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.
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A simple five-factor risk score may help identify people at high risk of dementia, particularly in low- and middle-income countries (LMICs), where around 60% of the world's dementia cases now occur.
Developed and validated by researchers at Northumbria University, the risk score uses five everyday factors to identify older adults at higher risk of dementia. It aims to address a gap in dementia research, as existing prediction tools have largely been developed using data from high-income countries and may not work as well in lower-income settings.
The research team developed the model using data from more than 11,000 older adults across seven countries and three continents.
“We know the burden of dementia is shifting towards lower-income parts of the world, yet the prediction models clinicians and researchers rely on were designed with wealthier populations in mind. This model is a step towards changing that. It is simple, it is built for the settings where it is needed most, and it gives researchers a practical way to find the people who should be the focus of future studies and trials,” said Dr Eduwin Pakpahan, from Northumbria University's Applied Statistics and Data Science Research Group. The study is published in the American Journal of Epidemiology.
Also read: WHO's New Dementia Guidelines Prioritize Healthy Habits, Warn Against Supplements
The model can be applied using information gathered through a straightforward conversation with an older adult and, where relevant, a family member or carer. It does not require blood tests, brain scans or specialist equipment.
The five factors included in the risk score are:
Each factor contributes points towards a total score ranging from 0 to 9. A person scoring 0 has around a 1% chance of developing dementia within three years, while someone scoring 9 has a nearly 19% chance.
The researchers built and tested the model across seven sites in China, Cuba, the Dominican Republic, Puerto Rico, Venezuela, Mexico and Peru. It achieved a performance score of 0.75, above the 0.70 threshold generally regarded as clinically useful.
However, the researchers emphasise that the tool is primarily intended for research rather than routine screening of the general population. It could give researchers and clinical trial teams a practical, low-cost way to identify and recruit people at higher risk of dementia.
The team has also called for the model to be validated in regions not covered by the study, particularly South Asia, the Middle East and North Africa, and Sub-Saharan Africa.
Read More: Dementia Is More Than Forgotten Birthdays, Lost Keys: Doctors Explain Early Signs Before Memory Loss
Dementia affects more than 57 million people worldwide, with around 60% of cases occurring in LMICs across Latin America, the Caribbean, Asia and Africa.
Identifying people at higher risk could help researchers in these regions plan studies and clinical trials that better reflect their populations. A simple tool based on everyday information may also make risk assessment more accessible in settings where specialised diagnostic resources are limited.
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From Independence Day and Janmashtami to Ganesh Chaturthi, Onam, Eid, Navratri, Dussehra, Diwali, Christmas and New Year, the period from August to January means celebrations across the country. However, some can also suffer from stress, loneliness and worsening of pre-existing mental health symptoms.
In India, festivals can provide connection, cultural continuity and family bonding. However, celebration is not positive for everyone. For some, the period can lead to issues such as social pressure, loneliness, grief, financial concerns and even interpersonal conflict. Festive periods can be challenging for the general population, while people with pre-existing mental health conditions may be vulnerable to worsening symptoms, increased sensitivities or relapse.
Festivals carry an expectation that everyone should be happy. People are expected to participate, dress up, attend gatherings and appear enthusiastic. Though some may experience anxiety, burnout, depression or emotional exhaustion, maintaining this expected level of participation can become another source of stress. Emotional wellbeing does not automatically change because it is a festival. Recognising this can reduce guilt and self-criticism.
Festivals frequently bring extended families together. While this can strengthen relationships, it can also reactivate longstanding interpersonal dynamics. Questions about marriage, children, career, finances, appearance or personal choices can become uncomfortable, particularly when they touch existing vulnerabilities.
For someone who has experienced criticism or comparison within the family, a seemingly casual festive comment may carry considerably more emotional weight because of the history attached to it. The festive setting can therefore bring individuals into closer contact with relationships or unresolved issues that they may otherwise have greater distance from.
For individuals already living with a mental health condition, the festive season can introduce several stressors simultaneously. Travel, disrupted sleep, irregular meals, increased social stimulation, financial pressure, family conflict and interruptions to established treatment routines can place additional demands on psychological functioning.
People with conditions such as depression, anxiety disorders, bipolar disorder, trauma-related conditions, obsessive-compulsive symptoms, eating disorders or other psychiatric difficulties may be more sensitive to these changes.
In individuals with a history of recurrent episodes, significant disruption may also contribute to relapse. Festivals themselves do not necessarily cause relapse. Rather, the accumulation of environmental, interpersonal and behavioural stressors can increase vulnerability in someone already at risk.
Changes from an individual's usual baseline such as significant alterations in sleep, appetite, mood, anxiety, irritability, impulsivity, social withdrawal or functioning can therefore be important early warning signs.
Many traditions are built around shared experiences: preparing food, decorating homes, travelling to family members, exchanging gifts or gathering for meals. When someone important is no longer present, familiar rituals can make their absence more noticeable.
