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.

Psoriasis is a long-term inflammatory skin disorder that impacts the immune system. It can cause itchy and unsightly areas of thick, flaky skin that can impact your confidence, relationships and everyday activities.

Symptoms can be erratic. Differ among individuals. Although a cure does not exist there are treatments that're effective. It is non-infectious.

What Happens In Psoriasis?

There is overactivity in the system causing an overproduction of skin cells. This causes a build-up of scaly patches known as plaques. The common form of psoriasis is plaque psoriasis. This type of psoriasis often appears on the scalp. It also often appears on the elbows. It also often appears on the knees. It also often appears on the back. This can cause itching, pain, breaking and bleeding. Nails can become pitted, with holes and can become thickened and lifted off the nail bed. Other forms can cause spots, shiny patches in areas of skin fold and pustules.

Depending on your skin colour, you may see /red patches on lighter skin or dark patches with less pink tones on darker skin. Sometimes your skin colour can become temporarily different when the inflammation has subsided.

Causes of Psoriasis

Whilst we do not fully understand the cause of psoriasis, it is caused by a combination of immune and environmental factors. If you have a family history, then you are more likely to develop psoriasis. Common triggers can vary between individuals, but infection, trauma, stress, smoking, excessive alcohol intake and certain medications can cause psoriasis or make symptoms worse.

Strep throat infections are commonly linked to guttate psoriasis (spot-like patches). Knowing your triggers can help; however, there may not always be a trigger.

Can We Reduce Flare-ups?

Unfortunately, there is no way to prevent psoriasis; however, keeping skin clean, taking medication and knowing your triggers can help reduce symptoms.

Have a shower using a cleanser and warm water. Apply a fragrance-free moisturiser to damp skin. Try not to scratch or rub your plaques. Try to avoid causing trauma to your skin and sunburn.

Keeping active, maintaining a weight if needed, quitting smoking and reducing alcohol can all improve your general health. Some people find keeping stress to a minimum helps; however, this cannot replace treatment. If your symptoms get worse when starting medication, let your doctor know. Do not stop taking your medication.

Treatments

This will depend on the type of psoriasis where it's how bad it is and how it is affecting your daily life. Your dermatologist will also take into consideration any medical conditions and if you have any joint symptoms.

Mild psoriasis can often be treated using various treatments. These can include steroids, vitamin D analogues and other medications. Steroids should be used at the correct strength and for the correct length of time depending on the area. Long-term steroids should be monitored.

Phototherapy uses specialist UV light, narrow-band UVB. This may be suggested if you have widespread psoriasis or topical treatments have not worked well enough. This should be monitored. Monitored. More severe or hard-to-treat psoriasis may need medication or biologicals. This can include Methotrexate, Ciclosporin, acitretin, or Apremilast. Biologicals work by targeting inflammatory pathways such as TNF, IL-17 and IL-23. This should be discussed individually with monitoring.

Talk to your doctor about any concerns you have regarding your treatment. This can include side effects, cost and difficulty sticking to a regimen. This will allow your doctor to put together a treatment plan.

Further Considerations

Some people with psoriasis can develop arthritis. If you have any pain, swelling, stiffness when waking up or heel pain, this should be assessed quickly. If left untreated, the inflammation can cause damage to your joints.

Psoriasis can put you at increased risk of developing disease, diabetes and other metabolic issues. This does not mean everyone with psoriasis will develop these conditions, but your doctor can advise what checks you need to do and how to keep your health in check. If your psoriasis is affecting your sleep, confidence, relationships or mood, let your doctor know. Counselling and other mental health support can be an addition to your treatment.

When To See A Doctor

If you have scaling changes to your nails or symptoms that are affecting your daily life, you should see a dermatologist. This will usually be diagnosed by looking at your skin and nails. Occasionally a skin biopsy may be needed.

If you have inflammation, scaling, pustules and are unwell or have a fever, you should seek urgent medical attention. This can indicate psoriasis and needs treating quickly. Whilst psoriasis can be unpredictable, there are treatments available. You deserve a treatment plan to help your symptoms.

The menstrual cycle is more than a monthly reproductive event. It is a complex physiological process involving fluctuations in hormones such as oestrogen and progesterone, which can influence appetite, energy balance, mood and digestion, raising the question: does a woman need to eat differently during different phases of her menstrual cycle?

Current research suggests that nutritional needs do not dramatically change from one week of the cycle to another for most healthy women. However, appetite, food intake and certain symptoms can change across the cycle. Understanding these changes can help women make practical dietary choices without turning nutrition into a complicated four-phase diet.

