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.
Credit: AI generated image
For years, PCOS was often diagnosed through the most visible disruptions: irregular periods, acne, facial hair, weight gain, or difficulty conceiving. That made many patients enter the healthcare system through gynecology, usually when menstrual, reproductive, or visible hormonal symptoms became hard to ignore.
The shift from Polycystic Ovary Syndrome to Polyendocrine Metabolic Ovarian Syndrome encourages clinicians to look earlier, wider, and more systematically at the condition.
The old name placed the ovary at the center of the condition. PMOS keeps ovarian function in the picture, but it widens the diagnostic lens to include the hormone and metabolic systems that are often involved from the start. This distinction matters because the condition is not defined by harmful ovarian cysts. In fact, ovarian cysts are not required for diagnosis, and some women with PCOS may not show polycystic ovaries on ultrasound at all. The newer name, therefore, helps move diagnosis beyond a scan-based or ovary-only understanding, and closer to how the condition actually presents and manifests itself in the body.
With PMOS, diagnosis should become less dependent on ultrasound and more attentive to the full clinical pattern. Doctors will still look at irregular or absent periods and signs of high androgen levels, such as acne, excess facial or body hair, hair thinning, and raised testosterone levels, where tested. But the newer framing should also make metabolic screening routine, especially for insulin resistance, type 2 diabetes risk, blood pressure, cholesterol, obesity, sleep apnea, and fatty liver-related concerns. WHO describes PCOS as a chronic metabolic condition that can persist beyond the reproductive years, with symptoms and risks varying from person to person.
The scale of underdiagnosis is large. It is estimated that PCOS affects 10–13% of reproductive-aged women, while up to 70% of affected women worldwide may not know they have the condition. A name that leads with “polyendocrine” and “metabolic” may help clinicians connect symptoms that were previously treated separately: a dermatologist sees acne, a gynecologist sees irregular periods, an endocrinologist sees insulin resistance, and a mental-health professional sees anxiety or poor quality of life.
The diagnosis is not changing into a different disease. The condition remains the same, but the way it is understood may become broader and more accurate. The real opportunity lies in better recognition: fewer patients being told their symptoms are only about cysts, weight, periods or fertility, and more patients being assessed for the long-term hormonal and metabolic risks that can come with the condition.
For this shift to matter, awareness must grow across the medical fraternity and among patients, so PMOS is approached as a multi-system condition; symptoms are recognized earlier, and care becomes more connected from the beginning.
(Written by Dr. Rashmi Dharaskar, Sr. Consultant Obstetrics and Gynaecologist at Surya Mother & Child Super Specialty Hospital).
Extreme heat is not “just a bad summer”. (Photo credit: AI generated)
When Indian summers touch 48 degrees, it’s no longer just uncomfortably hot—it’s a serious public health challenge. Extreme heat affects everything from hydration levels in the body to digestion, the health of your skin, heart, and even mental well-being. Surviving (and staying healthy) through such brutal temperatures requires 360-degree body care, not just an extra glass of water or switching on the AC.
Dr P. Venkata Krishnan, Senior Consultant & Director—Internal Medicine, Narayana Hospital, Gurugram, in an interview with Health and Me, shared a complete and practical survival plan to help your body cope with the extreme Indian summer—inside and out.
Hydration: Go Beyond Plain Water
In intense heat conditions, your body loses water and electrolytes very quickly through sweat. Electrolytes help carry water to the blood and tissues. Hence, drinking only plain water in summer may not suffice. Try sipping water consistently at regular intervals instead of gulping large quantities at once. Electrolyte-rich fluids like coconut water, lemon water with a pinch of salt, or buttermilk are healthy, affordable options to soothe parched throats. Avoid excess caffeine, colas, and alcohol, as they increase dehydration; if you must indulge, have a glass of water before your coffee or alcoholic drink.
Pro tip: Check your urine colour—dark yellow is a warning sign of dehydration.
Eat Light, Cool, and Smart
Our digestive systems are also tired in extreme summers. Spicy, heavy, and oily foods generate more internal heat, which puts an additional burden on digestion. Opt for seasonal fruits like watermelon, muskmelon, papaya, and berries instead of chips and snacks.
To ease digestion, add items like curd, rice, cucumber, and bottle gourd to your meals. Avoid red meat and fried foods during peak summer days. Smaller, lighter meals are easier for the body to process in extreme heat. Find ways to increase hydration through fruits and vegetables in your food too, apart from water intake.
