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.

Heavy menstrual bleeding caused by fibroids and other gynecological conditions is a major but often overlooked contributor to anemia among Indian women, said Dr. Roma Sinha, Chief Gynecologist and Director of Gynecological Robotic Surgery at Apollo Hospitals, Hyderabad, today.

Speaking at the Times Network India Health Summit 2026 at Hyderabad, Dr. Sinha highlighted how many women normalize excessive menstrual bleeding and delay seeking medical attention, often leading to severe anemia and a reduced quality of life.

Fibroids And Heavy Bleeding Behind Anemia

According to Dr. Sinha, it is not uncommon for women to visit her clinic with hemoglobin levels as low as five or six grams per deciliter.

"Most of the time, it is not nutritional anemia. Women lose so much blood during their menstrual cycles that they are unable to rebuild their hemoglobin levels," she said.

While national programs such as Anemia Mukt Bharat focus heavily on pregnant women, Dr. Sinha pointed out that anemia occurring during other stages of a woman's life often goes unnoticed.

She said many women learn from family members and friends that heavy bleeding is "normal" and simply continue to suffer without seeking treatment.

Also read: Violence Against Doctors Is A National Concern, Says IMA Dilip P. Bhanushali

Fatigue And Poor Quality Of Life

Beyond the underlying disease, Dr. Sinha emphasized the impact heavy menstrual bleeding has on women's daily lives.

"Many women think they are tired because of stress, work, or family responsibilities. But often it is low hemoglobin and iron deficiency causing that fatigue," she said.

The expert noted that a simple hemoglobin test can help diagnose anemia, yet many women continue to prioritize the health of their families over their own well-being.

Lack of Awareness

Dr. Sinha identified lack of awareness and negligence as two major reasons why women delay medical consultations.

"Heavy bleeding occurs only for a few days every month, so women tend to tolerate it and move on. Many don't realize that it is treatable and that ignoring it can lead to dangerously low hemoglobin levels," she said.

The expert stressed the need for greater public awareness and open conversations about menstrual health.

"It should not be a taboo to talk about heavy menstrual bleeding," she added.

Surgery Not The Only Treatment Option

Read More: Childhood Obesity Is A 'Do or Die' Crisis, Experts Warn

A common fear among women, Dr. Sinha said, is surgery. Many patients avoid consultations because they assume treatment will automatically mean a hysterectomy —the surgical removal of the uterus— after which pregnancy is impossible, the top gynecologist said. However, she clarified that surgery is not the only option available for fibroids.

"Fibroids are largely benign tumors. Women today have choices, including medical management, non-invasive treatments, myomectomy, or hysterectomy, depending on their individual needs and preferences," she said.

The expert added that modern technologies such as robotic surgery have significantly improved outcomes for women requiring treatment.

Dr. Sinha also highlighted long-term research conducted on women who underwent robotic surgery for fibroids.

"We followed patients for ten years and found that 86.3 per cent conceived and delivered successfully after surgery," she said.

The findings, she noted, should reassure younger women concerned about fertility after fibroid treatment.

Early Diagnosis

Read To Know: AI Cannot Replace Doctors, It Can Only Complement, Says Dr Santosh Sivaranjani

While early detection cannot eliminate fibroids completely, Dr. Sinha said it can prevent severe anemia and improve overall quality of life. "Current treatments can control symptoms and act as bridge therapies, helping women avoid complications and delay more definitive treatment when appropriate," she explained.

'Don't Ignore Heavy Bleeding'

In her message to women, Dr. Sinha urged them to listen to their bodies and seek help when they notice abnormal menstrual bleeding.

"If you feel your periods are heavier than normal, don't ignore it. Get a simple hemoglobin test and consult a gynecologist," she said.

Dr. Sinha also called on families, particularly men, to support women in seeking care and to pay attention when they complain of persistent fatigue or excessive menstrual bleeding.

Violence against healthcare professionals is no longer just a workplace issue but a national concern that threatens the very foundation of India's healthcare system, said Dr Dilip Bhanushali, Immediate Past National President of the Indian Medical Association (IMA), at the ongoing Times Network India Health Summit 2026 in Hyderabad.

Addressing a session on Building Trust in Healthcare: Addressing Violence Against Healthcare Professionals, the expert highlighted the alarming rise in attacks on doctors, nurses, and other healthcare workers, calling for urgent legal reforms, stronger security measures, and a renewed effort to rebuild trust between patients and medical professionals.

Over 60% Healthcare Workers Face Violence

Drawing attention to the scale of the problem, the Dr Dilip said studies show that more than 60 per cent of healthcare workers in India have experienced some form of violence, with verbal abuse being the most common. Emergency departments continue to be among the most vulnerable areas for such incidents.

"Behind every statistic is a doctor who went home shaken, a nurse who cried silently after a night shift, or a medical student questioning their future in the profession," he said.

The growing normalization of violence against healthcare workers, he warned, is one of the most worrying aspects of the crisis.

Doctors Become Targets When Outcomes Go Wrong

Dr. Dilip noted that while doctors are often celebrated when treatments succeed, they frequently become targets when outcomes are unfavorable despite their best efforts.

"Medicine is not mathematics. Not every illness can be cured, not every complication can be predicted, and not every life can be saved," he said.

