anemia? A Case-Control Study (Tayyebi et al., 2019): This study found associations between migraine and iron deficiency, particularly among women. Read more here.
• Is Iron-Deficiency Anemia Associated With Migraine? Is There a Role for Anxiety and Depression? (Pamuk et al., 2016): This study found migraine was common among patients with iron-deficiency anemia. Read more here.
• Association Between Iron Deficiency Anemia and Chronic Daily Headache: A Case-Control Study (Singh et al., 2023): Iron-deficiency anemia was independently associated with chronic daily headache. Read more here.
• Iron Deficiency Without Anaemia: A Diagnosis That Matters (Al-Naseem et al., 2021): This review explains how iron deficiency can occur despite normal hemoglobin levels. Read more here.
• British Society of Gastroenterology Guidelines for the Management of Iron Deficiency Anaemia in Adults (Snook et al., 2021): These guidelines explain how ferritin and other iron markers are used to diagnose iron deficiency. Read more here.
• Non-Anaemic Iron Deficiency (Balendran & Forsyth, 2021): This review covers low iron stores despite normal hemoglobin and their clinical management. Read more here.
• Iron in the Migraine Brain (Tepe, Yemisci & Karatas, 2025): This review explores iron deficiency, iron overload, oxidative stress, and neuroinflammation in migraine. Read more here.

Disclaimer: This podcast is for informational purposes only and does not substitute for providing medical advice. Always consult your healthcare professional before making any health-related decisions.

For women, men, and children who suffer from migraine disease, Migraine Heroes is your go-to resource for understanding, managing, and overcoming migraine attacks.

We cover all types of migraines and related headaches, including primary and secondary migraines, chronic migraines, and cluster migraines. We dive deep into the complexities of migraine with aura and migraine without aura, as well as rarer forms like hemiplegic migraine, retinal migraine, and acephalgic migraine (silent migraine). Our discussions also extend to cervicogenic headaches, ice pick headaches, and pressure headaches, which often mimic migraine or contribute to overall migraine burden.

Jessica’s migraine story began in childhood and followed her through major hormonal shifts, perfectionism, motherhood, and years of trying to figure things out alone. She shares how understanding her body differently helped her move from recurring three-day migraines toward greater freedom and why her biggest message is simple: don’t lose hope.

🎧 New episodes every Monday and Wednesday

🔗 Discover our work on migraineheroes.com

Disclaimer: This podcast is for informational purposes only and does not substitute for providing medical advice. Always consult your healthcare professional before making any health-related decisions.

For women, men, and children who suffer from migraine disease, Migraine Heroes is your go-to resource for understanding, managing, and overcoming migraine attacks.

We cover all types of migraines and related headaches, including primary and secondary migraines, chronic migraines, and cluster migraines. We dive deep into the complexities of migraine with aura and migraine without aura, as well as rarer forms like hemiplegic migraine, retinal migraine, and acephalgic migraine (silent migraine). Our discussions also extend to cervicogenic headaches, ice pick headaches, and pressure headaches, which often mimic migraine or contribute to overall migraine burden.

Waking up nauseated can feel confusing especially when the migraine pain has not started yet.

In this episode of Migraine Heroes Podcast, host Diane Ducarme explores why nausea can be an early part of a migraine attack and what it may reveal about the timing of the migraine process.

You’ll learn:

💡 Why nausea can begin before head pain — and what this tells us about where a migraine attack may actually start

💡 How sleep, your internal body clock, the hypothalamus, and the gut may contribute to nausea on waking

💡 How to recognize your own early-warning pattern, so morning nausea becomes useful information rather than another unexplained symptom

Sometimes, the first sign of migraine is not pain. Learning to notice what happens before the headache may help you understand your attacks much earlier.

