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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Leptospirosis gained attention after its cases surged in Kerala recently. The infection has also been reported in Maharashtra, Gujarat, Tamil Nadu, and Karnataka. The bacterial infection typically spreads via contact with water or soil that has been contaminated by the urine of animals infected with leptospirosis, especially during floods.
As monsoons are right at our doors, know why it is important to detect and nab dangerous infections like leptospirosis early.
Leptospirosis is a potentially serious bacterial infection sometimes called the "rat fever" because it can cause symptoms similar to the typical symptoms of common viral infections, which may not be noticeable in the early stages. It is caused by the bacteria of the genus Leptospira that are excreted in the urine of infected animals, including rats, cattle, dogs, and pigs.
In the monsoon season, there is a risk of waterlogging and contaminated animal urine mixing with floodwater and soil. Infestation occurs through direct contact with contaminated water or mud on cuts or abrasions or on the mucous membranes of the mouth, nose, and eyes. Those involved in outdoor work, sanitation, farming, construction, or who are walking in flooded streets are especially at risk.
Health and Me spoke to Dr. Sundar Krishnan, Senior Consultant - Internal Medicine, KIMS Hospital, Thane, about how to tackle leptospirosis this monsoon.
Dr. Krishnan says, “In the early stages, it may have flu-like symptoms, and that makes early recognition challenging. Symptoms are sudden onset of high fever, chills, very severe headache, muscle pain especially in the calves and lower back, fatigue, nausea, vomiting, and red eyes.”
The expert also said that occasionally, the patient may also have abdominal pain or diarrhea. He also says it can escalate quickly to jaundice, kidney failure, difficulty breathing, meningitis, internal bleeding, or multi-organ failure and can require immediate medical care.
Dr. Krishnan recommends several prevention tips to tackle leptospirosis in monsoon:
If leptospirosis is diagnosed early and treated with antibiotics, recovery is much quicker, avoiding life-threatening complications. But if detection and treatment are delayed, the kidneys, liver, lungs, and even the brain may be affected.
The expert advises that people who are ill after being exposed to flood water and are facing fever or flu-like symptoms for more than two days should also seek medical help as soon as possible, informing their doctor about their flood water exposure.
Even though the risk of leptospirosis is high during the monsoon, the best way to steer clear of this infection is to educate the masses about its symptoms and prevention. Early clinical intervention can help de-escalate the situation promptly.
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Headaches are one of the most common health complaints and are often caused by stress, lack of sleep, dehydration, excessive screen time, skipped meals, or other lifestyle factors. While most headaches are benign, experts said that frequent or unusual headaches should not be ignored, as they may signal an underlying medical condition that requires evaluation.
The experts told HealthandMe that paying attention to changes in headache frequency, pattern, and associated symptoms can help identify when medical attention is necessary.
According to Dr. Rajneesh Kummar, Vice Chairman & Unit Head, Neurology, Max Super Speciality Hospital, Dwarka, one of the most common concerns is increasing frequency.
“If someone who previously experienced occasional headaches starts getting them several times a week or finds that painkillers are needed more often than before, it is worth getting evaluated,” he told HealthandMe.
“People should seek medical attention if they have headaches more than 10 to 15 days a month, if the headaches are getting worse, or if they are beginning to interfere with work, daily activities, or quality of life,” added Dr. Praveen Gupta, Chairman, MAIINS, Marengo Asia Hospitals, Gurugram. He also noted that medication-overuse headaches can result from taking painkillers regularly, leading to a cycle of recurrent pain.
Also read: Shingles Vaccine May Help Fight Dementia, Suggest Studies
A change in the pattern of headaches should not be ignored. Dr. Kummar said a headache that feels different from what a person has experienced in the past, particularly after the age of 50, deserves medical attention. Headaches that wake a person from sleep, are worse in the early morning, or are associated with vomiting should also be assessed further.
Dr. Gupta advised prompt medical evaluation for people over the age of 50 who develop a new type of headache. He also recommends seeing a doctor if a person has a history of cancer, a weakened immune system, or develops a headache after a head injury.
The neurologists highlight several "red flag" symptoms that require urgent medical assessment. They advised immediate consultation if a headache is accompanied by
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Dr. Kummar stated that many people worry that every headache is related to a brain tumor or another serious brain disorder. Fortunately, this is rarely the case.
However, persistent or unusual headaches should not be self-diagnosed, and timely consultation helps identify the cause and ensures appropriate treatment before the problem begins affecting quality of life, the expert said.
Dr. Gupta told HealthandMe that early diagnosis can help manage common neurological disorders such as migraines, cluster headaches, and chronic tension-type headaches. A thorough history, neurological examination, and imaging studies, when appropriate, can help determine the cause.
The experts emphasize that if headaches are becoming more frequent, changing in patterns, or affecting daily life, it is time to consult a neurologist. Early diagnosis can provide relief, prevent complications, and improve overall quality of life.
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Several recent studies suggest that older adults who receive the shingles vaccine may be less likely to develop dementia, a condition affecting more than 57 million people worldwide.
Shingles is a painful viral infection caused by the reactivation of the varicella-zoster virus (VZV), which can remain dormant after chickenpox and later trigger a blistering rash and severe nerve pain.
A June 2026 study published in the Annals of Internal Medicine suggests that one in 17 dementia cases could potentially be prevented through shingles vaccination.
Researchers at Brown University found that older adults who received the recombinant shingles vaccine (Shingrix) after a stay in a skilled nursing facility had a 24% lower risk of being diagnosed with dementia over four years than those who were not vaccinated.
The study analyzed Medicare and health records from more than 500,000 adults aged 66 and older admitted to skilled nursing facilities. Researchers compared those who received at least one dose of Shingrix with those who remained unvaccinated.
“A lot of previous studies with similar results focused on an older vaccine,” said study author Kaley Hayes, an assistant professor at Brown University’s School of Public Health.
“This study looks at the newest vaccine only in an older, vulnerable adult population who were not up to date with shingles vaccination and are at a very clear clinical point in care: entering a skilled nursing facility.”
The findings add to growing evidence linking shingles vaccination with a lower risk of dementia.
Also read: How To Spot Leptospirosis, Dengue, Malaria During Monsoons? Early Symptoms Not To Neglect
Researchers believe the vaccine may help protect the brain by preventing shingles and the inflammation caused by the virus.
Shingles can cause a “war zone” of inflammation in the brain, said Dr. Jennifer Pauldurai, the medical director of the Inova Brain Health and Memory Disorders Program in Northern Virginia, NBC News reported.
It’s not that the shingles vaccine itself is a “magic pill,” Pauldurai said.
Rather, the vaccine guards against the disease, which is known to disrupt brain health.
The latest findings add to a growing body of international research.
A study involving more than 282,000 older adults in Wales, published in Nature in 2025, found shingles vaccination was associated with a 3.5% lower absolute risk of dementia over seven years.
Another study of more than 101,000 older adults in Australia, published in the Journal of the American Medical Association in 2025, found vaccine eligibility was associated with a 1.8% lower dementia risk over 7.4 years.
Similarly, a study involving more than 232,000 older adults in Canada, published in The Lancet Neurology in 2026, linked shingles vaccine eligibility to a 2% lower dementia risk over 5.5 years.
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After a person recovers from chickenpox, the VZV virus remains dormant in nerve cells and can become active again years or even decades later, particularly when the immune system weakens.
Older adults and people with weakened immune systems are at the highest risk of developing shingles.
According to the NHS, shingles often starts with:
Seek prompt medical attention if:
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