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.

Morning walks are a popular part of many older adults’ daily routines. But is walking alone enough to maintain bone strength and prevent osteoporosis as we age?

Walking 30–40 minutes every day is a good habit. However, it may not be enough to maintain bone and muscle strength as we age. A person may walk daily and still struggle to get up from a low chair or maintain balance on an uneven surface. These are important signs of functional strength that deserve as much attention as daily step counts, experts said on World Osteoporosis Day.

Falls are a significant concern among older adults worldwide. A 2022 systematic review and meta-analysis of 104 studies estimated that 26.5% of older adults globally experienced falls. In India, a 2026 analysis of data from the Longitudinal Ageing Study in India found that 11.56% of adults aged 60 and older reported a history of falls. Chronic joint disease was among the factors independently associated with falls.

Why Walking Alone May Not Be Enough

Also read: Osteoporosis Affects Nearly 20% Of US Women Aged 50+: Why Screening Is Key

Dr. Siddhart Yadav, Senior Consultant, Orthopedics and Joint Replacement Surgery, Apollo Hospitals, Navi Mumbai, told HealthandMe that bone density and muscle mass tend to decline with age.

“In women, bone loss can accelerate after menopause, while men too are at risk of age-related bone loss. When weaker bones are combined with reduced muscle strength and poor balance, even a relatively minor fall can result in a fracture, particularly around the hip or wrist,” he said.

“While women are hit hardest, often assuming household chores are adequate exercise, men are equally vulnerable as muscle mass silently declines after 50. In both, excess weight paired with weak muscle leaves weaker bones exposed to fractures during simple falls,” Dr. Thineshchandar Andiappan, Senior Orthopaedic and Joint Replacement Surgeon, Athulya Geriatric Hospital told HealthandMe.

What Exercises Should Adults Over 60 Include?

A casual morning walk alone may not provide enough stimulus to maintain bone density, muscle strength, and balance. Experts recommend combining walking with progressive resistance and strength training. Starting in your 40s can help preserve strength, but it is never too late to begin an appropriate exercise routine.

Along with regular walking, older adults should include simple strength and balance exercises in their routine.

Dr. Siddhart suggested chair sit-to-stands, supported squats, heel raises, and resistance-band exercises to help maintain the strength needed for everyday activities. Light dumbbell exercises for the upper body can also help strengthen the arms, shoulders and other upper-body muscles.

Exercises should be introduced gradually and tailored to individual health and mobility, particularly for people with osteoporosis or a history of fractures.

A 30-40-minute walk is beneficial, but it does not have to be completed in one stretch. If the muscles begin to feel tired, taking a short break of two to three minutes before resuming the walk is reasonable.

Diet and Vitamin D Also Matter

Read More: Osteoporosis Drugs Offer New Hope For Back Pain By Blocking Disc Mineralisation: Study

Along with exercise, adequate nutrition supports bone and muscle health. Calcium-rich foods such as milk, curd, paneer, ragi and sesame, together with adequate protein, can help meet nutritional needs. Vitamin D levels should be assessed when clinically indicated.

“Falls in elderly persons happen more often due to instability, muscle weakness, and other reasons. It is very important to address all the issues in addition to the management of osteoporosis for preventing such fractures. The comprehensive treatment will include a good diet, adequate sunlight exposure, in addition to exercises, which must involve weight training and stability-building training,” Dr. V Singaravadivelu, Senior Consultant and Academic Lead, Orthopaedic Surgery, Kauvery Hospital told HealthandMe.

A sugar naturally found in red meat may help explain why beef and lamb have long been linked to type 2 diabetes, according to a large new study presented at the European Association for the Study of Diabetes’ Annual Meeting in Milan.

Researchers tracked nearly 90,000 adults with no history of diabetes or cancer through NutriNet-Sante, a long-running French health study, according to a release from the European Association for the Study of Diabetes (EASD). Over a median follow-up of 7.2 years, 966 participants developed type 2 diabetes.

