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.

The number of autistic women is same as the number of autistic men, but women know to hide it well, says research. A study published in the BMJ, found that while the rates of diagnosis for autistic is found among young boys and girls, rates are almost identical by the time they reach adulthood. However, these new findings have also shown that women are more likely to "mask" signs of autism in order to fit in. This is why their diagnosis is done far later.

What Did The Study Find Out?

This is the first major study to find such high levels of condition among women. Previously, diagnoses rates were four times higher among boys and men than females.

Specialists say the findings highlight the urgent need to move away from outdated stereotypes that still influence how autism is recognized and diagnosed.

The international study, led by researchers at the Karolinska Institutet in Sweden, examined autism diagnosis rates among people born in Sweden between 1985 and 2000. More than 2.7 million individuals were followed for up to 37 years, making it one of the most comprehensive studies of its kind.

By 2022, around 2.8 per cent of the population studied had been diagnosed with autism spectrum disorder. The data revealed a clear pattern. In early childhood, boys were far more likely than girls to receive an autism diagnosis. However, this gap steadily narrowed during adolescence.

By the time participants reached their late teens and early 20s, diagnosis rates among men and women were broadly similar. Researchers noted that the male to female ratio of autism diagnoses decreased over time to the point that it may no longer be distinguishable in adulthood.

A Catch-Up Effect in Adolescence

Dr Caroline Fyfe, lead author of the study from the University of Edinburgh, said autism has long been viewed as a condition that mainly affects males. While that pattern was still visible in children under 10, the picture changed rapidly during adolescence.

Read: Mattel Launches First-Ever Barbie With Autism

She explained that diagnoses among girls rose sharply in the teenage years, creating what researchers described as a female catch-up effect. By the age of 20, autism rates were almost equal between men and women. According to Dr Fyfe, this suggests late or missed diagnoses in females rather than a true biological difference between sexes.

Masking and Mental Health Misdiagnoses

Experts say one major reason for delayed diagnosis is masking. Girls and women are often more likely to imitate social behavior, maintain eye contact and suppress traits traditionally associated with autism. While this can help them fit in socially, it can also make their difficulties harder to identify in clinical settings.

Dr Judith Brown from the National Autistic Society said gender should never be a barrier to diagnosis or support. She noted that autistic women who are misdiagnosed often develop additional mental health challenges due to years without appropriate understanding or help.

She added that the exhaustion of constant masking can contribute to anxiety and depression, reinforcing the importance of recognizing autism earlier in girls.

Clinical Biases Under Scrutiny

Dr Steven Kapp, senior lecturer in psychology at the University of Portsmouth, said research has consistently shown that clinical biases play a role in under-recognizing autism in women and girls. He explained that subtler behaviors and social adaptation often lead clinicians to overlook autism in females.

A linked editorial written by a patient and advocate echoed these concerns, warning that autistic women are frequently labelled with mood or personality disorders while waiting for a correct diagnosis. As a result, many are forced to self-advocate simply to be recognized as autistic.

Experts say the findings should prompt changes in diagnostic approaches, ensuring that autistic girls and women are no longer left unseen.

Actor Claire Foy has revealed that a long, uncomfortable health struggle picked up while travelling ended up reshaping her relationship with caffeine. The Crown star, 41, said she gave up tea and coffee after discovering she had stomach parasites, an experience she described as “gross” and “absolutely rank.”

Foy shared the story during her appearance on The Table Manners Podcast with hosts Jessie and Lennie Ware on February 4, where the conversation moved from food to a period of unexplained weight loss and constant hunger.

“I kept losing weight, and I didn’t know what was going on,” she told the hosts. Despite eating regularly, she said she never felt full. “I was so hungry,” Foy recalled, adding that the situation left her confused and worried.

Diagnosis After Years of Symptoms

The actor explained that the cause was eventually traced back to stomach parasites she had picked up while travelling in Morocco. The diagnosis came after medical tests, including stool samples, which she candidly described as unpleasant but necessary.

According to Foy, doctors told her she had been carrying the parasites for around five years, a length of time she herself described as “quite a long time.” While she did not name the specific parasites, she shared one detail that stuck with her. “They travel as a pair, I got told by the doctor,” she said, reacting with visible disgust even years later.

