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.

While GLP-1 weight-loss drugs such as Wegovy and Mounjaro have helped patients lose weight, a major concern has been weight regain once the therapy is stopped. Now, a new study by US scientists suggests that a daily pill may help prevent that rebound weight gain.

According to a clinical trial led by Weill Cornell Medicine and NewYork-Presbyterian, switching to the once-daily orforglipron pill may not only help maintain weight loss but also preserve cardiometabolic benefits.

Orforglipron is US drugmaker Eli Lilly’s first oral pill for weight loss, marketed as Foundayo. In April, it received approval from the US Food and Drug Administration (FDA).

Weight Loss With Daily Pill Orforglipron

In the Eli Lilly-funded trial, published in the journal Nature Medicine, researchers found that patients in the Phase 3b clinical trial maintained around 75–80 per cent of their weight loss. They also experienced several additional health benefits, including:

• Reduced waist circumference
• Improved blood pressure
• Better blood sugar control
• Lower triglyceride levels
• Improved cholesterol levels

The Clinical Trial

The ATTAIN-MAINTAIN trial enrolled patients who had already achieved substantial weight loss that later plateaued while taking weekly injectable GLP-1 drugs during the SURMOUNT-5 trial.

The study randomized:

• 205 patients taking tirzepatide
• 171 patients taking semaglutide

The results showed that patients switching from tirzepatide to orforglipron maintained an average of 74.7 per cent of their body weight reduction, compared with 49.2 per cent in the placebo group.

Meanwhile, patients who switched from semaglutide to orforglipron maintained 79.3 per cent of their body weight reduction, compared with 37.6 per cent in the placebo arm.

Over the 52-week trial period, participants treated with orforglipron gained:

• An average of 5 kg (11 lbs) in the tirzepatide group
• An average of 1 kg (2.2 lbs) in the semaglutide group

How The Daily Pill Orforglipron Works

Eli Lilly licensed orforglipron, the active ingredient in Foundayo, from a Japanese pharmaceutical company in 2018.

Like injectable GLP-1 drugs, Orforglipron is available in six doses ranging from 0.8 mg to 17.2 mg. Patients typically begin at the lowest dose and gradually increase under medical supervision.

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Unlike some oral GLP-1 drugs, people taking orforglipron do not need to restrict food or drink intake after taking the pill. Researchers say the small molecule is absorbed quickly into the bloodstream and reaches target tissues efficiently.

Orforglipron: Side Effects And Safety Concerns

Foundayo is not approved for use in children and carries warnings about potential thyroid tumours, including thyroid cancer.

The drugmaker advises patients to watch for symptoms such as:

• Lump or swelling in the neck
• Hoarseness
• Trouble swallowing
• Shortness of breath

• Nausea
• Constipation
• Diarrhoea
• Vomiting
• Indigestion
• Stomach pain
• Headache
• Swollen belly
• Fatigue
• Belching
• Heartburn
• Gas
• Hair loss.

In a major development for cancer care in India, Swiss pharmaceutical major Roche Pharma has launched Tecentriq SC, the country’s first subcutaneous (under-the-skin) immunotherapy for lung cancer that can be administered in approximately seven minutes.

While conventional intravenous (IV) infusions can take hours, Tecentriq SC can significantly improve the cancer treatment experience by reducing treatment time by nearly 80 per cent.

The seven-minute injectable immunotherapy has the potential to:

• Treat up to five patients in the time taken to treat one patient through intravenous infusion
• Help optimise healthcare resources
• Lower indirect treatment costs
• Minimise the need for patients to travel long distances
• Reduce the amount of time caregivers spend in hospitals

“With Tecentriq SC, we are bringing an innovation that meaningfully reduces treatment time while maintaining the established efficacy and safety profile of Tecentriq. We believe such advances can play an important role in enabling more patient-centric and future-ready cancer care delivery in India,” said Roche Pharma India Chief Medical Officer Dr Sivabalan Sivanesan, in a statement.

What Is Tecentriq SC? What's The Cost In India?

Tecentriq SC is the first and only PD-(L)1 inhibitor globally with both intravenous (IV) and subcutaneous (SC) formulations across multiple cancers.

First approved by the UK MHRA in 2023 and subsequently by the USFDA in 2024, Tecentriq SC is now approved in more than 85 countries, with over 10,000 patients benefitting globally.

In India, Tecentriq SC is currently approved by the DCGI for adjuvant and metastatic non-small cell lung cancer (NSCLC). NSCLC is the most common form, making up about 80–85% of all cases.

According to Sivanesan, the drug is priced at about "Rs 3.7 lakh per vial".

Also read: India Gets Its First Alzheimer’s Drug: Know All About Eli Lilly’s Lormalzi

How Does Tecentriq SC Work?

Tecentriq SC combines Tecentriq with Halozyme Therapeutics’ Enhanze drug delivery technology.