Understanding the Menstrual Cycle

The menstrual cycle can broadly be divided into the menstrual, follicular, ovulatory and luteal phases.

During menstruation, oestrogen and progesterone levels are relatively low, and the uterine lining is shed. The follicular phase begins with menstruation and continues until ovulation. Oestrogen generally rises during this period and reaches a peak around ovulation.

After ovulation, the body enters the luteal phase. Progesterone rises, along with another increase in oestrogen, before both hormones decline if pregnancy does not occur. These hormonal changes can influence appetite and food preferences.

Research has found that energy intake tends to be somewhat higher during the luteal phase than during the follicular phase.

Some studies suggest that resting metabolic rate may increase slightly during the luteal phase, although the estimated change is relatively small and varies between individuals and studies.

This is important because it means that feeling hungrier before a period is not necessarily a failure of willpower. It may partly reflect normal biological changes.

Why Nutrition Matters Across the Cycle

The goal should not be to follow a completely different diet every week. Instead, nutrition should provide the body with adequate energy, protein, fibre, vitamins, minerals and fluids throughout the entire cycle.

For women who experience premenstrual syndrome (PMS), dietary habits may be particularly relevant. PMS can include bloating, breast tenderness, headaches, fatigue, appetite changes, food cravings and mood changes.

Calcium is one nutrient that has attracted considerable attention. The American College of Obstetricians and Gynecologists recommends including calcium-rich foods such as yoghurt and leafy green vegetables as part of dietary strategies for PMS.

Iron is another important consideration, particularly for women with heavy menstrual bleeding. The recommended dietary allowance for iron is 18 mg per day for women aged 19–50 years. Good sources include lentils, beans, spinach, meat, poultry, seafood, fortified cereals and nuts. Vitamin C-rich foods can improve absorption of plant-based non-haem iron.

Dietary Recommendations

1. During menstruation: focus on iron, protein and hydration

If menstrual bleeding is moderate to heavy, prioritising iron-containing foods is sensible.

Include:

· Lentils, rajma, chickpeas and soy

· Green leafy vegetables

· Eggs, poultry or lean meat

· Sesame and pumpkin seeds

· Iron-fortified cereals

· Vitamin C-rich fruits such as oranges, guava, amla and kiwi

Pairing plant-based iron sources with vitamin C can improve iron absorption.

Adequate fluid intake can help maintain hydration, particularly if you experience symptoms such as bloating or headaches.

2. During the follicular phase: maintain a balanced eating pattern

There is no need for a special “follicular-phase diet”. This can be a good time to establish consistent meals containing whole grains, vegetables, fruits, pulses, dairy or alternatives, nuts and seeds.

Protein should be distributed throughout the day rather than concentrated in one meal.

For example, breakfast could include eggs or paneer with whole-grain toast; lunch could contain dal, vegetables and roti; and dinner could include tofu, paneer, fish or another protein source.

3. Around ovulation: focus on overall dietary quality

Focus on a diet rich in colourful vegetables and fruits, whole grains, legumes, nuts, seeds and adequate protein. These foods provide fibre and a broad range of micronutrients and plant compounds.

4. During the luteal phase: plan for appetite and cravings

This is perhaps where nutrition can be adapted most practically.

Since appetite may increase during the luteal phase, trying to rigidly maintain the same food intake every day may backfire for some women. A better approach is to choose satisfying foods.

Combine protein + fibre + healthy fats in meals and snacks. For example:

• Yoghurt with fruit and nuts
• Roasted chana with fruit
• Apple with peanut butter
• Oats with milk, seeds and fruit
• Whole-grain roti with dal and vegetables

ACOG also recommends complex carbohydrate-rich foods and reducing excessive intake of salt, sugar and high-fat foods when managing PMS symptoms.

Practical Tips

Keep a symptom and food diary. Tracking your cycle for two or three months can help identify personal patterns in appetite, cravings, bloating, bowel habits, headaches and mood.

Do not compensate for increased appetite through extreme dietary restriction. A modest increase in hunger during the luteal phase can be a normal physiological response.

Build meals around protein and fibre. These can improve satiety and help make meals more filling.

Stay consistent with calcium-rich foods. Milk, yoghurt, paneer, ragi, sesame and calcium-fortified alternatives can contribute to calcium intake.

Be cautious with supplements. More is not necessarily better. Evidence for nutrients such as magnesium and vitamin B6 in PMS is mixed, and supplementation should be individualised. High-dose vitamin B6 taken for prolonged periods can cause neurological problems.

Common Myths and Facts

Myth: Every woman needs a different diet for each menstrual phase.