🎧 New episodes every Monday and Wednesday

🔗 Discover our work on migraineheroes.com

References:

• Premonitory Symptoms in Migraine: A Systematic Review and Meta-Analysis of Observational Studies Reporting Prevalence or Relative Frequency (Eigenbrodt et al., 2022): This review identifies common symptoms that occur before migraine pain begins. Read more here.
• Brain Activations in the Premonitory Phase of Nitroglycerin-Triggered Migraine Attacks (Maniyar et al., 2014): This study identifies hypothalamic and brainstem activity before migraine headache begins. Read more here
• Hypothalamus as a Conductor of the Migraine Prodrome: A Narrative Review (Root & Schwedt, 2026): This review explores the hypothalamus as a key driver of early migraine symptoms. Read more here.
• Pathophysiology and Therapy of Associated Features of Migraine (Villar-Martinez & Goadsby, 2022): This review examines nausea, sensory sensitivity, and other symptoms accompanying migraine. Read more here.
• Migraine and Gastroparesis (Arca et al., 2022): This review explores the relationship between migraine and delayed gastric emptying. Read more here.
• Gastric Emptying in Migraine: A Comparison With Functional Dyspepsia (Yu et al., 2012): This study compares gastric emptying in migraine, functional dyspepsia, and healthy controls. Read more here.
• Pathofysiological and Clinical Correlates of Sleep in Primary Headache Disorders: A Narrative Review (van Liefland et al., 2026): This review examines how sleep and headache disorders interact biologically and clinically. Read more here.

Disclaimer: This podcast is for informational purposes only and does not substitute for providing medical advice. Always consult your healthcare professional before making any health-related decisions.

For women, men, and children who suffer from migraine disease, Migraine Heroes is your go-to resource for understanding, managing, and overcoming migraine attacks.

We cover all types of migraines and related headaches, including primary and secondary migraines, chronic migraines, and cluster migraines. We dive deep into the complexities of migraine with aura and migraine without aura, as well as rarer forms like hemiplegic migraine, retinal migraine, and acephalgic migraine (silent migraine). Our discussions also extend to cervicogenic headaches, ice pick headaches, and pressure headaches, which often mimic migraine or contribute to overall migraine burden.

Migraine is invisible and sometimes, that makes other people question just how disabling it can be.

In this episode of Migraine Heroes Podcast, host Diane Ducarme shares practical ways to respond when colleagues, friends, or family minimize your migraine, offer unwanted advice, or simply do not understand what you are going through.

You’ll learn:

💡 How to respond to dismissive comments without feeling you need to justify or over-explain your migraine

💡 How to adapt what you say depending on whether you’re speaking with a colleague, friend, family member, or well-meaning advice-giver

💡 How to protect your dignity and set firmer boundaries when someone continues to diminish your pain

You do not need everyone to understand migraine perfectly. But you can learn how to communicate what you need clearly, calmly, and without giving away more energy than the situation deserves.

🎧 New episodes every Monday and Wednesday

🔗 Discover our work on migraineheroes.com

Disclaimer: This podcast is for informational purposes only and does not substitute for providing medical advice. Always consult your healthcare professional before making any health-related decisions.

For women, men, and children who suffer from migraine disease, Migraine Heroes is your go-to resource for understanding, managing, and overcoming migraine attacks.

We cover all types of migraines and related headaches, including primary and secondary migraines, chronic migraines, and cluster migraines. We dive deep into the complexities of migraine with aura and migraine without aura, as well as rarer forms like hemiplegic migraine, retinal migraine, and acephalgic migraine (silent migraine). Our discussions also extend to cervicogenic headaches, ice pick headaches, and pressure headaches, which often mimic migraine or contribute to overall migraine burden.

Visual changes can be frightening, especially when you live with migraine. But not every blind spot, shimmer, or blurry patch means the same thing.

In this episode of Migraine Heroes Podcast, host Diane Ducarme breaks down the differences between visual migraine aura, scotoma, and blurred vision, so you can better understand what your eyes and brain may be telling you.

You’ll learn:

💡 How to recognize the typical features of a visual migraine aura, including one surprisingly useful clue

💡 What a scotoma really is and how to distinguish a blind spot from shimmering or blurred vision

💡 Which visual symptoms deserve prompt medical attention, rather than automatically being attributed to migraine

A practical episode to help you understand visual symptoms with more clarity and know when they may need a closer look.

