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.

A new oral GLP-1 medication has delivered encouraging results in a Phase 2b clinical trial for people living with type 2 diabetes.

According to AstraZeneca, its experimental tablet, elecoglipron, significantly lowered blood sugar levels and helped participants lose an average of 10.5% of their body weight after 26 weeks of treatment.

The findings were presented at the 2026 American Diabetes Association Scientific Sessions in New Orleans and published in The Lancet on June 8.

Elecoglipron joins a growing wave of GLP-1 therapies being developed as pills, offering an alternative to injectable drugs such as Ozempic, Wegovy, Zepbound, and Mounjaro.

The first oral GLP-1 treatment, Rybelsus from Novo Nordisk, received FDA approval in 2019 for adults with type 2 diabetes. Since then, oral options have continued to expand. In December 2025, the FDA approved a tablet version of Wegovy for weight management, while Eli Lilly’s oral obesity treatment, Foundayo, gained approval in April.

Independent experts say AstraZeneca’s results highlight the growing potential of non-injectable GLP-1 therapies for both diabetes and obesity treatment.

“It’s encouraging to see another oral medication demonstrating the benefits of GLP-1 therapy without requiring injections,” said Dr. Pouya Shafipour, a family and obesity medicine specialist at Providence Saint John’s Health Center in California.

Dr. Marilyn Tan, an endocrinologist and professor of medicine at Stanford University, noted that the rapidly expanding GLP-1 market could soon welcome another oral treatment option if elecoglipron succeeds in Phase 3 trials and ultimately secures FDA approval.

How Does GLP-1 Drug Work?

GLP-1 is a natural hormone produced in the intestines that regulates blood sugar, appetite, and digestion. Now, every time you eat, your body produces various hormones, including GLP-1. These are called post-nutrition hormones, and they help you absorb the energy you just consumed.

GLP-1 travels to your pancreas, prompting it to produce insulin. It also travels to the hypothalamus in your brain, which gives you the feeling of being full or satiated. GLP-1 pills imitate that hormone, thereby silencing the food chatter in the brain. Interestingly, for some people, this food chatter is really quiet, and for others it is an outburst. So with GLP-1, silencing this self-talk in the brain, people tend to lose their appetite and eventually weight.

However, it is important to note that losing weight includes not just fat but muscle as well. Losing too much muscle can lead to reduced strength and a shorter life span. Notably, records show that most people who start taking them stop them at 12 weeks; therefore, it is important for some but not for others.

What Are The Side Effects?

The side effects of these pills include:

• Nausea is a frequent side effect, especially when starting or increasing the dose, and vomiting may occur along with nausea.
• Diarrhoea and abdominal discomfort also show up.
• It can reduce appetite but may also lead to unintended weight loss or reduced food intake, causing discomfort for some people.
• There are certain less common, but serious side effects, like Pancreatitis, or inflammation of the pancreas.
• This drug may also cause severe kidney issues, particularly if dehydration occurs from side effects like vomiting or diarrhoea.

The most frustrating skincare experience is breaking out a week after using a new product. Niacinamide serum is the most common one that people blame when it happens. But the real question is: does Niacinamide cause purging? The answer is no, but understanding what happens in your skin when you introduce it can help you.

A well-formulated Niacinamide Serum at the right concentration is very gentle on the skin.

And pairing it with a Niacinamide Moisturizer helps your skin adjust if you are using it for the first time.

What Is Skin Purging and How Is It Different from Breakouts

Skin purging is the result of an active ingredient accelerating your skin's natural cell turnover cycle. Your skin renews itself every 28 days. Retinol, AHAs, and BHAs speed up this process, which pushes microcomedones, trapped sebum, and dead cell buildup up to the surface faster.

Your skin may appear like it is experiencing a sudden flare-up of pimples, but it is your skin clearing all the buildup in one go. True purging:

• Happens only with ingredients that increase cell turnover
• Appears in the same areas you normally break out
• Resolves within four to six weeks
• Involves small whiteheads and blackheads rather than deep cysts

A regular breakout appears in new areas with any product and does not follow the same predictable timeline. Understanding this difference is important before you blame any ingredient.

Does Niacinamide Cause Purging?

Dermatologists say no, and the reason comes down to how niacinamide works at the biological level. Purging occurs only when an ingredient accelerates cellular turnover, forcing the skin to shed faster to clear hidden congestion.

Niacinamide is a form of Vitamin B3, and its action is fundamentally different. It works in the following manner:

• Regulates sebum production through the sebaceous glands
• Strengthens the skin barrier by supporting ceramide production
• Niacinamide reduces redness and inflammation caused by acne
• Stops the transfer of melanin so that pigmentation reduces

Why Niacinamide Is Less Likely to Trigger Purging

No Cell Turnover Acceleration

Can niacinamide cause purging? Purging occurs when the old skin cells are shed, and new ones form at a faster pace. Niacinamide has no effect on this process. It works on controlling oil and improving barrier function. It does not work on exfoliation or renewal rate. There is no mechanism through which Niacinamide could cause purging without accelerating cell turnover.

Regulates Sebum, Doesn't Exfoliate

Niacinamide signals the sebaceous glands to produce less oil over time, whereas salicylic acid dissolves the sebum inside pores, and AHAs dissolve the bonds between dead skin cells. It reduces the congestion that leads to breakouts. Niacinamide for pimples works by calming the conditions that create them.

