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.
Credits: Screengrab and Wikimedia Commons
Josie Gibson, English TV personality, opened up about her secret health disorder and that she is turning to a "last resort" surgery for the same. She revealed that this health challenge has left her with extreme pain. This Morning presenter, 40, appeared on the show and spoke to Cat Deeley and Ben Shephard about being diagnosed and having a "lipodema" body. She said, "A couple of years ago somebody actually said on Instagram, 'you have got a typical lipodema body'. I thought, 'what's lipedema?'"
She said she did not even have a clue, but she knew something was not right. But she did not know what lipedema was. She got diagnosed about a year ago and had a surgery. She told her fans that she has been "constantly fighting" her genetics.
Speaking on ITV’s This Morning, Gibson said surgery was a “last resort” but described herself as happy with the results after spending around £7,000 on liposuction to treat her calves. She explained that the procedure, which combines liposuction with a technique that tightens the skin, had to be carried out in stages.
“The last thing I want to do is put myself through surgery, but it was my last resort,” she said, adding that she had only treated her calves so far. Gibson said the change in her appearance had been significant, telling viewers: “All my life I have wanted to have ankles. I’ve finally got them.”
Lipoedema is a condition that mainly affects women and causes an abnormal build-up of fat, most commonly in the legs and sometimes the arms. It can make the lower body appear out of proportion and is often associated with pain, tenderness and a feeling of heaviness.

Gibson said she had always felt something “wasn’t right” with her body but was only diagnosed with lipoedema last September. She said specialists told her that diet and exercise would not remove the affected fat. “They said I could train seven days a week and I wouldn’t get rid of lipoedema fat like that,” she said.
Describing the impact of the condition, Gibson said her legs felt increasingly out of place compared with the rest of her body and that symptoms had worsened over time, now also affecting her arms. “I could train, train and train but really, I’m going down the surgery route now,” she added.
Lipoedema specialist Dr Dennis Wolf, who also appeared on the programme, said the condition is not currently treated on the NHS due to the lack of a formal diagnostic test and limited research. He said doctors often rely on symptoms and patient experiences to identify it and believes some people may have a genetic predisposition.
Dr Wolf explained that lipoedema fat is resistant to weight loss, meaning people can exercise and diet without seeing changes in affected areas. While surgery is the most common way to manage the condition, other treatments include compression garments to help reduce discomfort.
Gibson also shared a light-hearted moment from her surgery, admitting the anaesthetic left her flirtatious and apologetic towards her surgeons.
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Fewer people are dying of heart disease, however, as per a new report from the American Heart Association (AHA), it is still the leading cause of death in the US. While the report noted a drop in rates of deaths by heart diseases for the first time in five years, the report also noted that it kills more American than any other condition. The report was published early Wednesday in the journal Circulation.
The report found that annual rates of heart disease deaths have in fact decreased by 2.7% between 2022 and 2023. This means it went from 941,652 to 915, 973. However, cardiovascular diseases still killed more people in the US than cancer and accidents combined.
The report found that deaths caused by blockages in the coronary arteries, the blood vessels supplying the heart, fell by 5.9%, dropping from 371,506 to 349,470 over the same period. Coronary artery disease, a major cause of heart attacks, still claims two lives every three minutes. Other vessel-damaging chronic conditions also remain widespread.
The report found that the share of U.S. adults with high blood pressure edged up to 47.3%, while overall obesity rates dipped slightly to 50%. However, obesity is increasing among children and teenagers, rising from 25.4% to 28.1% in those aged 2 to 19.
Prevention remains the most powerful tool to reduce heart disease deaths, experts say. Because heart disease cannot be cured, waiting for symptoms often means focusing only on treatment rather than stopping the problem early. Early prevention, by contrast, has a much bigger impact on saving lives.
The report highlights four key lifestyle habits for heart health: eating a balanced diet, staying physically active, getting enough sleep and avoiding tobacco. It also stresses four important health measures: managing weight, cholesterol, blood sugar and blood pressure.