Fact: There is currently no strong evidence that healthy women require four completely different diets. A nutrient-dense dietary pattern should remain the foundation throughout the cycle.

Myth: Eating certain seeds during each phase can balance hormones.

Fact: Seeds such as flax, sesame, pumpkin and sunflower seeds are nutritious foods, but there is insufficient clinical evidence that consuming particular seeds at specific cycle phases “balances” reproductive hormones.

Myth: Weight gain before a period always means fat gain.

Fact: Changes in body weight around menstruation can reflect fluid retention, gastrointestinal changes and altered food intake. These changes should not automatically be interpreted as an increase in body fat.

Myth: Increased premenstrual hunger means a lack of self-control.

Fact: Research indicates that energy intake can increase during the luteal phase. Individual responses vary, but increased appetite can have a physiological component.

Myth: Supplements are necessary to manage PMS.

Fact: Some nutrients, particularly calcium, have evidence supporting a role in symptom management, but dietary supplements are not automatically necessary for everyone. ACOG recommends discussing PMS products and supplements with a healthcare professional because some products have limited evidence or may interact with medications.

Conclusion

So, does the body need different foods at different times of the menstrual cycle? Not in the way social media often suggests.

The evidence does indicate that hormonal fluctuations can influence appetite, energy intake and possibly energy expenditure. For some women, these changes are noticeable, particularly during the luteal phase. Nutritional priorities such as iron, calcium, protein, fibre, hydration and overall dietary quality remain important throughout the month.

The most useful approach is therefore not strict “cycle syncing”, but cycle-aware nutrition: understand your own symptoms, respond to changes in hunger, maintain adequate nutrient intake and avoid unnecessary dietary restrictions.

Nutrition should work with the menstrual cycle, not become another source of stress.

(By Neha Kanodia, Senior Executive Nutritionist, Cloudnine Hospital,Faridabad)

The biological age of ovaries may be influenced by the environment surrounding the organs, rather than being an entirely irreversible process. A new experiment done on mice found that older ovaries became biologically younger after being transplanted into younger animals, restoring and extending their ability to support pregnancy.

The research, led by scientists at Harvard Medical School, body's environment may influence how quickly the ovaries age. The findings could help researchers investigate treatments aimed at preserving ovarian function and fertility for longer in women.

Older Ovaries Produced Healthy Offspring In Younger Mice

The researchers transplanted ovaries from 13-month-old mice into younger mice that were four months old. The older donor mice had crossed their reproductive age.

Four to five months after transplantation, the younger recipients gave birth to healthy offspring, even though the transplanted ovaries were 17 to 18 months of age.

The same effect was not observed when older ovaries were transplanted into older recipients. This suggested that the recipient's biological environment, rather than the age of the ovaries alone, affected their reproductive function.

The team also performed the reverse experiment. When young ovaries were transplanted into older mice, the ovaries showed signs of accelerated ageing.

Also read: Heart Health In Women After Pregnancy: Why Pre-Eclampsia And Gestational Complications Matter Years Later

More About The Experiment

The researchers developed an ovarian ageing clock called OvaAge to observe the changes. The clock uses patterns of gene activity to ascertain an ovary's molecular age.

The results showed that the molecular age of older ovaries dropped when they were placed in younger animals. Conversely, young ovaries in older recipients aged faster.

The researchers also observed that older ovaries in younger hosts showed reduced inflammatory activity, while young ovaries in older hosts showed increased inflammation.

Also read: Children’s Mental Health In The Digital Age: Can Governments Protect Them Without Restricting Internet Access? | Interview

Effects Of Ovaries On Ageing Of Other Organs

The study also explored whether the ovaries affect ageing elsewhere in the body. When young ovaries were transplanted into older mice, researchers observed that the molecular ages of the brain, liver and uterus also dropped. The findings suggest that the ovaries may also influence other organs through hormones or other signals.

The researchers also identified changes in gene activity and cellular processes linked to inflammation, metabolism and tissue maintenance. Understanding these signals could help scientists investigate whether some effects of ovarian ageing can be targeted without an organ transplant.

Study's Scope In Women's Fertility

Ovarian ageing refers to a decline in both the number and quality of eggs. This reduces women's fertility as they grow older. The ovaries also produce hormones, including oestrogen, that affect overall health.

The new findings spark the possibility that the environment surrounding the ovaries could be a target for future treatments to preserve ovarian function.

If researchers can identify the signals that allowed older ovaries to function in younger mice, they may eventually be able to investigate ways to reproduce those effects without transplantation. But substantial research is still needed to move ahead.

The study was based mice, and ovarian biology, reproductive ageing and fertility outcomes differ significantly between mice and humans.