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.

The boom in GLP-1 weight loss drugs is not only affecting the obesity market but also reshaping the beauty industry. Changes in consumer behaviour among those who use GLP-1 drugs is evident as people may see differences in their appearance after drastic weight loss. This phenomenon has prompted global beauty companies to explore products for people experiencing changes in their appearance after losing weight.

French cosmetics giant L’Oréal is among the companies exploring this emerging market segment. Its CEO, Nicolas Hieronimus, said the increasing use of these medications was affecting beauty and skincare consumption, compelling the company to explore products that address concerns like sagging skin after extreme weight loss.

“The rise in their (GLP-1 drugs) use was having an impact on beauty consumption and skin care consumption in particular,” Hieronimus said during an investor call on October 22, after the company's third-quarter results came out.

The development mirrors an important shift in the beauty industry as weight loss medications like Ozempic, Wegovy and Zepbound become more widely used for weight management.

Amid the growing market for these drugs, companies are now seeing increased demand for treatments that help changes in facial volume, skin firmness and elasticity after weight loss.

However, the science behind ‘Ozempic face’ is far more complicated than the name suggests. Experts say these changes are generally associated with losing facial fat during weight loss, especially when it happens rapidly.

What is ‘Ozempic Face’?

‘Ozempic face’ is an informal term for facial changes that occur after rapid and substantial weight loss. It is marked by hollowing around the cheeks and temples and more noticeable wrinkles or sagging skin.

GLP-1 medicines, including semaglutide and tirzepatide, act on appetite regulation, helping people feel fuller for a long time and reducing their calorie intake. As a result, some people lose a substantial amount of weight over a short period.

Beauty Companies Respond to GLP-1 Boom

Apart from L’Oréal, Swiss skincare company Galderma and Brazilian cosmetics group Natura are also seeing similar demands from consumers experiencing changes in their facial skin after medicated weight loss.

L’Oréal has said that it is testing products on people using GLP-1 medications. Its SkinCeuticals range also has products intended to address concerns such as skin sagging, according to Hieronimus.

“We have products in SkinCeuticals that are made to work alongside GLP-1 drugs and address their side effects, such as skin sagging and other related issues. It is very integrated,” he said.

Galderma, in which L’Oréal holds a 20% stake, has assessed some of its existing aesthetic treatments for changes due to GLP-1 use. Its portfolio includes Sculptra, an injectable that stimulates collagen, and Restylane, a range of hyaluronic acid-based dermal fillers.

Anne-Cecile Chevrier, Galderma's global head of injectable aesthetics, described the concerns that experts are seeing among consumers. “Sagginess is a concern, loss of firmness is a concern, some hollowness can be of concern and dullness can be a concern,” she said.

Can Skincare Products Reverse ‘Ozempic Face’?

The expansion of this market does not necessarily mean that skincare products can reverse facial changes due to rapid weight loss.

The skin has several layers, and topical products act on the skin's surface. Facial fat loss happens when fat accumulated beneath the skin melts off. Skincare products cannot simply replace this process.

Dr Graeme Glass, a plastic and craniofacial surgeon and aesthetic director at British beauty brand LYMA, explained the limitations of topical treatments. “They can't reposition the deep fat pads of the face. There is a limit to what these things can do,” he said.

Moisturisers and other products may help improve hydration, texture and the appearance of fine lines. But these benefits should not be confused with correcting sagging skin.

Treatments like fillers and collagen injectables may address these concerns directly, but they involve different risks, costs and clinical considerations.

Avani Sinha, MD, and FACE endocrinologist and program director of the Northwell Health Division of Endocrinology, Diabetes and Metabolism fellowship told Women's Health Magazine that it is important to take care of nutrition and muscle-building to "fill up spaces where you are losing that skin laxity".

“We are what we eat, we are what we do,” she said, stating that protein intake is especially important on a GLP-1. She suggested aiming 0.8 to 1.8 grams per kilogram of body weight.

Sinha also recommended staying hydrated along with strength training to build muscle. “You build up that muscle, you're going to fill up those spaces where you're losing that skin laxity,” she said.

US journalist Norah O’Donnell recently spoke about the importance of early skin cancer detection a decade after being diagnosed with melanoma, the most dangerous form of skin cancer.

She said her experience changed her outlook towards sun protection. She also shared advice related to skin cancer from her dermatologist, Dr Elizabeth Hale.

According to CBS News, O’Donnell recalled that it was during a routine dermatology appointment when Hale noticed two concerning spots on her back.

A biopsy confirmed melanoma, but the cancer was detected early and removed before it could spread.

O’Donnell said she now seeks shade wherever she can find, wears UV-protective clothing and regularly reapplies broad-spectrum sunscreen when spending time outdoors. She also reflected on her past exposure to sunburns and tanning salons.

Detecting Melanoma Early

Melanoma develops in the cells that produce melanin, the pigment responsible for skin colour. Although it accounts for a smaller proportion of skin cancer cases, it is responsible for an alarming share of skin cancer deaths.