Together, these eight factors could prevent up to 40% of heart disease deaths and cut the risk of developing serious heart disease symptoms by as much as 74%. These same habits also benefit the brain, helping slow brain ageing and lower the risk of dementia, especially by keeping blood pressure under control.
Cutting down cardiovascular disease in the U.S. would not only help people live healthier lives, it could also ease the strain on the economy, experts say. Heart disease carries a massive financial cost, with an estimated $414.7 billion spent each year on direct treatment and indirect losses between 2021 and 2022.
Even though the benefits of healthy habits are well known, getting people to prioritize heart health remains difficult. Only one in four U.S. adults meets national guidelines for both aerobic and muscle-strengthening exercise. Control of chronic conditions is also lacking, with less than half of Americans with type 2 diabetes managing their disease effectively.
Experts stress that regular physical activity, tailored to individual ability, can make a real difference. Simple, consistent movement and timely health checkups can go a long way in protecting both personal health and the wider economy.
Credit: Canva
Been noticing yellow deposits on your or your loved ones' eyelids? It may be a sign of a future heart attack, experts warn.
Xanthelasma is a harmless, yellow growth that appears on or around the corners of your eyelids next to the nose. These lesions are often painless and can vary in size, sometimes merging to form larger patches.
But while xanthelasma itself is not a disease, its development can signal elevated cholesterol levels and an increased risk of cardiovascular diseases such as coronary artery disease and atherosclerosis, which can lead to a heart attack in the future.
According to Dr Sudhir Kumar, a neurologist associated with Apollo Hospital in Hyderabad, xanthelasma patches can appear even when blood tests show normal cholesterol levels and should prompt 'a proper lipid evaluation, not just a cosmetic procedure'.
In an X post, he noted: "These yellow patches on the eyelids are NOT just cosmetic. They are called xanthelasma and they can be your skin’s clue to hidden heart risk. These are:
1. Often linked to abnormal lipids
2. Can be present even when LDL cholesterol is normal
3. Strongly associated with atherosclerosis & heart disease"
READ MORE: Heart Cells Can Regrow After A Cardiac Arrest, Scientists Say
Heart attacks occur when blood flow to the heart is severely reduced or blocked due to a buildup of plaque which is made of fat, cholesterol and other substances in the heart's arteries.
During a heart attack, a lack of blood flow causes the cells and tissue in the heart muscle to die, leading to irreversible damage that can result in serious complications like arrhythmias, heart failure, cardiogenic shock, or cardiac arrest
It is one of the leading causes of death in the country. Four Indians experience a heart attack every minute, with one in four dying of the cause. Experts have also noticed a rising trend of nearly 50 percent of heart attack patients being under the age of 40, with half of all heart attacks in Indian men occurring under 50.
Additionally, it can also indicate thyroid issues such as hypothyroidism. Xanthelasma and hypothyroidism are linked as both thyroid dysfunction and high cholesterol/lipid levels, often seen with hypothyroidism, can cause the eyelid plaques.
Coronary artery disease (CAD) is one of the most common illnesses that can cause a heart attack in people. It develops over the years and has no clear signs and symptoms apart from a heart attack.
The illness begins due to a buildup of fats, cholesterol and other substances known as plaque in and on the artery walls.
Over time, this can cause narrowing or blockage of the coronary arteries and block the supply of oxygen-rich blood to heart which can lead to chest pain (angina), shortness of breath and ultimately, heart attacks.
Typically, those above the age of 45, having a biological family member with heart disease, lack of sleep, smoking, consuming saturated fats along with other autoimmune diseases such as lupus and rheumatoid arthritis, can increase the risk of developing CAD.
Nearly one in 10 Indian adults suffer from CAD and about two million people die from the disease annually. Apart from this, about 18 to 20 million American adults aged 20 and older are also affected about the disease.
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