Reduces Inflammation Instead

The anti-inflammatory action of Niacinamide calms the redness and swelling around active breakouts. So, does niacinamide cause pimples? Its inflammation-reducing properties make it the safest active for acne-prone skin, which you can introduce at any concentration between 5% and 12%.

What Could Actually Be Causing Your Purging

If you started a niacinamide product and broke out, here are the more likely reasons for it.

New Product Adjustment

Any new skincare product can cause a temporary adjustment period as your skin gets used to a new formula or ingredients. This is not purging, but your skin reacting to change. It settles within one to two weeks if the formula is compatible with your skin.

Reaction to Other Formula Ingredients

Many niacinamide serums contain additional actives, such as AHAs, BHAs, Retinol, or exfoliating enzymes, which increase cell turnover in your skin. If your Niacinamide serum contains these ingredients as well, the purging may result from them. So, always check the full ingredient list before blaming a reaction on any single ingredient.

Wrong Concentration for Your Skin

Using a 20% Niacinamide formula directly when your skin has never used actives before can cause irritation that looks like a breakout. It's your skin reacting to a concentration that it is not ready for. A safe way is to start between 5% and 10% and build up slowly to prevent flare-ups.

How to Add Niacinamide Properly to Your Skincare Routine

The chances of a reaction reduce a lot when you introduce Niacinamide correctly.

1. Patch test first: Take a small amount and apply it to your inner arm or jawline, and observe for any reaction in the next 24 hours before using it on your full face. Gentle ingredients can react differently on certain skin types, so you must do a patch test.

2. Start at a lower concentration: 5% to 10% is the best starting point if you are a beginner. Give your skin four weeks at this level before going with anything stronger.

3. Introduce one product at a time: If you add multiple new products all at once, you will never know which one is causing a reaction. Add Niacinamide on its own first and give it two to three weeks before introducing other active ingredients.

4. Apply after washing your face: Niacinamide works best when the skin is fresh. Apply it after your face wash and before your moisturizer so that it absorbs better into the skin.

5. Be consistent: The oil-regulating and pore-refining benefits of Niacinamide show only after four to eight weeks of daily use. So, you may not get the results if you stop using it abruptly because of an unrelated reaction.

Conclusion

If you are still wondering, does niacinamide cause purging? It does not. An increase in cell turnover results in purging, and Niacinamide does not work that way. The main reasons for breakouts can be your skin trying to adjust to a new product or another active ingredient in the formula. Higher concentrations can also be tough for your skin to tolerate, which may result in breakouts.

Researchers have found that up to 25 per cent more adults could be classified as obese, even if their body mass index (BMI) score falls under the normal category. As per the current rules, a BMI score of 18.5 to 25 is considered healthy, 25–29 is overweight, and 30 onwards is considered obese. Obesity can contribute to a long-term risk of serious illness, but according to an international team of experts, BMI may not be the most reliable measure for ascertaining obesity levels in an individual.

Why is BMI not a reliable parameter?

Researchers have found that adding the weight-to-height ratio and waist circumference could be a good way to ascertain unhealthy body fat levels. Fat, according to scientists, builds up in people who are not considered overweight or obese under the current rules, depending on where it is stored. Older bodies have a higher fat build-up around the waist, which, when combined with loss of muscle mass, means that there is no change in total weight. This means that the fat that accumulates, known as "skinny fat," does not always raise an alarm.

The new study from scientists at the University of Southern California analysed data from 5,642 adults in the US and discovered that a quarter of them had a normal BMI but actually met the obesity criteria. Furthermore, over 50 per cent of overweight people, according to their BMI, also met the updated obesity criteria. These findings, according to experts, suggest that millions of Americans with obesity-related health complications could be missing much-needed health interventions.

BMI is problematic because it does not evaluate body fat but reflects total body weight, including muscle and bone. Therefore, a muscular person is likely to have a high BMI but not much fat. However, a person with a normal BMI can have excess body fat, which can lead to complications later. The good news, experts say, is that these obesity-related issues can be addressed. Either lifestyle changes, medication, or both can be effective in reducing body fat levels and lowering the risk of future health problems. The sooner it is diagnosed, the better it is for long-term well-being.

Read more: Why 'Normal Weight' Doesn’t Always Mean Healthy

Does obesity risk increase with age?

Researchers estimate that 30 per cent of adults living in England aged 16 years and above are obese. This increases with age, with over 35 per cent of people aged 55 to 74 years living with obesity. Under the new rules, obesity would be defined as a BMI of 30 and above, or at least one elevated measure, such as a high waist circumference, a high waist-to-height ratio, or a BMI of 40 and above. Researchers have labelled these obesity subtypes as BMI-plus-anthropometric obesity.

What is an unhealthy waist circumference?

According to the NHS, an unhealthy waist circumference is 37 inches in men and 31.5 inches or above in women. An unhealthy waist-to-height ratio occurs when the waist circumference is half or more of a person's height. According to the British Heart Foundation, BMI is calculated by dividing weight by height squared. There are multiple BMI calculators available online. It is classified as follows:

1. Underweight – below 18.5
2. Healthy weight – 18.5 to 24.9
3. Overweight – 25 to 29.9
4. Obese – 30 and above

If BMI is in the overweight category, it is linked with a heightened risk of heart disease and incidents such as stroke or heart attack. If it falls within the obese category, the risks are higher. Underweight people are not exempt from risk, as they have a greater likelihood of developing long-term health problems.