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.

Ramzan, the holiest month in Islam, marked by dawn-to-dusk fasting, poses health risks for people with diabetes. Health experts urge patients to consult their doctors before observing the fast.

Ramzan is a period of intense spiritual reflection, self-discipline, and devotion for Muslims worldwide. During the month-long fasting period, the believers refrain from eating and even drinking (including water), from dawn to sunset.

The faithful eat a modest meal (sehri) before the first light of dawn to provide energy for the day. The fast is broken at sunset, traditionally starting with dates and water, followed by a larger meal (iftar).

According to health experts, for individuals whose diabetes is well controlled, fasting may be possible with proper adjustments.

"Diabetes requires regular monitoring, balanced meals, and timely medication. When eating patterns change during Ramzan, blood glucose levels can fluctuate. That is why I strongly recommend consulting your doctor before you plan to fast,” Dr. Saptarshi Bhattacharya, Senior Consultant, Endocrinology, Indraprastha Apollo Hospitals, told HealthandMe.

The expert advised people not to skip sehri, and to include complex carbohydrates such as whole grains, along with protein like eggs, dal, or curd, and plenty of fluids to help maintain stable glucose levels throughout the day.

At iftar, avoid overeating. Start with light, balanced food and limit fried items, sweets, and sugary drinks, as these can cause a sudden spike in blood glucose, Dr. Bhattacharya said.

Type 2 Diabetes patients with good glycemic control, lifestyle management, or stable oral medications can fast safely.

However, those on multiple insulin doses, with complications, or with poor control are considered moderate to high risk, Dr. Kartik Thakkar, Consultant Medicine, Ruby Hall Clinic, told HealthandMe.

The health expert also noted that most Type 1 diabetes patients are considered high risk, especially those with brittle diabetes, frequent hypoglycemia (low blood sugar), or a history of diabetic ketoacidosis (DKA). Many are medically advised not to fast, particularly if glucose control is unstable.

Children and adolescents with type 1 diabetes are considered high risk and are usually advised against fasting due to the unpredictable nature of insulin requirements.

Who Should Avoid Fasting Altogether?

• People with a history of severe hypoglycemia in the last 3 months;
• Recurrent hypoglycemia;
• Advanced kidney disease;
• Elderly patients with frailty; and
• Pregnant women with diabetes

Dr. Thakkar said that such individuals fall into the very high-risk category and are medically exempt from fasting.

The expert also suggested clinical tests to determine whether a diabetic patient is fit to fast. These include:

• Glycemic control (HbA1c levels)
• Duration of diabetes (long-standing diabetes can increase complication risk)
• Presence of complications (neuropathy, nephropathy, cardiovascular disease)
• Kidney function and hydration status

What Warning Signs Should Prompt Breaking The Fast Immediately?

A diabetic patient must break the fast if:

• Blood glucose <70 mg/dL (3.9 mmol/L)
• Blood glucose >300 mg/dL (16.7 mmol/L)
• Severe dizziness or fainting
• Confusion or blurred vision
• Persistent vomiting
• Symptoms of dehydration (extreme thirst, very low urine output)
• Chest pain or breathlessness

A new study has shown that people who survived COVID-19 infections are more likely to develop obstructive sleep apnea (OSA) for years after the infection with the SARS-CoV-2 virus.

OSA is a common and serious sleep disorder that causes the throat muscles to relax and block the airway, resulting in fragmented, nonrestorative sleep, low blood oxygen, and loud snoring.

The February 2026 study, published on the preprint server medRxiv, found that people with both severe and non-severe COVID infections are at higher risk of developing sleep apnea and other sleep issues for 4.5 years.

"SARS-CoV-2 infection is independently associated with increased risk of new-onset OSA. These findings support targeted screening in post-COVID populations,” said Sagar Changela, Department of Radiology, Albert Einstein College of Medicine, in the paper.

What The Study Found

Although an infection with the SARS-CoV-2 virus has been associated with long-term respiratory and neurological conditions, its role in new-onset OSA remains unclear.

The retrospective study, which has not been peer-reviewed, involved 910,393 patients. The results showed that patients hospitalized due to COVID were 41 percent at risk of new onset of OSA.

One-third of people with mild COVID infection, who weren't hospitalized, also suffered from sleep issues.

The researchers also linked OSA to cardiovascular, metabolic, and cognitive morbidity. The team found that OSA increased the risk of heart failure and pulmonary hypertension among hospitalized COVID patients, compared to those with mild infections.

On the other hand, the non-hospitalized COVID patients were significantly more likely than controls to develop obesity.

Further analyses showed that the risk of new-onset OSA was higher in hospitalized COVID patients with asthma and those who were younger than 60 years. Notably, women were also found at greater risk than men, while vaccination status did not vary by risk.