This can occur during religious festivals as well as occasions such as Independence Day or New Year, when people naturally reflect on their lives and relationships. Participating in a celebration does not mean grief has disappeared, just as sadness during a celebration does not eliminate the capacity for joy.
The festive season can also place pressure on household finances. Clothing, gifts, travel, home decoration and social events can increase expenditure over several months. For those already experiencing financial uncertainty, this can create considerable stress.
People living alone, those estranged from family, individuals experiencing relationship difficulties, older adults and people who have recently relocated may become more conscious of social isolation during this period. New Year can be particularly challenging because social expectations around parties, relationships and celebration become highly visible.
Also read: Can Mental Health Improvement Help Lower High Blood Pressure? Study Points Towards 3 Habits
Celebrating Diwali, Eid, Navratri, Onam, Christmas or Gurpurab away from India can provide an important connection with cultural identity and family traditions. At the same time, it can highlight physical distance from parents, siblings and extended family.
A person may attend a community celebration abroad while still missing the food, sounds, neighbourhood atmosphere and family rituals associated with celebrations in India. Those unable to travel home may experience increased homesickness, particularly when several major occasions occur within a short period.
Feeling tired, overwhelmed, irritated, lonely or emotionally sensitive during a demanding period does not automatically indicate a psychiatric disorder.
Even psychologically healthy individuals can experience festive stress because of travel, social obligations, financial commitments or difficult family interactions.
For those receiving mental health care, prescribed medication, therapy and established support systems should not be casually disrupted during the festive period.
Curated festive content represents selected moments, not the entirety of another person's life.
Professional support becomes particularly important when festive stress is accompanied by persistent hopelessness, severe anxiety, substantial social withdrawal, changes in sleep or appetite, increased substance use, impaired functioning or other marked behavioural changes.
The goal is not to remove complexity from celebration, but to make space for it. Allowing people to experience the festive season without the pressure to feel festive can itself be an important form of psychological care.
By Ms Dhara Ghuntla, Psychologist/Psychotherapist, Sujay Hospital, 7 Hills Hospital & Criticare Hospital
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As Delhi wakes up to another spell of deteriorating air quality just days ahead of Diwali, ophthalmologists warn that dust, smoke, particulate matter, and toxic gases can affect children's eyes, triggering redness, itching, burning, excessive watering, and dryness.
On Tuesday, India's national capital's average Air Quality Index (AQI) climbed to 331 at 7 am, entering the ‘very poor’ category. At the same time, eight monitoring stations recorded readings above 400, falling in the ‘severe’ zone, according to the Central Pollution Control Board (CPCB).
As per data from the CPCB, 33 of the city's 58 monitoring stations recorded AQI levels in the ‘very poor’ category. Meanwhile, the India Meteorological Department (IMD) and the Indian Institute of Tropical Meteorology have forecast that air quality is likely to remain in the ‘very poor’ category over the coming days.
“Children’s eyes are more sensitive to irritants in the environment, and exposure to pollutants, particulate matter and toxic gases can irritate the surface of the eye,” Dr Shibal Bhartiya, Clinical Director – Ophthalmology and Program Director – Community Outreach and Wellness at Marengo Asia International Institute of Neuro and Spine (MAIINS), told HealthandMe.
The experts warned that exposure to pollutants and particulate matter can irritate the surface of children's eyes, causing redness, itching, burning, excessive tearing and dryness.
Dr Neepa Thacker Dave, Senior Consultant in Paediatric Ophthalmology at SRCC Children's Hospital, told HealthandMe that the eye’s surface is protected by a delicate tear film that provides lubrication, maintains clear vision and helps defend against environmental irritants. Exposure to airborne pollutants can disturb this protective layer and contribute to ocular surface irritation and inflammation.
"Excessive watering does not necessarily mean that the eyes are adequately lubricated. Irritation can trigger reflex tearing even when the tear film is unstable. Consequently, children may experience watering alongside dryness or discomfort," she said.
Further, children with existing allergies or sensitive eyes may notice their symptoms worsening during periods of high pollution.
“Long-term exposure to poor air quality may also worsen pre-existing ocular surface conditions,” Dr Bhartiya said.
Read More: Rising AQI In Delhi-NCR: Doctors Warn Of Lung And Heart Risks As Pollution Builds
Reducing children's exposure to pollution is important, particularly on days when air quality is poor.
Dr Bhartiya advised parents to:
Dr Dave also highlighted the importance of greater awareness, reduced exposure and timely medical care in protecting children from pollution-related eye irritation and discomfort.
Dr Dave said children may not always have the vocabulary to describe eye discomfort. Parents and teachers should watch for frequent eye rubbing, excessive blinking, squinting, watering or reluctance to participate in reading and outdoor activities.
Parents should not dismiss eye irritation in children, particularly when pollution levels are high.
Although mild irritation may improve when exposure is reduced, recurring or persistent symptoms warrant an eye examination. Eye pain, significant sensitivity to light, blurred or reduced vision, marked redness or difficulty opening the eye require prompt medical attention.
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