The technology uses recombinant human hyaluronidase PH20 (rHuPH20), an enzyme that temporarily increases permeability in the subcutaneous space, enabling rapid dispersion and absorption of the medicine into the bloodstream, the company said.

How Tecentriq SC will Boost Cancer Care In India

The launch of Tecentriq SC also aligns with the broader shift toward decentralised cancer care in India. Shorter administration formats can free up hospital beds, healthcare staff time, and oncology resources at tertiary care centres, while helping shift care delivery to daycare centres and beyond traditional tertiary hospitals.

“India’s growing cancer burden requires us to rethink how cancer care is delivered. Innovations such as subcutaneous immunotherapy have the potential to simplify treatment administration, reduce pressure on hospital beds and support more decentralised models of care beyond large metro hospitals,” said Dr Amit Rauthan, Consultant and HOD of Medical Oncology at Manipal Hospital.

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Tecentriq SC: Safety

Global studies have indicated strong patient preference for subcutaneous administration.

According to results from the IMscin002 study presented at the European Lung Cancer Congress (ELCC) 2024:

• Four out of five patients preferred Tecentriq SC over IV administration
• Patients cited less time in clinics, greater comfort, and lower emotional distress as key reasons for preference

Studies have also shown that subcutaneous administration is associated with less discomfort, pain, and irritation compared to IV administration.

In the IMscin001 study presented at ESMO 2023:

• 90 per cent of healthcare professionals agreed the SC formulation was easy to administer
• 75 per cent believed it could save time for healthcare teams.

Even as Polycystic Ovary Syndrome (PCOS) got rebranded as Polyendocrine Metabolic Ovarian Syndrome (PMOS), it signals a major shift in how doctors understand and treat one of the most common hormonal conditions affecting women, said health experts today.

Speaking to HealthandMe, the experts noted that from the earlier narrowed focus on ovarian cysts, the transition toward PMOS will better capture the condition’s complex metabolic and endocrine nature.

Dr. Isha Kriplani, Consultant – Obstetrics and Gynecology at Paras Health, said the renaming marks “the beginning of a new era in women's gynecological health.”

What Does PMOS Mean?

Also read: PCOS Is Now PMOS: What The Name Change Means For Millions Of Women

The new name aims to explain the condition more accurately and comprehensively.

Polyendocrine means it affects multiple hormones in the body.

Metabolic refers to issues linked to weight, insulin, blood sugar, and heart health.

Ovarian highlights its impact on ovulation and reproductive health.

Syndrome refers to a group of symptoms occurring together.

In simple terms, PMOS is a hormonal and metabolic condition that can affect periods, fertility, skin, mood, weight, and long-term health.

How Will The Change Impact Women

Dr. Isha stated that the term PMOS acknowledges that the disorder is not solely linked to hormonal imbalance or ovarian dysfunction, but also deeply connected to metabolic health. She explained that many women experience symptoms such as weight gain, skin issues, fatigue, insulin resistance, and hormonal disturbances without necessarily showing ovarian cysts on ultrasonography.

“Rebranding Polycystic Ovary Syndrome (PCOS) into Polyendocrine Metabolic Ovarian Syndrome (PMOS) is the beginning of a new era in women's gynecological health. This is because renaming helps us understand that the complex interplay of this disease is not only about imbalanced hormones but also metabolism,” she told HealthandMe.

Dr. Isha added that the shift could help broaden diagnosis and encourage early intervention to prevent long-term complications such as type 2 diabetes and hypertension. She noted that the new terminology also provides women with a more accurate understanding of the syndrome and encourages treatment strategies focused on addressing the root metabolic causes.

Why The Change To PMOS Was Necessary

Dr. Raina Chawla, Associate Director – Gynecology at Sarvodaya Hospital, told HealthandMe the transition from PCOS to PMOS corrects what she described as one of medicine’s “most persistent misnomers.”

She explained that for years, the term PCOS led many patients to believe the condition was purely ovarian in nature, often resulting in confusion and delays in diagnosis. According to Dr. Raina, the so-called “cysts” seen in PCOS are actually immature follicles that develop as a consequence of the disorder rather than being its primary cause.

Also read: PCOD vs PCOS vs PMOS: Why The Condition’s Name Has Changed Over Time

“The shift from PCOS to Reproductive Metabolic Syndrome (PMOS) is an important move toward correcting one of medicine’s most persistent misnomers,” Dr. Raina said.

She further emphasized that the newer terminology places appropriate attention on insulin resistance and androgen excess, helping doctors and patients approach the disorder as a systemic endocrine and metabolic condition rather than a localized ovarian issue.

Experts believe the change in terminology could also reduce stigma and improve awareness about the wide-ranging symptoms associated with the syndrome, while encouraging a more holistic treatment approach that includes lifestyle modifications, metabolic screening, and long-term preventive care.