The focus was a sugar called N-glycolylneuraminic acid, or Neu5Gc, found mainly in beef and lamb. People with the highest intake of meat-derived Neu5Gc had a 63% higher risk of developing type 2 diabetes than those with the lowest intake, the EASD reported. The risk rose steadily with intake: the second-highest group already carried a 41% higher risk.

“This is a relative risk: people in the top fifth of meat-derived Neu5Gc intake had a 63% higher risk than those in the bottom fifth, after accounting for many other factors,” said lead author Dr. Leopold Fezeu of Universite Sorbonne Paris Nord told Medical News Today. “It does not mean that 63% of high consumers will develop diabetes.”

Also Read: World Osteoporosis Day: Why Women Face A Higher Risk of Osteoporosis As They Age

Why Scientists Suspect Inflammation

Most mammals produce Neu5Gc naturally, but humans lost that ability after an ancient genetic mutation, according to the EASD. The sugar can still enter the body through food and get absorbed into human tissue. Because the body doesn’t recognise Neu5Gc as its own, the immune system may treat it as foreign, producing antibodies against it in a prolonged immune response called xenosialitis, previously linked to cardiovascular disease and cancer.

“Our findings support chronic inflammation as a specific mechanism linking red meat consumption with T2D, partly beyond the amount of red meat a person eats and partly independent of body fat,” Fezeu said.

What Are The Key Findings?

Not just weight: Notably, obesity accounted for only about 13% of the link between Neu5Gc intake and diabetes risk, the EASD reported, suggesting the sugar’s effects may extend beyond weight gain alone.

Dairy showed no link: Despite also containing Neu5Gc, dairy products showed no association with diabetes risk, likely because cow’s milk contains far smaller amounts than red meat.

An important caveat

When researchers additionally adjusted for total red meat intake, the Neu5Gc-diabetes link weakened and was no longer statistically significant, though it pointed the same direction.

“There may be differences between sources, or other components of red meat may contribute,” Fezeu said, meaning the study can’t fully separate Neu5Gc’s effect from red meat generally.

What comes next

Since the study is observational, it cannot prove Neu5Gc causes diabetes. Fezeu’s team plans to measure antibodies against Neu5Gc directly and study how it interacts with iron in red meat.

“Future research should explore whether reducing exposure to meat-derived Neu5Gc, for example by favoring poultry or plant-based proteins over beef and lamb... could help prevent T2D,” Fezeu said.

As we brace ourselves for another bout of winter, we can’t help but feel wary about the changes the dip in temperature brings on our mood and mental well-being. You are not imagining winter depression when you start to feel sudden loss of joy.

Seasonal depression is more than feeling gloomy. You may no longer enjoy the activities you once relished, like listening to music, exercising or meeting friends. This isn’t just another effect of winter. Experts have designated a term for it: anhedonia.

Anhedonia refers to the loss of pleasure or interest in something you once enjoyed. It is one of the symptoms of depression, including seasonal affective disorder (SAD). Unlike sadness, anhedonia can render someone feeling disconnected with or indifferent towards things they once enjoyed.

A person experiencing anhedonia may still participate in activities they enjoy but will no longer reap emotional rewards from it.

“Anhedonia is not the kind of sadness where you’re feeling down but still have moments of enjoyment,” Dr Deeksha Kalra, Associate Consultant, Psychiatry, Artemis Hospital, Gurugram, explained to HealthandMe.

Dr Samant Darshi, Consultant Psychiatrist and Neuromodulation Expert at Yatharth Hospitals, told us, “While sadness entails the state of feeling unhappy about something, anhedonia pertains to the lack of enjoyment.”

Dr Kalra said, during SAD, anhedonia may be experienced during the affected season like winter.

“This can happen at the same time as low mood, but it can also be one of the clearest symptoms. In SAD, these changes are usually present during the affected season and resolve with the resolution of the depressive episode. So anhedonia is about muted pleasure, not just feeling sad,” Dr Kalra explains.

