Migraines In Women: How Hormones Influence Neurological Health
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.
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:
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.
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 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 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.
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.
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.
While hormonal changes are inevitable, several strategies can help manage migraines effectively:
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.
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.
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.
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.
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.
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Type 2 diabetes is an incurable but manageable metabolic disorder that affects millions worldwide. But a new clinical trial has shown promise in reversing type 2 diabetes in young adults through intensive diet and exercise. It suggests that more than half younger adults with this condition may be able to achieve remission within six months through a structured programme combining a low-calorie diet with supervised aerobic and strength training.
The study, published in The Lancet Regional Health – Americas, found that 54% of participants who followed the intensive lifestyle programme achieved diabetes remission after 24 weeks. In comparison, only 4% of those receiving usual medical care reached the same outcome.
The research, called the RESET for Remission trial, was led by researchers from McGill University in Canada and the University of Leicester in the UK. It focused on adults with early-onset type 2 diabetes, a form of the disease diagnosed before the age of 45.
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The trial enrolled 96 adults aged 18 to 45 who had both obesity and type 2 diabetes. Participants were recruited at research centres in Montreal and Edmonton in Canada, and Leicester in the UK. None of them were using insulin.
Of these, 50 were assigned to the intensive diet-and-exercise programme, while 46 received usual medical care. For the first 12 weeks, participants in the intervention group followed a very low-calorie diet providing 800 to 900 calories a day.
During the first two weeks, they consumed meal-replacement products. From weeks three to 12, they could include one structured meal containing lean protein and vegetables alongside the meal replacements.
The programme also included supervised aerobic and resistance training twice a week, along with one independent exercise session each week. For the next 12 weeks, participants followed a healthy diet designed to maintain their weight loss and continued exercising.
Blood sugar and blood pressure medications were stopped at the beginning of the intervention under medical supervision, according to the study protocol.
To qualify for remission, participants had to maintain an HbA1c level below 6.5% without taking medication for at least 12 weeks. HbA1c is a blood test that reflects average blood sugar levels over approximately three months.
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At the end of 24 weeks, 27 of the 50 participants in the intensive lifestyle group had achieved remission, compared to two of the 46 participants receiving usual care.
After considering relevant factors, researchers found that participants following the intensive programme were 21 times more likely to achieve remission than those receiving standard care.
The intervention group also experienced greater weight loss. Participants with available weight data lost an average of 8.4 kg over 24 weeks, compared to 1.2 kg in the usual care group. After adjustment, the difference in weight loss between the groups was approximately 7.5 kg.
The benefits were not just limited to body weight and blood sugar. MRI scans showed that participants in the intervention group lost more than 9% of their liver fat and more than 24% of their visceral fat, which is the fat stored around internal organs.
Their physical fitness improved, grip strength increased, and blood pressure and resting heart rate declined. Participants also reported fewer symptoms of depressed mood, distress and better quality of life.
One of the important aspects of the programme was its focus on preserving muscle during rapid weight loss. Losing weight through severe calorie restriction can reduce both body fat as well as mass, which includes muscle. Researchers wanted to determine whether adding resistance training could help participants lose fat while maintaining muscle.
Lead author Dr Kaberi Dasgupta, professor of medicine and director of the Division of General Internal Medicine at McGill University, told Fox News Digital, "Our study shows that it is possible to combine a low-calorie diet with supervised exercise in young adults with type 2 diabetes," she said.
"There has previously been some concern about combining the two as being too much of a burden for people. However, people in our study stayed in our study."
Explaining the role of exercise in the results, Dasgupta said, "In our study, we think the diet provoked the weight loss, and exercise helped make sure it was [not] from muscle."
She added, "We were happy and surprised that not only did people lose fat from their organs and liver, our MRI studies indicated their muscle did not decrease at all and their handgrip strength went up."
The researchers also focused on muscle preservation. "Our findings demonstrate the feasibility and efficacy of combining structured aerobic and resistance exercise with a low energy diet in early onset type 2 diabetes, supporting its potential to deliver substantial and holistic health and well-being benefits alongside diabetes remission."
However, the trial did not include a separate group following the low-calorie diet without exercise. Therefore, researchers could not establish how much of the muscle preservation and fitness improvement was specifically due to exercise.
Dasgupta acknowledged this limitation and said, "The main limitation is that we had to compare the diet plus exercise with usual care," she said. "We would have liked to compare diet alone against diet and exercise to perfectly prove the point that the improvements in muscle and fitness were from the exercise."
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Metformin has been long used to manage diabetes. But a major analysis based on more than 256,000 adults with obesity and prediabetes has found that people who take GLP-1 medications like Ozempic and Mounjaro were less likely to develop type 2 diabetes than those taking metformin.
The study also found that people taking GLP-1 medications were more likely to return to normal blood sugar levels and had lower risks of heart attacks, strokes, heart failure and death from any cause compared to those taking metformin.
The findings come from preliminary research presented at the American Heart Association's (AHA) Scientific Sessions 2026. Researchers compared health records of adults to both obesity and prediabetes to examine whether GLP-1 medications could help prevent the progression to type 2 diabetes.
According to the AHA, the analysis included 256,492 adults, with an average age of 52 years. Women accounted for 76% of the participants.
About half of the participants were taking GLP-1-based medications, including semaglutide, tirzepatide, liraglutide and dulaglutide, while the remaining participants were taking metformin.
Researchers used electronic health records from the TriNetX global multicentre network, which included 104 institutions. The records covered the period from 2010 to 2023. The participants were followed for an average of approximately three years.
The researchers matched participants based on factors such as age, existing health conditions, including high blood pressure and sleep apnoea, nicotine dependence and other medications.
