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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Glaucoma is an umbrella term for a group of eye diseases that create pressure inside your eyeball, which can damage delicate, critical parts at the back of your eye, including the optic nerve.
While most of the diseases are progressive, meaning they gradually get worse and eventually cause permanent vision loss and blindness. In fact, glaucoma is the second-leading cause of blindness worldwide and is the leading cause of blindness for people over 60 years old.
Dr Niteen Dedhia, Medical Director, Ojas Maxivision Eye Hospital tells Business Standard: "Glaucoma slowly and quietly causes damage to the optic nerve. Changes in eye pressure, blood flow and nerve fibres occur over time, while the brain often compensates for the loss.
"As a result, symptoms go unnoticed, and by the time vision loss becomes apparent, the damage is usually permanent."
Many forms of glaucoma have no warning signs and the effect is extremely gradual, to the point that you may not notice a change in vision until the condition is in its late stages.
Here are some symptoms that mid-age people need to keep an eye out for:
One of the earliest symptoms of glaucoma is damage and subsequent loss of peripheral vision. Dr Dedhia noted: “Glaucoma starts by damaging the peripheral vision but doesn’t affect the centre (front) vision."
If you seem to struggle with spotting objects approaching from the side or bump into things more often, you may be experiencing early stages of the disease and not merely experiencing normal ageing.
Dr Neeraj Sanduja, Ophthalmologist, Eye Surgeon at Viaan Eye Centre, Gurgaon told the publication: "Needing frequent prescription changes or feeling that glasses 'never feel quite right' may reflect subtle visual field changes caused by glaucoma rather than simple refractive error progression."
Open-angle glaucoma, the most common form of the condition that causes patchy blind spots in your side vision, is often painless or limited to a mild sense of pressure or heaviness in the eyes.
Those suffering from open-angle glaucoma may notice a dull ache after prolonged screen time or reading that improves with rest. Frequently mistaken as regular eye strain, it is often ignored, however, may indicate subtle increases in eye pressure that require professional evaluation.
Frequent headaches, especially when accompanied by eye strain or blurred vision, should not be ignored as migraine pain as it may signal rising eye pressure or early glaucoma changes, Dr Dedhia warns.
Certain groups of people have a higher than normal risk of getting glaucoma which includes those who:
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Abnormal sleeping patterns, whether excessive or brief, can significantly increase your risk of developing chronic liver disease, an EMJ study suggests.
Sleep duration has previously been linked to worsening your chances of Type 2 diabetes; obesity; cardiovascular diseases including hypertension, stroke, heart attack; mental disorders such as depression, anxiety; weakened immune system and potentially contributing to neurological conditions such as dementia.
However, researchers have now also found that sleep disruption may intensify existing stress on the liver which can worsen metabolism and pave the way for disease progression.
The authors noted that poor sleeping habits may influence liver health for multiple reasons including by altering glucose metabolism, increasing inflammation and disrupt circadian rhythms that regulate liver function.
"Participants who reported consistently short sleep duration were more likely to have elevated liver enzymes and higher fibrosis risk scores compared with those reporting moderate sleep duration. Long sleep duration was also associated with adverse liver markers, though the relationship was weaker than that observed for short sleep," the study noted.
Despite discovering links, the involved researchers noted that the study only highlighted sleep as a potential factor that could worsen liver function along with other lifestyle reasons and did not act as a clear cause.
Once a rare condition, non-alcoholic fatty liver disease (NAFLD) now affects one in three Indians. A JAMA study has now found that about 40 percent of the global population is now suffering from NAFLD, with abdominal obesity identified as its single biggest risk factor.
Researchers found that nearly 70 percent of people with Type 2 diabetes and about 80 percent of those with obesity are affected by NAFLD. They also discovered that NAFLD prevalence is higher in men than in women, with rates of 15,731 per 100,000 population in men compared with 14,310 in women.