Effects Of Winter On Pleasure And Motivation

Also read: The Silent Struggle Of Raising A Child With Mental Health Challenges: How Parents Can Cope With Stigma

Changes that come with SAD, a type of depressive phase, usually pertains to specific seasons, like mostly winter. Due to less duration of daylight, the body’s internal clock, known as circadian rhythm, may get affected. Along with circadian rhythm, poor diet, irregular sleep pattern and limited physical activity can also contribute to SAD.

This could cause one to feel difficult to initiative activities they enjoy as they no longer feel motivated, affecting the brain reward system.

“Seasonal affective disorder (SAD) causes disturbance of mood, sleep, energy, and motivation. Activities which were pleasurable before become less rewarding because of this. The changes in daylight hours may affect the body clock or the physiological processes related to mood control. The decrease in energy and motivation makes doing the activity even harder and less pleasurable,” said Dr Darshi.

Dr Kalra explains that there are a lot of phases to experiencing ‘enjoyment’. It involves identifying something rewarding, anticipating it, experiencing pleasure and learning from the experience. Depression can affect all these phases, making previously enjoyable activities feel less rewarding.

“Brain networks including the striatum and nucleus accumbens, contribute to the valuation of rewarding experiences and the motivation of behavior. When their responses are dulled and something that was once naturally rewarding may not have the same emotional resonance,” she says.

Dopamine’s Role In SAD

Also read: Children’s Mental Health Often Goes Unnoticed: Can India’s New School Policy Change That?

Dopamine is a neurotransmitter in the brain responsible for motivation, rewards, learning, and directing behaviour as per goals. When we talk about SAD and anhedonia, dopamine comes into the picture as it is related to motivation and rewards.

Dr Kalra explained, “Dopamine is involved in motivation, reward anticipation, learning and determining the value of pursuing something. That’s why dopamine has been looked at when researchers have investigated anhedonia and low motivation.”

But doctors say that anhedonia is not characterised by shortage of dopamine. According to research, SAD has been reported to affect dopamine signalling, including lower dopamine transporter availability in the striatum during symptomatic depression.

Dr Darshi also emphasises that dopamine is only a part of the process.

He said, “Studies concerning depression and anhedonia indicate that changes in the activity of dopamine result in the decrease in motivation and reward sensitivity. However, anhedonia encompasses many brain processes.”

SAD And Anticipatory Pleasure

Also read: Self-Diagnosis Could Go Wrong: Are We Overusing The Words Anxiety, Trauma and ADHD?

Anhedonia makes one indifferent by directly affecting the anticipatory pleasure mechanism. Anticipatory pleasure is the excitement one feels before an event. Consummatory pleasure is the enjoyment experienced while the event is in progress.

“Anhedonia can affect the anticipatory pleasure you feel when you look forward to something and the consummatory pleasure you experience when it actually happens. Someone might know that a favorite meal, holiday or meeting with friends should be enjoyable but feel little excitement beforehand. The pleasure might also feel weaker than expected when the event happens,” Dr Kalra explains.

Not Everyone May Experience Same SAD Symptoms

Everyone with SAD experiences anhedonia in different ways. While some may lose interest and pleasure, others may withdraw socially, sleep excessively, eat more, feeling more tired among other symptoms.

“SAD doesn’t affect everybody in exactly the same way any more than depression is a single biological process. Different people can experience different combinations of changes in mood regulation, circadian rhythms, sleep, appetite and energy and reward processing,” says Dr Kalra.

She also said that multiple symptoms may interact. For example, poor sleep could result into daytime sluggishness, making energetic activities less tempting.

Dr Darshi explained, “Individuals with SAD have different presentations since biology, genetics, circadian rhythm, and psychology are unique for each person. Some individuals have disturbances in reward and motivation, whereas others have sleep disturbances or carbohydrate cravings, or even fatigue. Symptoms might be overlapping and are a reflection of various underlying mechanisms.”