According to the team of researchers, the major factors for OSA among COVID patients are low-grade systemic inflammation after a SARS-CoV-2 infection that reduces upper-airway neuromuscular control.

In addition, the higher levels of inflammatory cytokines often seen in long-COVID patients can also affect respiratory drive and upper-airway stability -- key factors for OSA.

What Is Sleep Apnea?

Sleep apnea is a serious sleep disorder where a person's airway can collapse completely or partially. It causes breathing lapses during sleep, and the body stops breathing many times while an individual is asleep. It also weakens throat muscles, leading to airway collapse during sleep. The decrease in oxygen saturation can also lead to death.

While OSA is the most common type of the sleep disorder, other types include central sleep apnea and complex sleep apnea.

Obesity is the major cause of this disorder, and loud snoring is the most common symptom. The person suffering from the condition feels tired, even after getting adequate sleep.

Treating sleep apnea is key to preventing long-term health complications such as cardiovascular disease, hypertension, diabetes, stroke, and increased mortality.

CPAP machines, oral appliances, and lifestyle modifications are common and effective treatment measures.

For decades, diabetes conversations have revolved around diet, weight and genetics. While these remain central, growing medical evidence shows two often ignored factors play a powerful biological role in blood sugar control: stress and sleep.

Dr Narendra BS, Lead Consultant in Endocrinology and Diabetology at Aster Whitefield, Bengaluru, recently wrote for NDTV explaining that these are not minor lifestyle irritants but metabolic triggers.

According to him, poor sleep and chronic stress “create a biological environment that puts us at risk for developing type 2 diabetes or make it harder to control blood sugar if we already have the condition.”

How Stress Raises Blood Sugar

When the body senses danger, it activates its major stress systems including the hypothalamic pituitary adrenal axis and the sympathetic nervous system. These release cortisol and adrenaline, hormones designed to help survival.

They rapidly increase blood glucose so the body has instant energy. This is useful during emergencies but harmful when stress becomes constant.

“Continuous stress from work pressure, caregiving or anxiety reduces the body’s insulin sensitivity,” Dr Narendra explains. Over time, cells stop responding properly to insulin and glucose levels rise.

Long term studies now link persistent stress patterns to insulin resistance and a higher risk of diabetes. In simple terms, even if diet remains unchanged, chronic emotional strain can gradually push the body toward metabolic disease.

The Hidden Damage From Poor Sleep

Sleep disturbance works just as strongly against blood sugar regulation.

Sleep restriction, irregular schedules and fragmented sleep impair glucose tolerance, sometimes within days. Research shows that even partial sleep loss raises fasting glucose and insulin levels. Over time, this increases HbA1c and diabetes risk.

“When you don’t get good sleep, your body is simply not as efficient at handling sugar,” he notes.

The problem worsens because stress and sleep feed each other. Stress disrupts sleep, sleep deprivation increases stress hormones, and both promote unhealthy habits such as late night snacking, skipping exercise and excess caffeine intake.

Doctors in India increasingly link this cycle to urban lifestyles and rising diabetes prevalence.

Encouragingly, The Damage Can Be Reversed

The positive takeaway is that these effects are modifiable. Improving sleep duration and reducing stress measurably improves insulin sensitivity.

Sleep extension trials have shown improvements in glucose metabolism. Stress management programs have lowered fasting glucose and HbA1c levels.

Because the science is clear, Dr Narendra recommends that diabetes care must include mental and sleep assessment. Screening for insomnia, anxiety and depression should be routine in metabolic clinics.

What Patients Can Do

Sleep should be treated like medicine. Adults should aim for 7 to 8 hours of consistent sleep, maintain fixed bedtimes and avoid screens for at least an hour before bed. Shift workers may require specialist guidance due to circadian rhythm disruption.

Stress management can begin with simple practices. Deep breathing, mindfulness and short cognitive exercises can lower daily cortisol levels. Therapy and medication may help when anxiety or depression is present.

Physical activity is equally important. Regular exercise improves insulin response and prevents excessive stress reactions. Even a short walk after meals helps reduce blood sugar spikes.

A New Approach To Diabetes Care

Healthcare providers are encouraged to actively discuss sleep and psychological health during treatment. A combined approach using lifestyle modification, mental health care and medication provides better results than focusing on diet alone.

“Blood sugar is not just a number on a test,” Dr Narendra emphasizes. “It reflects lifestyle, biology and psychology. Addressing sleep and stress tackles a major but often neglected contributor to poor control.”

In short, managing diabetes is no longer only about what is on the plate. It is also about what happens at night and what weighs on the mind.