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Compared to people on metformin, those taking GLP-1 medications had a 31% lower risk of developing type 2 diabetes.
They were also 1.5 times more likely to return to normal blood sugar levels, suggesting that the medications may help reverse the progression from prediabetes in some people.
The analysis also identified differences in cardiovascular results. Compared to the metformin group, people taking GLP-1 medications had:
The risk of death from any cause was also 41% lower among people taking GLP-1 medications.
Most earlier research on GLP-1 medications has focused on people who already have type 2 diabetes. This analysis examined their benefits at an earlier stage, when blood sugar levels are higher than normal but have enough for a diabetes diagnosis.
Commenting on the findings, study author Vinicius de Sousa Barzon Serra, MD, a research fellow in the Department of Cardiovascular Medicine at Mayo Clinic in Scottsdale, Arizona, said, “The great news with prediabetes is that it’s still possible to reverse the progression of the disease.”
He added, “This research may add to the case for considering GLP-1 medications earlier for certain patients, rather than waiting until they develop Type 2 diabetes.”
However, Serra said the findings do not mean metformin should be replaced by GLP-1 medications.
“The main effect these findings could have is on the shared decision-making discussion between doctors and patients exploring various treatment options, and the pros and cons for each,” he said.
“Metformin is still a first-line treatment choice. It is safe, inexpensive and has a long track record. This is less about replacing one medication with another and more about discussing additional options with specific patients,” he added.
Serra also highlighted the importance of lifestyle changes in preventing diabetes.
“It's important to note that an essential component of prediabetes treatment is lifestyle changes to manage weight, including diet and exercise and considering medications, including metformin, based on each individual's overall health and any other medical conditions,” he said.
Robert Eckel, MD, FAHA, a former volunteer president of the American Heart Association and professor of medicine emeritus at the University of Colorado Anschutz Medical Campus, said the findings were not surprising. “The benefits noted in this study likely relates to the patients losing weight, which is known to help prevent Type 2 diabetes,” said Eckel.
He explained that preventing the progression from prediabetes to type 2 diabetes could also help reduce cardiovascular complications.
“Preventing the progression from pre-diabetes to Type 2 diabetes keeps patients from having Type 2 diabetes, and it also helps prevent heart attack and strokes,” he said.
Eckel added, “GLP-1s provide another option for prevention, perhaps as an add-on therapy. However, costs and access to these medications are important factors.”
The findings should not be interpreted as evidence that Ozempic or Mounjaro is superior to metformin for every person with prediabetes.
The American Diabetes Association's 2026 Standards of Care identify metformin as an option for people at particularly high risk of developing type 2 diabetes, including adults aged 25 to 59 years with a BMI of 35 or higher, higher blood glucose levels or a history of gestational diabetes.
The guidelines also say that metformin has the most robust evidence for pharmacological diabetes prevention. While GLP-1-based therapies can be considered for weight management in people with overweight or obesity, long-term evidence does not currently support using glucose-lowering medications other than metformin solely for the purpose of preventing type 2 diabetes.
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Obesity during the 20s and 30s can fuel the risk of many lifestyle disorders like type 2 diabetes, cardiovascular diseases, metabolic syndrome, non-alcoholic fatty liver disease, sleep apnea and many others.
But according to a large study published in Annals of Internal Medicine, obesity could also increase the risk of developing cancer before midlife. The study identified higher chances of thyroid, endometrial and ovarian cancers.
Researchers examined health records of 6,313,338 adults in South Korea, aged between 20 to 39 years, who had no previous history of cancer.
Participants were followed for an average of 11.2 years to study the relationship between body weight and cancer risk.
During the follow-up period, 151,893 cancer cases were recorded. The findings showed that cancer risk increased in people with higher body mass index (BMI).
The researchers found that the 10-year total incidence of cancer was 1.84% among people with normal body weight. This increased to 2.24% among those with class I obesity and 2.62% among those with class II obesity.
In other words, the 10-year cancer incidence was approximately 0.78 percentage points higher among people with class II obesity than among those with normal weight.
The researchers also found that people with abdominal obesity were at higher cancer risk than those who didn’t have.
Among people with class I obesity, the 10-year cancer incidence was 2.45% in those with abdominal obesity, compared with 2.13% in those without it.
“Because abdominal obesity may be an important indicator for distinguishing cancer risk, it is important to manage waist circumference along with weight from a young age,” the authors wrote.
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The study identified particularly strong associations between obesity and cancers involving the thyroid and female reproductive system.
Thyroid cancer: Excess body weight has previously been linked with changes in metabolic and hormonal changes that may affect thyroid cancer development.
Endometrial cancer: Obesity can increase oestrogen levels because fat tissue produces this hormone. Prolonged exposure to excess oestrogen can stimulate the growth of the uterine lining and increase the risk of endometrial cancer.
Ovarian cancer: The relationship between obesity and ovarian cancer is complex and may involve inflammation, insulin resistance and hormonal changes.
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Obesity causes several biological changes that may contribute to cancer development. One of them is chronic inflammation.
Excess fat tissue can fuel inflammation that may create an favourable environment for abnormal cell growth.
Obesity can also lead to insulin resistance, in which the body’s cells respond less effectively to insulin. This can cause higher insulin levels, which may fuel cell growth and proliferation.
Hormonal changes are also a factor. Fat tissue produces oestrogen, and higher levels of this hormone have been linked with cancers like endometrial and ovarian.
The study authors wrote, "Some cancers have recently become more common even among younger people, and this study confirmed that obesity in young adults is significantly associated with the development of these cancers."
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