🎧 New episodes every Monday and Wednesday

🔗 Discover our work on migraineheroes.com

References:

• The International Classification of Headache Disorders, 3rd Edition (International Headache Society, 2018): The classification defines migraine aura, including its gradual development, reversibility, and typical duration. Read more here.
• Are These Visual Symptoms Due to Migraine? A Guide for General Practice (Goldsmith, 2020): This guide explains features that help distinguish migraine visual aura from other visual symptoms. Read more here.
• A Phase-by-Phase Review of Migraine Pathophysiology (Dodick, 2018): This review describes migraine as a multiphase disorder and links aura with cortical spreading depression. Read more here.
• Biological Insights From the Premonitory Symptoms of Migraine (Karsan & Goadsby, 2018): This review explores what early migraine symptoms reveal about attack neurobiology. Read more here.
• Visual Aura in Migraine: An Analysis of 165 Patients in a Tertiary Care Hospital in North India (Singla et al., 2021): This study describes common visual aura symptoms, including scintillating scotoma and zigzag lines. Read more here.
• Symptoms Related to the Visual System in Migraine (van Dongen & Haan, 2019): This review covers aura, visual blurring, photophobia, visual snow, and other visual symptoms. Read more here.
• Neuroimaging for Migraine: The American Headache Society Systematic Review and Evidence-Based Guideline (Evans et al., 2020): This guideline explains when brain imaging may be appropriate in migraine, including unusual or changing aura. Read more here.

Disclaimer: This podcast is for informational purposes only and does not substitute for providing medical advice. Always consult your healthcare professional before making any health-related decisions.

For women, men, and children who suffer from migraine disease, Migraine Heroes is your go-to resource for understanding, managing, and overcoming migraine attacks.

We cover all types of migraines and related headaches, including primary and secondary migraines, chronic migraines, and cluster migraines. We dive deep into the complexities of migraine with aura and migraine without aura, as well as rarer forms like hemiplegic migraine, retinal migraine, and acephalgic migraine (silent migraine). Our discussions also extend to cervicogenic headaches, ice pick headaches, and pressure headaches, which often mimic migraine or contribute to overall migraine burden.

Grief is emotional, but it can also be deeply physical. Changes in sleep, stress, appetite, energy, and nervous system activity may all influence the way migraine shows up in your body.

In this episode of Migraine Heroes Podcast, host Diane Ducarme explores why loss can affect far more than your mood, and why your brain and body may need time to adapt to a reality that has suddenly changed.

You’ll discover:

💡 Why grief can affect your entire nervous system and potentially change your migraine pattern

💡 Why your brain may continue to expect the person, place, or life you have lost to still be there

💡 How Eastern philosophy can offer a gentler way to move through grief, without expecting yourself to simply “get over it”

This episode is an invitation to understand grief not as something to rush through, but as a process your whole body may need time to navigate.

🎧 New episodes every Monday and Wednesday

🔗 Discover our work on migraineheroes.com

References:

• Health Outcomes of Bereavement (Stroebe et al., 2007): This review examines how bereavement can affect both physical and mental health. Read more here.
• Grief and Bereavement: A Pre-Registered Systematic Review of Neuroimaging Studies (Evstigneev et al., 2026): This review examines brain changes linked to grief, including emotion, reward, and cognitive networks. Read more here.
• Major Life Changes Before and After the Onset of Chronic Daily Headache (Scher et al., 2008): This study links major life changes with increased risk of developing chronic daily headache. Read more here.

Disclaimer: This podcast is for informational purposes only and does not substitute for providing medical advice. Always consult your healthcare professional before making any health-related decisions.

For women, men, and children who suffer from migraine disease, Migraine Heroes is your go-to resource for understanding, managing, and overcoming migraine attacks.

We cover all types of migraines and related headaches, including primary and secondary migraines, chronic migraines, and cluster migraines. We dive deep into the complexities of migraine with aura and migraine without aura, as well as rarer forms like hemiplegic migraine, retinal migraine, and acephalgic migraine (silent migraine). Our discussions also extend to cervicogenic headaches, ice pick headaches, and pressure headaches, which often mimic migraine or contribute to overall migraine burden.

When the medication you rely on for relief starts being followed by more and more headaches, it can feel confusing and frustrating.

In this episode of Migraine Heroes Podcast, host Diane Ducarme explores rebound headache, also known as medication-overuse headache, and why frequent treatment can sometimes begin feeding the migraine cycle instead of calming it.