Protect Your Skin from Heat Damage
Heat doesn’t just tan your skin—it accelerates ageing, causes pigmentation, and triggers rashes. Incorporating a summer skincare regimen can help prevent damage to your skin.
Mind Your Heart and Blood Pressure
Extreme temperatures put additional stress on the cardiovascular system, especially in people with hypertension, diabetes, or heart conditions. There are just a few things to bear in mind. When the temperature outside sizzles, avoid stepping outdoors for prolonged periods, especially between 12 pm and 4 pm, when the sun beats down mercilessly.
Take all prescribed medications exactly as advised—don’t skip doses even if you experience heat-induced nausea. If you feel dizzy or experience palpitations or severe fatigue, consult your doctor as soon as possible. Heat exhaustion can silently progress to heatstroke, which is a medical emergency.
Smart Cooling at Home and Work
Air conditioning is helpful, but overexposure can lead to dry skin, headaches, and respiratory discomfort. However, since the emphasis is more on cooler environments in summer, there are a few ways to avoid overexposure to AC.
Once every two or three hours, step away from your desk for a few minutes. Walk or stand, and sip some water. Open windows, if possible, to avoid thermal shock. Set AC temperatures between 24 and 26 degrees, despite the urge to cool the surroundings further. Use fans and cross-ventilation whenever possible, relying a little less on air conditioning in the process. Never move directly from extreme heat into freezing AC environments, or vice versa, as it can impact your body suddenly.
Sleep & Mental Well-being Do Matter
Poor sleep due to heat can increase irritability, anxiety, and fatigue. Include some calming activity before bedtime. Put away screens, as they radiate heat too. Some tips to help you sleep better:
Special Care for Vulnerable Groups
Children, elderly individuals, pregnant women, and outdoor workers are at higher risk of heat-related health concerns. They should particularly ensure that they hydrate more frequently.
A holistic approach covering hydration, nutrition, skincare, heart health, and mental well-being can help your body adapt and stay resilient. Extreme heat is not “just a bad summer." Treat it seriously, listen to your body, and make smart daily choices, because protecting yourself from the heat today prevents long-term health problems tomorrow.
Drinking alcohol is one of the risk factors for cancer. (Photo credit: iStock)
Cancer is one of the most dreaded diseases. It is characterised by a malignant tumor that obstructs the normal functioning of organs. According to a recent analysis from the World Health Organisation (WHO), more than a third of cancer cases in the world are preventable. Cervical, stomach, and lung cancers make up half of the cases. This implies that millions of such deadly cases in the world can be prevented with behavioural changes, timely medical intervention, reduced occupational risks, and an ability to tackle environmental pollutants. It turns out that most preventable cancers can be avoided by making two simple lifestyle changes.
Researchers say that addressing preventable causes represents one of the most powerful opportunities to reduce the global cancer burden. The analysis also noted that, in 2022, there were approximately 19 million new cases of cancer, and 38 per cent were related to 30 modifiable risk factors. The most common modifiable risk factors are:
The most common preventable risk factor, however, was smoking tobacco. It is associated with 15 per cent of all cancer cases in a year. In men, the risk was significantly higher. Smoking contributed to 23 per cent of the new cancer cases globally in men that year. However, smoking alone was not the only cause; air pollution, depending upon the region, played a huge role. In East Asia itself, 15 per cent of lung cancer cases in women were attributed to air pollution. In Western Asia and Northern Africa, 20 per cent of lung cancer cases in men were due to air pollution.
After smoking tobacco, the next key lifestyle risk factor was drinking alcohol. It accounted for 3.2 per cent of all cancer cases—approximately 7 lakh. As per researchers’ estimates, drinking alcohol and smoking tobacco account for about 48 per cent of all preventable cancer cases. Infections, however, were associated with 10 per cent of new cancer cases. Among women, the largest share of these cases was attributed to high-risk human papillomavirus (HPV), which contributes to cervical cancer cases. However, with the HPV vaccine being more accessible, cervical cancer cases have reduced.
Stomach cancer cases are higher among men and are mostly associated with inadequate sanitation, smoking, infections, and poor access to clean water. A first-of-its-kind analysis, this study helps show how much cancer risk comes from preventable causes. By examining these patterns, countries can be alerted to work towards preventing cancers in the first place by taking appropriate steps.
Researchers also mentioned in their paper that 4 in 10 cancer cases in the world in 2022 could have been prevented by eliminating the risk factors considered in the study. The study was published in the Nature Medicine journal.
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