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.

Brain disorders are becoming one of India's fastest-growing public health challenges, said health experts ahead of Brain Day on July 22.

The experts highlighted that an ageing population, rising lifestyle diseases and limited access to specialist care are contributing to an increasing burden of conditions such as stroke, epilepsy, Parkinson's disease, dementia and multiple sclerosis.

Access Gap Delays Diagnosis, Treatment

Dr. Madhukar Bhardwaj, Director & Head of Department, Neurology, Aakash Healthcare, said neurological disorders have become one of India's most urgent healthcare concerns.

"Neurological disorders are no longer a concern of a small section of the population—they are one of the most pressing emerging healthcare challenges of our time. In a country as vast and diverse as India, with a rapidly ageing population, this is a matter of urgency. What makes the situation even more worrying is the lack of equitable access to care," he said.

According to the World Health Organization's Global Status Report on Neurological Disorders (2025), India faces a severe shortage of neurologists, with the neurologist-to-patient ratio nearly 80 times worse than in high-income countries, leaving specialist care concentrated in major cities.

Stroke Increasingly Affects Younger Adults

Experts also highlighted a worrying shift in disease patterns, with strokes increasingly affecting younger people. Dr. Bhardwaj said strokes, once considered a disease of older adults, are now being seen more frequently among people in their 30s and 40s, underscoring the need for greater awareness and prevention.

Lifestyle Diseases Driving Brain Disorders

Doctors identified uncontrolled hypertension, diabetes, obesity, smoking, chronic stress, physical inactivity and poor sleep as major contributors to the rising burden of neurological diseases.

Dr. Rajas Deshpande, Consultant and Head of Neurology, Jupiter Hospital, Pune, said many neurological conditions share common lifestyle-related risk factors.

"Controlling hypertension, diabetes, obesity, smoking and physical inactivity can significantly reduce the risk of stroke and vascular dementia. Prevention deserves as much attention as treatment because many neurological disorders share common modifiable risk factors," he said.

Early Diagnosis Can Improve Outcomes

Dr. Bhardwaj stressed that many neurological disorders progress silently, making early diagnosis critical.

"Whether it is stroke, epilepsy, Parkinson's disease or memory disorders, early diagnosis can significantly improve outcomes. Unfortunately, many patients seek specialist care only after the disease has advanced, either because symptoms are ignored or because neurological services are not easily accessible. Greater public awareness and timely referrals are essential," he said.

Brain Health Linked to Women's Reproductive Health

Experts also emphasized that brain health extends beyond cognition. Dr. Hrishikesh Pai, Consultant Gynecologist & IVF Specialist, Lilavati Hospital Mumbai and Fortis Hospitals Delhi & Chandigarh, said the brain plays a central role in regulating women's reproductive health.

"Brain health plays a critical role in women's reproductive health. The hypothalamus and pituitary gland in the brain regulate the hormonal signals that control menstruation, ovulation, and pregnancy," he said.

He added that chronic stress, neurological disorders, pituitary diseases and certain medications can disrupt hormonal balance, leading to irregular menstrual cycles, infertility and pregnancy-related complications.

As wildfire smoke continues to affect communities across North America and Europe, fertility experts are recommending people undergoing vitro fertilization (IVF) to pay attention to an overlooked factor before embryo implant: air quality.

A new study suggests that exposure to unhealthy levels of air pollution, particularly from wildfire smoke, could significantly reduce the chances of a successful pregnancy after IVF.

Researchers, therefore, recommend discussing the timing of embryo transfer with a fertility specialist when air quality deteriorates.

Wildfire Smoke May Interfere With Embryo Implantation

The study, published in the journal Human Fertility, indicates that air pollution may affect reproductive health.

Between June and July 2023, researchers from Northwell Fertility in New York examined 190 fresh and frozen embryo transfers, when smoke from massive Canadian wildfires caused hazardous air quality across the northeastern United States.

They then compared the rate of successful pregnancies based on the Air Quality Index (AQI) on the day of embryo transfer.

Clinical pregnancy rates were approximately 62% on days with good air quality and 65% on days with moderate air quality.

But when the AQI rose above 100, a level considered unhealthy for sensitive groups; the pregnancy rate dropped to just 27%.

Although only 11 embryo transfers took place on days with unhealthy air quality, the researchers say the findings raise concerns about whether temporary exposure to wildfire smoke could affect one of the most critical stages of IVF.

Also read: Miles Apart, But Planning A Family Together: The Fertility Reality Of Long-Distance Marriages In India

How Can Air Pollution Affect Fertility And IVF Success Chances?

IVF embryos are created and stored in strictly controlled laboratories, meaning they are protected from polluted air and other contaminants in the environment.

Instead of damaging the embryo, researchers believe that wildfire smoke can affect the woman's body by increasing inflammation and oxidative stress. This could create a less favourable environment for the embryo to implant in the uterus.

Air pollution contaminant, PM2.5, a fine particulate matter, is one of the main pollutants in wildfire smoke. It is minute enough to enter the lungs, bloodstream, and trigger inflammatory responses throughout the body.

Previous studies have already indicated that PM2.5 exposure could cause pregnancy complications and harm fertility.

Dr. Randi Goldman, Program Director at Northwell Fertility and co-author of the study, said the research suggests patients and physicians should consider environmental conditions when planning embryo transfer.

