Migraines In Women: How Hormones Influence Neurological Health

Updated Dec 15, 2024 | 11:00 PM IST

SummaryThe hallmark of migraine is its pulsating, unilateral pain, lasting from 4 to 72 hours, often preceded by aura—transient neurological symptoms such as visual disturbances or tingling sensations.
Migraines In Women: How Hormones Influence Neurological Health

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.

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.

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Hemophilia: Why Bone Health Needs Attention From Childhood

Updated Oct 29, 2026 | 04:00 PM IST

SummaryChildhood and adolescence are critical for building peak bone mass, making early intervention important for long-term musculoskeletal health, said health experts.
Hemophilia: Why Bone Health Needs Attention From Childhood

Credit: iStock

People with hemophilia face an increased risk of poor bone health due to recurrent joint and muscle bleeds, joint damage and reduced physical activity. Experts told HealthandMe that preventing bleeds from childhood, alongside adequate nutrition, appropriate exercise and regular assessment, can help protect bone health throughout life.

Globally, an estimated 836,000 people have hemophilia, including approximately 284,000 with severe hemophilia. In India, the World Federation of Hemophilia (WFH) reported nearly 28,000 diagnosed and registered patients as of 2026, including more than 24,000 with Hemophilia A. However, the estimated prevalence could be as high as 1,36,000, suggesting many cases remain undiagnosed or misdiagnosed.

Childhood and adolescence are critical for building peak bone mass, making early intervention important for long-term musculoskeletal health, said health experts.

How Hemophilia Can Affect Bone Health

Hemophilia is an inherited bleeding disorder caused by a deficiency of clotting factor VIII (Hemophilia A) or factor IX (Hemophilia B). It primarily affects males, while women are often carriers.

Repeated bleeding into joints can cause chronic pain, joint damage, deformity and reduced mobility. Muscle bleeds can further restrict movement, limiting participation in physical activities that help maintain bone strength.

“Bone health begins in childhood, but protecting it is a lifelong commitment. In people living with hemophilia, recurrent joint and muscle bleeds, reduced physical activity and other risk factors can contribute to poor bone health and an increased risk of osteoporosis,” Dr. Varun Bafna, associate professor in the Department of Hematology at Chhatrapati Shahu Maharaj Government Medical College, Kolhapur, told HealthandMe.

Why Prophylaxis Matters

Prophylaxis involves preventive treatment to reduce bleeding episodes rather than treating bleeds only after they occur. Regular factor prophylaxis can help prevent recurrent joint bleeds, preserve joint function and support mobility.

“Regular factor prophylaxis helps prevent repeated joint bleeds and preserve joint function. That protection can support mobility, an important contributor to bone health,” Dr. Hitha B, associate professor and haematologist in the Department of Medicine at Government Medical College, Kozhikode, told HealthandMe.

She advised patients to discuss breakthrough bleeding or difficulties accessing treatment with their healthcare team so their treatment plan can be reviewed.

Dr. Bafna said consistent prophylaxis can also support muscle strength and safer participation in physical activity.

“Prophylaxis is not just about preventing bleeding today; it is an important part of protecting long-term musculoskeletal health and quality of life at every age,” he noted.

How to Protect Bone Health From Childhood

Experts recommend an individualized approach based on age, joint health, mobility and other risk factors. Key measures include:

  • Calcium and vitamin D: Ensure adequate intake through diet and discuss supplementation with a healthcare professional when needed.
  • Appropriate physical activity: Weight-bearing exercises suited to individual joint health can help maintain bone strength, with guidance from the care team.
  • Physiotherapy: Tailored rehabilitation can help maintain muscle strength, mobility and joint function.
  • Regular assessment: Periodic evaluation can identify bone-health concerns and determine whether further investigations are needed.
  • Consistent prophylaxis: Adhering to prescribed preventive treatment can reduce bleeding episodes and help protect joints.

A Multidisciplinary Approach to Lifelong Care

Hematologists, physiotherapists and other healthcare professionals can help patients and families integrate preventive treatment, rehabilitation, nutrition and appropriate physical activity into an individualized care plan.

Early intervention and consistent care can help preserve joint function, mobility and quality of life as people with hemophilia grow older.

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World Stroke Day: What Is BE FAST? Stroke Warning Signs To Watch For

Updated Oct 29, 2026 | 03:00 PM IST

SummaryOn World Stroke Day, we look at stroke symptoms like sudden dizziness, blurred vision, facial drooping and slurred speech that can be easy to dismiss. Doctors explain the BE FAST warning signs, why immediate medical attention is crucial, and how recognising symptoms early could improve recovery outcomes. In India, call 112 for emergency assistance if a stroke is suspected.
Doctors Highlight Stroke Warning Signs

Doctors emphasise the importance of recognising stroke symptoms early and seeking emergency medical care to improve the chances of recovery. (Image Credits: iStock)

A stroke rarely announces itself loudly. A sudden wobble, a blurry eye or a slightly lopsided smile is easy to ignore. But in a stroke, minutes decide how much of the brain survives.

On World Stroke Day, doctors want everyone to know one simple tool: BE FAST.

What Doctors Say

Dr. Abhinav Gupta, Director of Neurology at Sarvodaya Hospital, Greater Noida West, and Dr. Atampreet Singh, Senior Director and Head of the Institute of Neurosciences at ShardaCare, Healthcity, told HealthandMe, “Knowing the early warning signs of a stroke can shorten the road to full recovery,” they said.