You’ll discover:

💡 How to recognize when frequent migraine medication may be contributing to increasingly frequent headaches

💡 Why rebound headache happens in the brain, and why it does not mean you are weak, dependent, or treating migraine “wrong”

💡 How to begin breaking the cycle safely, including one practical step you can take without suddenly stopping medication on your own

This episode will help you better understand your medication patterns, recognize when something may be shifting, and approach the next steps with more clarity and support.

🎧 New episodes every Monday and Wednesday

🔗 Discover our work on migraineheroes.com

References:

• Medication-Overuse Headache (International Headache Society): These criteria define medication-overuse headache and its diagnostic thresholds. Read more here.
• Pathophysiology, Prevention, and Treatment of Medication Overuse Headache (Diener et al., 2019): This review explains the mechanisms, prevention, withdrawal, and treatment of medication-overuse headache. Read more here.
• European Academy of Neurology Guideline on the Management of Medication-Overuse Headache (Diener et al., 2020): This guideline outlines education, withdrawal, and preventive treatment strategies. Read more here.
• Comparison of 3 Treatment Strategies for Medication Overuse Headache (Carlsen et al., 2020): This trial compares withdrawal, preventive treatment, and their combination. Read more here.
• Efficacy and Safety of Erenumab for Nonopioid Medication Overuse Headache in Chronic Migraine (Tepper et al., 2024): This trial found erenumab 140 mg increased medication-overuse headache remission. Read more here.
• Brief Intervention for Medication-Overuse Headache in Primary Care: The BIMOH Study (Kristoffersen et al., 2015): This trial found a brief primary-care intervention reduced medication use and headache days. Read more here.
• Activation of the Microglial P2X7R/NLRP3 Inflammasome Mediates Central Sensitization in a Mouse Model of Medication Overuse Headache (Wang et al., 2023): This animal study links microglial inflammation with central sensitization in medication overuse. Read more here.
• Acupuncture for Migraine Without Aura and Connection-Based Efficacy Prediction (Zhang et al., 2026): This trial found acupuncture improved migraine outcomes and explored brain connectivity as a predictor of response. Read more here.

Disclaimer: This podcast is for informational purposes only and does not substitute for providing medical advice. Always consult your healthcare professional before making any health-related decisions.

For women, men, and children who suffer from migraine disease, Migraine Heroes is your go-to resource for understanding, managing, and overcoming migraine attacks.

We cover all types of migraines and related headaches, including primary and secondary migraines, chronic migraines, and cluster migraines. We dive deep into the complexities of migraine with aura and migraine without aura, as well as rarer forms like hemiplegic migraine, retinal migraine, and acephalgic migraine (silent migraine). Our discussions also extend to cervicogenic headaches, ice pick headaches, and pressure headaches, which often mimic migraine or contribute to overall migraine burden.

Exercise can be one of the most helpful tools for migraine prevention, but when your body is already under strain, the wrong intensity can sometimes push you toward an attack.

In this episode of Migraine Heroes Podcast, Diane Ducarme explores why movement can both support and challenge a migraine-sensitive nervous system, and how to find the level of exercise that works with your body rather than against it.

You’ll discover:

💡 Why regular movement may help reduce migraine frequency, even if some workouts seem to trigger symptoms

💡 The signs that exercise is exceeding your current capacity and it may be time to slow down or adjust

💡 A simple migraine-friendly movement approach you can try at home without pushing your body beyond its limits

The goal is not to exercise harder. It is to find the kind of movement that helps your nervous system become more resilient, without tipping it into overload.

🎧 New episodes every Monday and Wednesday

🔗 Discover our work on migraineheroes.com

References:

• Exercise as Migraine Prophylaxis: A Randomized Study Using Relaxation and Topiramate as Controls (Varkey et al., 2011): This trial found exercise may be an effective option for migraine prevention. Read more here.
• The Association Between Migraine and Physical Exercise (Amin et al., 2018): This review examines exercise as both a potential migraine trigger and preventive strategy. Read more here.
• Provocation of Migraine With Aura Using Natural Trigger Factors (Hougaard et al., 2013): This study tested whether exercise and bright or flickering light could provoke migraine with aura. Read more here.
• What Is the Efficacy of Aerobic Exercise Versus Strength Training in the Treatment of Migraine? (Woldeamanuel & Oliveira, 2022): This analysis compares strength and aerobic exercise for reducing migraine frequency. Read more here.
• Prescription of Therapeutic Exercise in Migraine: An Evidence-Based Clinical Practice Guideline (La Touche et al., 2023): This guideline provides evidence-based recommendations for exercise in migraine care. Read more here.
• How Much Aerobic Exercise Is Needed to Reduce Migraine? A Dose–Response Meta-Analysis of Pain Intensity and Frequency (Ogrezeanu et al., 2026): This analysis examines the amount of aerobic exercise associated with migraine improvement. Read more here.
• Relationship Between Kinesiophobia, Cognitive Aspects, Level of Physical Activity, and Disability in Individuals With Migraine (Pina et al., 2025): This study links fear of movement with greater disability and lower physical activity in migraine. Read more here.
• Primary Exercise Headache (International Headache Society, 2018): These criteria define headache occurring specifically during or after strenuous exercise. Read more here.

Disclaimer: This podcast is for informational purposes only and does not substitute for providing medical advice. Always consult your healthcare professional before making any health-related decisions.

For women, men, and children who suffer from migraine disease, Migraine Heroes is your go-to resource for understanding, managing, and overcoming migraine attacks.

We cover all types of migraines and related headaches, including primary and secondary migraines, chronic migraines, and cluster migraines. We dive deep into the complexities of migraine with aura and migraine without aura, as well as rarer forms like hemiplegic migraine, retinal migraine, and acephalgic migraine (silent migraine). Our discussions also extend to cervicogenic headaches, ice pick headaches, and pressure headaches, which often mimic migraine or contribute to overall migraine burden.

What if recovery is not time lost, but part of what helps your migraine system regain stability?

In this episode of Migraine Heroes Podcast, host Diane Ducarme explores why the end of head pain does not always mean the migraine attack is fully over — and why your body may still need time to recover.

You’ll learn:

💡 Why post-migraine recovery is biological, not imaginary

💡 How cycling between intense productivity and complete exhaustion may destabilize a sensitive migraine system

💡 How to make recovery feel restorative rather than guilt-filled

This episode is a reminder that protecting your energy can be just as important as using it.

🎧 New episodes every Monday and Wednesday

🔗 Discover our work on migraineheroes.com

References:

• The Migraine Postdrome: An Electronic Diary Study (Giffin et al., 2016): This study describes fatigue, concentration problems, and other symptoms that persist after migraine pain resolves. Read more here
• Reduction in Perceived Stress as a Migraine Trigger: Testing the “Let-Down Headache” Hypothesis (Lipton et al., 2014): This study found that a drop in stress may be associated with migraine onset the following day. Read more here
• Understanding Migraine Through the Lens of Maladaptive Stress Responses (Borsook et al., 2012): This review explores migraine through chronic stress and allostatic load. Read more here
• Insufficient Sleep May Alter Cortical Excitability Near the Migraine Attack (Mykland et al., 2023): This study suggests insufficient sleep may alter brain inhibition around migraine attacks. Read more here
• Fatigue in Migraine Patients and Its Clinical Correlates (Hou et al., 2026): This study links migraine-related fatigue with sleep problems, disability, and psychiatric symptoms. Read more here
• Operant Approach Activity Pacing Interventions for the Management of Chronic Pain (Antcliff et al., 2026): This review evaluates activity-pacing strategies for managing chronic pain and fatigue. Read more here

Disclaimer: This podcast is for informational purposes only and does not substitute for providing medical advice. Always consult your healthcare professional before making any health-related decisions.

For women, men, and children who suffer from migraine disease, Migraine Heroes is your go-to resource for understanding, managing, and overcoming migraine attacks.

We cover all types of migraines and related headaches, including primary and secondary migraines, chronic migraines, and cluster migraines. We dive deep into the complexities of migraine with aura and migraine without aura, as well as rarer forms like hemiplegic migraine, retinal migraine, and acephalgic migraine (silent migraine). Our discussions also extend to cervicogenic headaches, ice pick headaches, and pressure headaches, which often mimic migraine or contribute to overall migraine burden.