Also read: Global Female Infertility Could Affect 80 Million Women Aged 35+ by 2036: Lancet Study

"The embryo is safely protected inside the laboratory. The effect we're seeing is more likely related to how air pollution influences the body before and after embryo transfer rather than the embryo itself," Goldman said.

She opines that patients experiencing severe wildfire smoke or hazardous air quality should discuss whether delaying embryo transfer by a few days could improve the chances of success.

"Patients invest enormous emotional, physical and financial resources into IVF. Delaying treatment is difficult, but when air quality reaches unhealthy levels, it may be worth discussing timing with your fertility specialist," Goldman said.

Expert-Recommended Tips To Improve IVF Success

Adopt a Fertility-Boosting Lifestyle: Eat a balanced diet, exercise daily, and enjoy a healthy BMI. Reduce alcohol intake, do not smoke, and avoid recreational drugs.

Take Key Supplements: Folic acid, CoQ10, and vitamin D can improve egg quality and overall fertility.

Stress Management Is Key: Elevated cortisol levels can affect reproductive hormones. Practice mindfulness, yoga, or acupuncture.

Sleep Well: Aim for at least 7–8 hours of restful sleep to support hormonal balance.

Address Underlying Health Conditions: Conditions such as PCOS, thyroid issues, and endometriosis can interfere with fertility outcomes if left unmanaged.

Start Early, If Possible: The earlier IVF is initiated—especially for women over 35—the better the chances.

The detection of the Omicron RF.5 subvariant in Andhra Pradesh has raised concerns about a possible resurgence of COVID-19 in India. However, health experts say there is no evidence so far that the new sub-lineage causes more severe illness than other recently circulating Omicron variants.

While RF.5 may spread more efficiently, experts stress that the focus should remain on protecting vulnerable groups rather than panicking.

RF.5 Transmissible, Not More Deadly

Speaking to HealthandMe, Dr. Aijaz Ilmi, Senior Consultant – Preventive Wellness & Metabolic Diseases, Pacific OneHealth Hospital, said the detection of RF.5 should prompt vigilance, not fear.

"At present, there is no convincing evidence that RF.5 causes more severe disease than other recently circulating Omicron variants, although it may spread efficiently. Ongoing surveillance remains essential, as seen in Telangana."

Dr. Tushar Tayal, Associate Director, Internal Medicine, CK Birla Hospital, Gurugram, added that countries including Singapore have already detected RF.5 without reporting a corresponding rise in hospitalizations, suggesting the variant may be more transmissible but not more severe.

Also read: India Logs 339 COVID-19 Cases In First Half Of July: What To Know About The RF.5 Omicron Subvariant

Mild Illness For Most Healthy People

Dr. G.C. Khilnani, Chairman, PSRI Institute of Pulmonary, Critical Care, told HealthandMe that the current outbreak is being driven by the Omicron variant, which generally causes a milder upper respiratory illness than earlier COVID-19 strains.

He said healthy individuals typically experience fever, cough, runny nose and body aches, while the risk of severe disease remains much lower than during previous waves.

"This virus remains confined to the throat, or what we call the oral cavity, and does not traverse to the lungs. Therefore, in a normal healthy individual, it does not cause pneumonia. So, it is not life-threatening in immunocompetent or healthy individuals."

Who Is at Risk?

Following four COVID-19-related deaths reported in Andhra Pradesh over the past two weeks, experts said people with weakened immunity continue to face the highest risk of severe illness. This includes cancer patients undergoing chemotherapy, people with uncontrolled diabetes, older adults, those on long-term steroid therapy and people living with HIV/AIDS.

"Most infections are expected to present with mild upper respiratory symptoms such as sore throat, fever, cough, runny or blocked nose, fatigue, headache and body aches," Dr. Ilmi said.

He added that older adults, pregnant women, people with heart, lung or kidney disease, obesity, cancer, diabetes, weakened immunity and those who are inadequately vaccinated remain the most vulnerable to severe COVID-19.

Symptoms Remain Similar

Read More: India’s First Approved Dengue Vaccine: Takeda’s QDENGA Protects Against All Four Virus Serotypes

Experts said RF.5 does not appear to cause unusual symptoms. Common signs include:

• Sore throat
• Fever
• Cough
• Runny or blocked nose
• Fatigue
• Headache
• Body aches

They advised seeking immediate medical attention if symptoms such as breathlessness, persistent chest pain, confusion or low oxygen levels develop.

COVID-19 in India: Vigilance, Not Panic

India has reported a renewed uptick in COVID-19 cases, with 339 infections recorded between July 1 and July 16, according to the Andhra Pradesh Health Department.

Reported cases during this period include:

• Kerala: 115
• Karnataka: 64
• Maharashtra: 43
• Tamil Nadu: 39
• Andaman and Nicobar Islands: 18
• Delhi: 18
• Rajasthan: 12
• Other states: Remaining cases

How To Prevent

Experts said public health guidance has not changed despite the emergence of RF.5. They recommend wearing masks in crowded places, getting tested if symptoms develop, and isolating after a positive test to reduce transmission.

Dr. Khilnani also stressed the importance of early diagnosis, avoiding crowded places while infected, wearing a mask and following proper cough etiquette. He added that people with weakened immunity should be especially cautious, avoid crowded settings and maintain good hand hygiene.

Early testing, adequate hydration, rest and symptomatic treatment remain the cornerstone of management, particularly for high-risk individuals.