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.

Millions of people around the world undergo blood tests every year to measure LDL, commonly known as "bad" cholesterol. But researchers now suggest that this standard test may not always provide the most accurate picture of heart disease risk.

A new study from Northwestern Medicine found that a blood test measuring apolipoprotein B (ApoB) may be better than LDL cholesterol testing for identifying people who need more intensive treatment to reduce their risk of heart attacks and strokes.

The researchers also found that using ApoB to guide treatment decisions could prevent more cardiovascular events while remaining cost-effective for healthcare systems. The findings were published in the journal JAMA.

"We found that ApoB testing to intensify cholesterol-lowering medication would prevent more heart attacks and strokes than current practice, and that these health benefits were achieved at a cost that represents good value for US healthcare payers," said study lead author Ciaran Kohli-Lynch, Assistant Professor of Preventive Medicine in the Division of Epidemiology at Northwestern University Feinberg School of Medicine.

ApoB vs LDL: What's the Difference?

Also read: Confused By Your Cholesterol Report? Here's What LDL And ApoB Really Mean

Doctors have traditionally relied on LDL ("bad") cholesterol and non-HDL cholesterol levels to assess heart disease risk and decide when patients should begin or intensify cholesterol-lowering treatment. While these tests provide useful information, researchers say they do not tell the whole story.

The difference lies in what the two tests measure:

• LDL cholesterol test: Measures the amount of LDL cholesterol in the blood.
• ApoB test: Measures the number of cholesterol-carrying particles—including LDL and other potentially harmful particles—that can enter artery walls and contribute to plaque buildup.

"Research strongly shows that apolipoprotein B (ApoB) is better at identifying who is at risk because it counts the total number of harmful particles in the blood," Kohli-Lynch said.

According to the researchers, the number of harmful particles may provide a more accurate measure of cardiovascular risk than LDL cholesterol levels alone.

What Is ApoB?

Read More: US Cardiologist Explains Why 2026 AHA Cholesterol Guidelines Recommend Starting Young

In a post on X, Dr. Sudhir, Senior Consultant Neurologist at the Institute of Neurosciences, Apollo Hospitals, Hyderabad, explained that ApoB is a protein found on potentially harmful cholesterol-carrying particles such as LDL and VLDL (very low-density lipoprotein).

"Think of ApoB as a count of the particles capable of entering artery walls and causing plaque. One ApoB is equal to one potentially harmful particle," he said.

Dr. Sudhir explained that two people can have the same LDL cholesterol level but very different numbers of cholesterol-carrying particles. The person with more particles will usually have a higher ApoB level and, potentially, a greater risk of cardiovascular disease.

He added that ApoB often provides a more accurate assessment of heart disease risk than LDL cholesterol alone.

Despite growing evidence supporting ApoB, the test is still not widely used in routine clinical practice because it generally requires an additional blood test beyond the standard cholesterol panel, increasing both cost and inconvenience.

"Our study asked: Is it worth spending extra money to use ApoB instead of LDL to guide treatment intensification?" Kohli-Lynch said.

Dr. Sudhir suggested that ApoB testing should be considered for:

• people with diabetes,
• prediabetes,
• metabolic syndrome,
• obesity,
• elevated triglycerides,
• strong family history of heart disease.

New Cholesterol Guidelines

Earlier this year, the American Heart Association and 10 other medical organisations released updated guidelines recommending that many people begin cholesterol-lowering therapy at younger ages.

"This means it is increasingly important to accurately identify who would benefit most from intensive treatment," Kohli-Lynch said.

The updated guidelines also recommend measuring ApoB, particularly in people with high triglycerides, diabetes or in situations where LDL cholesterol levels may underestimate the number of harmful cholesterol-carrying particles.

Do you often forget where you kept your keys or glasses and worry that it could be a sign of Alzheimer's disease? While many people become more forgetful with age, doctors say that occasional memory lapses are a normal part of ageing. Alzheimer's disease, however, causes a different pattern of decline that affects memory, thinking and the ability to function in everyday life.

HealthandMe spoke to two neurologists who explained how to tell the difference between normal age-related forgetfulness and the warning signs of Alzheimer's disease.

"Many people worry when they start becoming more forgetful with age. While some changes in memory and thinking are a natural part of growing older, Alzheimer's disease causes a different pattern of decline that affects everyday life," said Dr. Rajneesh Kummar, Vice Chairman & Unit Head, Neurology, Max Super Speciality Hospital, Dwarka.

Dr. Praveen Gupta, Chairman, MAIINS, Marengo Asia Hospitals, Gurugram, added, "Alzheimer's is not a normal part of ageing. It's a neurodegenerative disease that affects memory, thinking and how you function each day. Recognising the difference can help people get medical evaluation and treatment sooner."

Also read: India Gets Its First Alzheimer’s Drug: Know All About Eli Lilly’s Lormalzi

The experts advised that persistent memory concerns should not be ignored. If symptoms become more noticeable or begin affecting day-to-day functioning, a medical assessment can help identify the cause and guide appropriate treatment and support.

They outlined six key differences that can help distinguish normal ageing from Alzheimer's disease.

1. Occasional Forgetfulness vs Repeated Memory Loss

According to the doctors, it is common to occasionally misplace items, forget a name or an appointment, and remember the information later.