While emphasizing that accountability and transparency are essential when mistakes occur, the expert stressed that violence can never be justified. "A complication is not necessarily misconduct, and a bad outcome is not necessarily a crime," he added.

Trust Is The Oxygen of Healthcare

Also read: Childhood Obesity Is A 'Do or Die' Crisis, Experts Warn At Times Network India Health Summit 2026

Calling trust the foundation of effective healthcare delivery, Dr. Dilip said the erosion of trust between patients and doctors has serious consequences for the entire healthcare ecosystem.

"Without trust, every prescription is questioned, every diagnosis is doubted, and every conversation becomes a confrontation," he noted.

The Indian Medical Association has consistently maintained that violence against healthcare workers is not merely an attack on an individual doctor but on the healthcare system itself, he added.

Demand for Stronger Laws and Faster Justice

The IMA leader reiterated the association's long-standing demand for a comprehensive central law to protect healthcare personnel and institutions.

While acknowledging that several states have enacted legislation against violence towards healthcare workers, they argued that enforcement remains inconsistent.

The association is seeking stricter penalties, mandatory registration of cases, speedy investigations, and time-bound prosecution of offenders.

"Laws on paper alone cannot protect healthcare workers. Enforcement is equally important," Dr. Dilip said.

Hospitals Must Be Designated Safe Zones

Read More: Times Now Health Summit 2026: AI Cannot Replace Doctors, It Can Only Complement, Says Dr Santosh Sivaranjani

Beyond legislation, Dr Dilip said called for practical measures to improve safety within healthcare facilities.

Recommendations included regular security audits, adequate CCTV coverage, trained security personnel, emergency response systems, and controlled-access areas within hospitals.

"No healthcare professional should fear for their safety while caring for patients," he said.

"The future of healthcare cannot be built on fear; it must be built on trust," Dr Dilip said.

Healthcare professionals, he added, continue to serve despite long hours, emotional strain, and personal sacrifices, and deserve both protection and respect.

"Protect the healer, and you protect healing itself," Dr Dilip said.

The ongoing Times Now India Health Summit 2026 – South Edition in Hyderabad is bringing together leading voices from government, medicine, research, and the healthcare industry to discuss the future of India's healthcare system.

The summit featured renowned doctors, policymakers, hospital leaders, researchers, and healthcare innovators, with discussions spanning preventive healthcare, artificial intelligence, women's health, public health policy, and medical innovation.

As artificial intelligence (AI) continues to transform healthcare worldwide, concerns about technology replacing doctors remain a topic of debate.

Dr. Santosh Sivaranjani, popularly known as "The ORS Lady of India," addressed these concerns at the Times Now India Health Summit 2026 – South Edition in Hyderabad.

The renowned pediatrician and social activist emphasized that AI can only assist doctors and cannot replace the core human qualities that define medical care.

Dr. Sivaranjani acknowledged that doctors are increasingly embracing innovations such as artificial intelligence to improve patient care and health education. However, she stressed that technology has clear limitations.

"No matter how much AI advances, it can only complement us. It cannot replace the human touch, clinical acumen, or the genuine empathy that doctors have towards their patients," she said. "We should be proud of being doctors" because such qualities cannot be replicated by machines, she said.

The Privilege and Challenge of Being a Doctor in India

Speaking before an audience of healthcare professionals, Dr. Sivaranjani also highlighted the unique challenges and rewards of being a doctor in India. She described the profession as both a privilege and an extraordinary challenge, citing the immense patient load, demanding work schedules, and personal sacrifices made by medical professionals every day.

"Our journey demands countless sleepless nights, missed birthdays, missed anniversaries, and even caring for other patients when our own loved ones are unwell," she said. "Yet the moment we see a patient recover and smile, all those sacrifices seem worthwhile."

Changing Perceptions of the Medical Profession

Dr. Sivaranjani also reflected on the changing perception of doctors in India. She noted that physicians were once regarded with deep respect and seen as pillars of strength during families' most difficult moments. While many doctors continue to uphold these values, she expressed concern that rising healthcare costs and changing public expectations have altered doctor-patient relationships.

"Most doctors work to the best of their ability and according to their conscience, not to please patients but to provide the right treatment," she said.

Concerns Over the Consumer Protection Act

The pediatrician further highlighted concerns about the inclusion of doctors under the Consumer Protection Act, arguing that it has contributed to a more defensive doctor-patient relationship.

"Medicine often requires difficult and sometimes risky decisions to save lives. However, fear of legal consequences can make doctors hesitant to take those necessary risks," she said.

Rebuilding Trust Through Empathy and Ethics

Calling for efforts to rebuild public trust, Dr. Sivaranjani urged medical professionals to prioritize empathy, transparency, ethical practice, and patient education. She emphasized that medicine is not only a science but also an art that requires compassion and effective communication.

"The moment a patient enters your consultation room, half of their illness should disappear because of the confidence and reassurance you provide," she said. "Arrogance has no place in our profession."

She also stressed the need to strengthen public healthcare infrastructure to ensure equitable access to quality medical services across the country.

Concluding her address, Dr. Sivaranjani paid tribute to healthcare workers across India for their dedication and resilience.

"It is a privilege to be a doctor in this great country and to make a difference in so many lives," she said. "At the same time, it is an extraordinary challenge to protect ourselves from violence, navigate legal pressures, and help people understand that we are here not to please them, but to heal them."