Hale emphasised that early detection can make a considerable difference. “Even though it only accounts for 5% of new cases of skin cancer, it’s responsible for more than 75% of skin cancer-related deaths,” she said.

She also spoke about the importance of getting suspicious spots examined rather than waiting for them to become more noticeable and serious.

“There have been major advances in melanoma treatment, but it’s still really best to get your skin checked because when melanoma is caught early it has greater than a 99% five-year survival. But once it spreads, that survival rate goes down precipitously,” Hale said.

Also read: Jeana Keough’s Cancer Battle: Why The ‘RHOC’ Star Is Struggling To Recover After Tongue Cancer Treatment

Tanning Beds And Sunburns Increase Melanoma Risk

Speaking about skin cancer risks related to tanning beds and sunburns, Hale said melanoma cases have been increasing among women in their 20s and 30s.

“It is directly related to exposure to tanning beds and to sunburns,” she said.

According to the Skin Cancer Foundation, using tanning beds before 35 could increase melanoma risk by 75%.

Hale also warned against the growing trend of deliberately seeking a tan through prolonged, unprotected sun exposure.

“There really is no such thing as … a safe, healthy tan,” she said.

A tan is not simply a cosmetic appeal. As Hale explained, it denotes “DNA damage” that may contribute to cancer later in life.

Also read: Daily Vaping In The US Surged 230%; Nearly 50% Of Young Adult Daily Vapers Used High-Nicotine E-Cigarettes: Studies

What Does Her Dermatologist Recommend?

Hale recommends regular skin examinations to nab suspicious skin changes early. She advises people to discuss their individual cancer screening needs with a dermatologist, especially if they have a family history of skin cancer.

Sun protection is another essential part of prevention. Hale recommends using a broad-spectrum sunscreen with SPF 30 or higher and reapplying it every two hours when spending extended periods outdoors.

Her advice on choosing sunscreen is straightforward: “the best sunscreen is the one you’ll actually use”.

Non-Negotiable Sunscreen Ritual

As per the Johns Hopkins Medicine, wearing sunscreen is the easiest and the best ways to protect your skin's appearance and health at any age. It recommends to use it regularly to prevent sunburn, skin cancer, and premature aging.

While everyone needs sun exposure to produce vitamin D, unprotected exposure to the sun's UV rays can cause damage to the eyes, skin, and the immune system.

To protect, apply 1 ounce of sunscreen throughout your body. To protect your face and neck, you will need about half a teaspoon of sunscreen.

Experts also believe that as long as the sunscreen is at least SPF 30 and is water-resistant, it does not matter what order you apply your skin care products. While some people find it is easiest to work with bare skin, some do it at the end.

Protective clothing and seeking shade can provide additional protection, especially during prolonged outdoor activities.

Arthritis is sometimes treated like a normal part of getting older. Yet it can show up in many age groups. It can also limit how freely someone moves. That can affect daily independence and overall comfort.

Some people think arthritis care always means an operation, like joint replacement. In reality, the path to care is wider. What happens next depends on symptoms, which joint is affected, a person’s age, how active they are, and their general health.

Early-Stage Arthritis: Why Physiotherapy And Exercise Matter

Where the disease is in its early stages or is perceived to be mild, treatment will begin in a very low-key manner. This will involve physiotherapy and exercise. Where necessary, losing excess body weight can be beneficial. Minor changes in daily activities will decrease stress. Doctors will prescribe medication depending on the situation. Here, the main objective is to alleviate symptoms and maintain function. It will not be the initial step and will only be considered where appropriate.

In case arthritis is severe, pain and stiffness will persist for a long period of time. Performing simple activities becomes difficult. Even walking will become challenging. Sleep may also be affected. When this happens, it helps to check again. Doctors can use exam findings and imaging to see how much the joint has changed. They can also review whether non-surgical care is working as expected.

Also read: Arthritis Day: Stanford Researchers Explore Possibility To Treat Osteoarthritis Without Knee Replacement Surgery

How Doctors Decide On The Right Treatment

Good arthritis care is about choosing the right path for the right person. Timing matters too. It begins with a close look at symptoms and a clear diagnosis. Sometimes it also means getting scans when they are needed. After that, the plan should rely on what the best research shows.

Treatment should be set up with rehab in mind. The aim is to fit the person, not just the label on the chart. One person may do well with physical therapy and simple habit shifts. Another person may need a procedure, mainly when a joint is badly worn.

Why Early Arthritis Management Matters

The main goal is easier daily comfort and better movement. Just as important, it should help someone keep their independence. It is also not only about chasing the newest option.

People should not wait until pain makes normal life hard. When they seek help early, it can be easier to see what is driving the joint pain. It can also help show how far the arthritis has gone. With that in hand, a care plan can be built with more clarity.

When care starts early and matches the person, many can stay active longer. They may also better protect joint function and keep it working well for more time.