READ MORE: This Deadly Liver Disease Is Affecting People In Their 20s And This One Symptom Is The Red Flag
Between 2010 and 2021, India recorded a 13.2 percent increase in age-standardized prevalence, ranking just behind China at 16.9 percent and Sudan at 13.3 percent. Additionally, the disease peaks earlier in men, between 45 and 49 years of age, while women show the highest prevalence between 50 and 54 years.
NAFLD, now called as metabolic dysfunction-associated steatotic liver disease (MASLD), is when excess fat builds up in the liver, unrelated to heavy alcohol use, due to obesity, Type 2 diabetes, high blood pressure and cholesterol.
It ranges from simple fat accumulation to inflammation and damage, which can progress to fibrosis, cirrhosis or liver cancer, The disease often has no symptoms and is managed with lifestyle changes such as diet and weight loss.
Poor diets (high carbs/sugar), sedentary habits and rising obesity are some of the key reasons why an uptick in NAFLD cases has been seen pan-India. Increased intake of refined carbs, sugary drinks, processed foods and unhealthy fats can increase the risk of obesity, diabetes, hypertension and high cholesterol which can pave the way for this liver disease.
Experts also note that working long hours at desks without any proper physical activity can lead to weight gain and fat accumulation in the liver.
According to the Union Health Ministry, the prevalence of the condition could be in the range of 9-53 percent. Multiple other health studies also suggest nearly 40 percent of urban Indians may have some form of fatty liver disease
Hepatologist Dr Cyriac Abby Philips, popularly known as LiverDoc on social media, noted on X that many patients do not realize that timely lifestyle changes can completely reverse the condition. “All it takes is being in charge of your body and health. No shortcuts—go slow and steady,” he wrote.
If left untreated, NAFLD can progress to Non-Alcoholic Steatohepatitis (NASH), where liver inflammation begins. Over time, this inflammation can lead to scarring of the liver, known as fibrosis. Advanced fibrosis results in cirrhosis, which severely affects liver function.
NAFLD can also increase the risk of chronic liver disease, liver failure and hepatocellular carcinoma. Many patients diagnosed with liver cancer have a history of untreated fatty liver.
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Over 2 million Americans have Alzheimer's. It is the most common cause of dementia and is a progressive disease. This means the disease will get worse, however, it could be managed, though cure is not available. It is the biological process that begins with the appearance of a buildup protein in the form of amyloid plaques and neurofibrillary tangles in the brain. This causes brain cells to die over time and the brain to shrink.
The fact that there is no cure for Alzheimer's disease is one of the most unique part of the condition. In advanced stages, loss of brain function can cause dehydration, poor nutrition or infection.
The symptoms of Alzheimer's are unique because the signs are easily miss-able. These signs could seem like a day to day problem and not anything serious. At first, it starts with trouble in remembering recent events or conversations. Over time, memory gets worse and other symptoms occur.
While everyone could have trouble with memory at times, the memory loss that happens with Alzheimer's is lasting. The signs could be:
Alzheimer's could also lead to trouble in concentrating, thinking, especially about abstract concepts like number. Your thinking and reasoning abilities take a hit. In fact, in many cases, people with Alzheimer's are not able to recognize numbers.
There are many tasks that you do in your day to day life, which come easy to you, could become difficult over time. As Alzheimer's advances, people forget how to do basic tasks such as dressing or bathing.
Read: What A Finger-Prick Blood Test Could Mean for Alzheimer’s Diagnosis
With Alzheimer's, your personality too can change, as the disease could affect moods and behaviors. Symptoms include:
UK researchers say fruit flies could help unlock why devastating brain and nerve conditions such as Alzheimer’s, Parkinson’s and motor neurone disease develop, despite decades of medical research. Scientists have known for years that many neurodegenerative disorders are linked to genetic mutations. What has remained unclear is how those mutations actually trigger disease inside the nervous system.
According to the Mirror, new findings published in the journal Current Biology suggest a breakthrough may lie in studying fruit flies, insects whose genes behave in strikingly similar ways to those in humans.
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