The problem, they added, is that “a stroke’s symptoms can be easy to dismiss as minor inconveniences, like being tired or having weak muscles.”

What Is BE FAST?

BE FAST was developed by Intermountain Healthcare as an adaptation of the American Stroke Association’s FAST model, according to a Frederick Health handout. The doctors break it down like this:

  • B – Balance: “Unsteady feeling or sudden lack of muscle control and dizziness can be a warning sign of a stroke.”
  • E – Eyes: “Don’t overlook loss of sight in one or both of a person’s eyes, sudden blurring, or double vision.”
  • F – Face: “Ask the person to smile. Unevenness or droopiness on one side of the face can be a sign.”
  • A – Arms: “Have the person raise both of their arms. If the person has difficulty holding one arm up or has unusual arm weakness, get emergency help.”
  • S – Speech: “Sudden lack of ability to talk, inability to understand what others are saying, or slurred words, can be signs of a stroke.”
  • T – Time: “If one of these symptoms occur out of the blue, then call emergency services. When the emergency operators are on the line, let them know what symptoms have presented.”
On the cause, the doctors said: “A stroke is caused by the disruption of blood flow to part of the brain. When the brain is deprived of the necessary blood supply, cells start to die.” They named high blood pressure, diabetes, high cholesterol, smoking and heart disease as common causes. But they noted that “strokes can occasionally occur even in the absence of obvious risk factors.”

Also Read: Times Network India Health Summit 2026 Key Takeaways: AI, Fertility, AYUSH, Cancer Care & More

Why “Time” Matters The Most

Time is not a symptom. It is a reminder to hurry. Duke Health, citing the American Stroke Association, says to call for help even if the symptoms go away. Weill Cornell Medicine, citing the same group, says never to drive yourself to hospital.

The Frederick Health handout adds that you should note when the symptoms began. UChicago Medicine estimates that about 1.9 million brain cells die every minute in a stroke caused by a large blocked artery.

India’s biggest problem is delay in seeking medical treatment.

An ICMR study of 34,792 stroke cases at 30 hospitals between 2020 and 2022 found that only 5.3% of patients reached hospital within the first hour, according to South First. Nearly four in ten waited more than 24 hours. Down To Earth, reporting on a Lancet Neurology study, says India had over 1.25 million new stroke cases in 2021, up 51% since 1990.

If you see even one sign, don’t wait for the others. Call 112, India’s single emergency number, which also covers the 108 ambulance service, according to Factly. Say what you see and when it began.

Share BE FAST with your family tonight. You may be the one who spots it.

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From Cracked Heels to Numbness: Common Foot Problems That Shouldn’t Be Ignored

Updated Oct 29, 2026 | 01:31 PM IST

SummaryCracked heels, persistent foot pain, tingling and numbness may signal more than everyday wear and tear. From fungal infections and nerve damage to diabetes-related complications, recognising common foot problems and their warning signs can prevent serious complications.
From Cracked Heels to Numbness: Common Foot Problems That Shouldn’t Be Ignored

Credit: iStock

Many people track their steps, sleep and heart rate with a precision that once seemed unusual. The feet behind those steps rarely get the same attention, hidden as they are inside shoes all day.

A crack, an ache or a patch of numbness is easily put down to the weather, age or an ill-fitting pair of sandals. Yet some complaints reach a clinic only after they begin to interfere with everyday life.

Symptoms That Are Easy to Explain

Cracked heels are a good example, because they are so common that most people treat them as a cosmetic matter and reach for a moisturiser. That is usually reasonable, although a deep fissure that bleeds or keeps reopening gives bacteria a way into the skin and is worth having examined.

Heel pain often has a musculoskeletal cause and tends to respond to rest and supportive footwear, but pain that lingers for weeks points to something more specific. Numbness gives the least warning of all, since it can arise from nerve compression, poor circulation, nutritional deficiencies or diabetes, and because it does not hurt, an injury can go unnoticed for days.

Also read: Toddler’s Swollen Knee Turned Out To Be Juvenile Arthritis Diagnosis: Signs Parents Should Not Ignore

Why Weekly Measurement Matters

When a wound does develop, understanding whether it is actually healing becomes just as important as recognising the early warning signs. Researchers who monitor wounds over time know that appearance alone does not always tell the full story.

What a Recent Case Report Showed

A 2025 case report in the Journal of the Foot & Ankle followed two adults with long-standing diabetes and neuropathic plantar ulcers for twelve weeks, with wound area quantified by digital planimetry. One wound, treated with a graft of decellularised human dermis, shrank by 80 percent by week four and had fully epithelialised by week eight.

The other, managed with gauze-based moist wound care, reduced by 7.8 percent at week two, grew by 21.6 percent between weeks three and five, and reached a 68.6 percent reduction by week twelve without closing. No adverse events were recorded in either patient during the twelve weeks.

Reading the Evidence Carefully

The report is descriptive, and two patients cannot settle questions about any treatment. The lesson that carries beyond the clinic is more modest, since progress is easier to judge when it is tracked against a timeline.

Asking How Long, Not How Bad

For readers, the message is to pay attention not just to how serious a symptom looks, but also to how long it has lasted and whether it is changing. Cracks that repeatedly reopen, persistent heel pain and spreading numbness deserve medical attention.

For people with diabetes, any new foot wound should be assessed promptly rather than waiting to see whether it improves on its own.

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