Living with the condition took a toll on her body and routine. The ongoing symptoms pushed her to rethink how she approached treatment and daily habits, including what she consumed.

Read: 10 Signs You May Have A Parasite

Clair Foy Had Parasites For 5 Years: Why Caffeine Had to Go

It was during treatment that Foy made the decision to give up caffeine entirely. She explained that she wanted to avoid very strong antibiotics if possible and instead followed a strict diet alongside other treatments. “I basically had to go on this diet,” she said. “I didn’t want to take really hardcore antibiotics.”

As part of that process, caffeine was cut out. “I took all this gross stuff and part of that was giving up caffeine,” Foy told the hosts. At the time, it was a major shift. She admitted she had been a heavy caffeine consumer, drinking around 15 cups of tea a day along with two coffees she had carefully planned into her schedule.

A Habit That Never Came Back

Giving up caffeine was not easy, but once she did, Foy decided to stick with it. “Once you’ve given it up, it’s such a mission to give it up, that I was like, well, maybe I’ll just give it a go,” she said.

Now fully caffeine-free, she even brought her own tea bags to the podcast recording. The show is known for hosts and guests sharing food and drinks in the Ware family kitchen, making her preparation a small but telling detail of how seriously she takes the change.

Medical experts note that parasitic infections usually require medication to clear completely, often involving antiparasitic drugs and sometimes antibiotics or antifungals. In many cases, a combination of treatments is needed.

"I went into chemo-induced menopause at 37," said Lisa Ray, a Canadian actress during an interview with BBC. She also shared the clip of the interview on her Instagram account talking about the importance of awareness about the side effects of cancer and its treatment on women. Sharing the clip on her Instagram story, she wrote "This is me in menopause. Menopause does not have one face...I went into premature chemo-induced menopause at 37."

She revealed that she had blood cancer, called Multiple Myeloma. "At that time, it was the least of my worries. I had a blood cancer called Multiple Myeloma to contend with… But after recovering, I could focus on what being in menopause suddenly at 37 would mean. And I had no one to talk to," said Lisa, now 53.

What Is Chemo-induced Menopause?

Chemotherapy do not just target cancer cells, but it can also harm healthy cells, which are fast diving. Ovaries fall into that category and thus they stop producing hormones like estrogen and progesterone, which pushes the body into sudden menopause.

This condition is called iatrogenic menopause or chemotherapy-induced ovarian failure. While it could be temporary for some people, for others, it could be permanent. Experts explain that women under 30 could see their periods return after the treatment.

Chemotherapy works by attacking cells that grow and divide rapidly. While this helps destroy cancer cells, it also affects healthy cells, such as those responsible for hair growth, which is why hair loss is a common side effect.

This process can also impact reproductive organs, including the ovaries, and disrupt hormone production. As a result, levels of estrogen and progesterone—the key hormones involved in menopause—may become imbalanced due to chemotherapy’s effects on the endocrine system.

Damage to cells and these hormonal shifts can trigger menopausal symptoms and, in some cases, cause periods to stop altogether.

For people over 40, hormone levels may already be naturally declining. In such cases, chemotherapy can accelerate a menopausal transition that has already begun.

Chemo-induced Menopause Symptoms

The symptoms are same as one experiences in natural menopause, which include:

• Hot flashes
• Night sweats
• Mood swings
• Fatigue
• Vaginal dryness
• Loss of libido

However, Lisa also points out the emotional impact, which could be intense especially for someone who is young and was not expecting to face menopause for decades. “Both menopause and disease-induced menopause have been treated with shame and silence for too long,” Lisa wrote on her Instagram post.

Chemo-induced Menopause: What Can Help?

Hormone Replacement Therapy (HRT): When considered safe and not restricted by hormone-sensitive cancers, HRT can help manage symptoms while supporting bone strength and heart health.

Non-hormonal treatments: Certain medications, including SSRIs, SNRIs, and gabapentin, may reduce hot flashes, while vaginal moisturizers and lubricants can relieve dryness.

Lifestyle changes: Staying physically active, following a calcium and vitamin D-rich diet, maintaining a healthy weight, and managing stress can significantly support overall wellbeing.

Fertility support: Options such as egg or embryo freezing before treatment, along with consultations with a fertility specialist afterward, may help preserve future parenthood possibilities.