However, people with Alzheimer's disease may repeatedly forget recent events, conversations, appointments or newly learned information and may not recall them even after reminders.

2. Slower Thinking vs Difficulty With Everyday Tasks

Normal ageing may mean taking longer to learn new technology or complete routine tasks.

In Alzheimer's disease, people may struggle to manage bills, prepare meals, follow directions, learn to use a new phone or remember instructions given only moments earlier.

3. Misplacing Things vs Forgetting They Were Ever There

Occasionally losing keys or glasses is considered a normal part of ageing, and most people can usually retrace their steps and find them.

By contrast, people with Alzheimer's disease may not remember putting an item down or even recall recently getting or buying it.

Read More: Anti-Inflammatory Diet May Help Lower Dementia Risk, Even In Those Who Show Early Signs Of Alzheimer’s: Study

4. Temporary Confusion vs Disorientation

Older adults may occasionally lose track of the day or date but usually remember it shortly afterwards.

According to the doctors, Alzheimer's disease can cause confusion about time, dates and places. People may repeatedly ask the same questions or become disoriented, even in familiar surroundings.

5. Searching for Words vs Difficulty Communicating

Everyone experiences occasional "tip-of-the-tongue" moments.

With Alzheimer's disease, people may frequently lose their train of thought, repeat themselves, struggle to follow conversations or have difficulty finding the right words.

6. Remaining Independent vs Needing Increasing Support

The doctors said one of the biggest differences is that normal ageing generally does not prevent a person from living independently.

Alzheimer's disease, however, gradually affects a person's ability to carry out everyday activities, adapt to changes in routine and maintain self-care without assistance.

Bryan Johnson, the billionaire biohacker and longevity enthusiast, has been diagnosed with an incurable autoimmune disease called Autoimmune Gastritis (AIG).

Johnson is known for his radical longevity experiments, including measuring the biological age of his organs in an effort to reverse aging, injecting himself with ketamine, taking over 50 pills a day, undergoing fat transfers, and receiving blood transfusions from his teenage son.

In a recent post on X, he made the shocking announcement of his autoimmune conditions, which went undetected for years: Autoimmune Gastritis.

Calling it "bad news," Johnson wrote: "I have an autoimmune disease. My stomach is eating itself."

"2-5 per cent of people have this, too. Likely more, because it hides," he added.

According to Johnson, his stomach had been attacking itself without causing noticeable symptoms. The condition was only discovered in May.

Also read: Bryan Johnson Blames Sugary Cereals, Soda and Stress for His Autoimmune Disease; Shares Treatment Plan

The Early Warning Sign: Low Ferritin

Autoimmune Gastritis, a condition in which the immune system attacks the stomach's acid-producing cells, also impairs the absorption of iron and vitamin B12.

Johnson said one of the earliest signs of the condition was persistently low ferritin levels over the past 11 years despite not having anemia.

"We continually tried to raise my iron levels with food and supplementation, but nothing would work."

He said he followed a plant-based diet, trained intensely, used a sauna and hyperbaric oxygen therapy, and took iron supplements, yet his iron levels remained low.

Ferritin stores the body's iron. Iron is essential for transporting oxygen and producing energy, and low iron levels can lead to fatigue, weakness, and dizziness.

Johnson said autoimmune gastritis is difficult to diagnose because its earliest clue is often overlooked.

"The earliest clue, low ferritin, is the one standard medicine waves through. Low iron stores get normalized and rarely investigated at all when anemia hasn't shown up yet. That blind spot is what hid mine for a decade."

While initially it wasn't clear why his iron levels were continuously dipping, after further testing, Johnson's team identified three interconnected issues.

Read More: Bryan Johnson Battles Autoimmune Gastritis: Which Parts Of His Longevity Guide Are Actually Worth Copying?

Autoimmune Gastritis was preventing normal iron absorption by damaging the stomach cells that produce acid. He also discovered autoimmune thyroid disease.

"The iron deficiency, the autoimmune gastritis driving it, and the autoimmune thyroid disease alongside it. Iron and thyroid feed each other both ways; low iron impairs the conversion of thyroid hormone into its active form, and an underactive thyroid impairs how the body uses iron," Johnson explained.

Iron Deficiency May Be More Common Than Many Realize

According to research published in JAMA Network Open, about one in four Americans may have inadequate iron intake or absorption.

As per the study of more than 8,000 Americans, 14 per cent of adults had absolute iron deficiency, reflecting depleted iron stores.

Even after excluding common causes such as anemia, pregnancy, heart failure, and chronic kidney disease, 11 per cent remained iron deficient. Another 15 per cent had functional iron deficiency, where iron levels appear normal but the body cannot use the mineral effectively.

How Bryan Johnson Is Managing The Condition

Since receiving the diagnosis, Johnson has begun iron infusions, which deliver a full dose of iron in a single treatment.

He said his team will continue routine monitoring of his ferritin and iron levels.

Johnson ended his post with a warning that hidden health conditions can go unnoticed for years.

"You too may have a lurking health issue that is undiagnosed and could increase in severity from unhealthy life choices, without your knowing… A gentle nudge that minding your health, no matter your situation in life, is a good decision-making."