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.

Neurology can sometimes be overwhelming because the nervous system touches almost every part of the body. This means, from memory to speech, to sleep and every sensation, all of them are part of neurology. So, naturally, neurologists deal with a vast range of conditions, including carotid artery disease, seizure disorders, Alzheimer’s and frontotemporal dementia, migraines and facial pain, Parkinson’s disease, muscle disorders, narcolepsy, and many others.

“If there’s a nerve somewhere, a neurologist could get involved,” says Dr. Andrew Dorsch, division chief for general neurology at Rush University System for Health and a specialist in neurologic rehabilitation, as reported by Times. “And there’s nerves everywhere in the body. There’s a lot that can go wrong, and figuring it out often takes real detective work.”

The problem is that many people ignore early neurological symptoms, because it looks like any other normal thing that could happen to anyone under immense stress. Here are 11 symptoms doctors say you should never ignore.

Double vision that comes on suddenly

One overlooked symptom is a specific type of double vision that happens when both eyes are open and improves when either eye is closed. This is known as neurological diplopia and is different from eye-related vision problems.

Dr. Luis Cruz-Saavedra, a neurologist with Memorial Hermann Health System, told Times, this type of double vision can be linked to serious conditions such as multiple sclerosis, stroke, aneurysm, myasthenia gravis, brain tumors, or brain infections.

If double vision starts suddenly, it is an emergency. “Immediately,” he says. Doctors may check for stroke warning signs and order imaging such as a CT scan or MRI to identify the cause.

Weakness in one arm or leg

Subtle weakness is another symptom people tend to ignore. Dragging one foot, limping, dropping objects, or struggling to write with a dominant hand are all red flags.

“I see people come in months after symptoms begin,” Cruz-Saavedra says. Many assume it is a pinched nerve, but weakness can signal stroke, brain tumors, multiple sclerosis, or brain inflammation. Neurologists usually test strength, reflexes, balance, and coordination to narrow down the cause.

Brief episodes of unresponsiveness

Some people suddenly stare blankly for a few seconds and then return to normal with no memory of the episode. These moments are often noticed by family members rather than the patient.

Cruz-Saavedra explains that this can be a sign of temporal lobe seizures, which affect areas of the brain involved in memory and emotion. People may describe it as losing a small chunk of time, which should always be medically evaluated.

Trouble speaking or understanding words

Speech problems are among the most common warning signs of stroke, yet many people delay seeking care.

Dr. Enrique Leira, director of the division of cerebrovascular diseases at the University of Iowa, toles Times, stroke symptoms often appear suddenly. Speech may become slurred, slow, or difficult to understand. Some people struggle to find words or comprehend language altogether. In these cases, urgent medical attention is critical.

Sudden, severe headache during exertion

Most headaches are harmless, but some require immediate attention. A headache that strikes suddenly, feels unusually intense, and occurs during physical effort can indicate something serious, including stroke.

Leira says headaches that do not gradually build up and instead arrive abruptly should always be checked right away.

Persistent numbness in feet or fingers

Dr. Dorsch says numbness commonly affects the feet or fingers and suggests that nerves are failing to send signals properly. This is different from tingling, which usually means nerve irritation.

Numbness may result from diabetes, autoimmune conditions, genetic disorders, or nerve damage. A full neurological workup helps determine which nerves are affected and why.

Frequent déjà vu

Occasional déjà vu is normal. Experiencing it repeatedly is not.

“If it’s happening regularly, that’s not typical,” Dorsch says. Frequent déjà vu episodes can be an early sign of temporal lobe seizures and should be evaluated.

Difficulty standing up from a chair

Struggling to rise from a chair on a regular basis is not just about aging or stiff joints. Dorsch says neurologists want to rule out problems involving muscles, nerves, or the spinal cord, including Parkinson’s disease or amyotrophic lateral sclerosis.

Changes in voice

Neurologists pay close attention to voice changes. Dr. Alexandru Olaru of University of Maryland St. Joseph Medical Center notes that an unusually soft or breathy voice may indicate Parkinson’s disease. Slurred speech can point to stroke.

Another concerning sign is a wet or gurgly voice caused by saliva pooling in the throat. This can occur in conditions like Parkinson’s disease, ALS, and multiple sclerosis.

Muscle twitches that do not stop

Muscle twitches are common and often harmless. But when they occur repeatedly in the same location, they should be discussed with a doctor.

Olaru explains that these fasciculations may be benign or linked to conditions such as spinal stenosis, ALS, or autoimmune nerve disorders. Tests like electromyography can help identify the cause.

Sudden personality or behavior changes

Abrupt shifts in behavior, including paranoia, withdrawal, impulsivity, or inappropriate behavior, can signal neurological disease.

Cruz-Saavedra says conditions like autoimmune encephalitis or frontotemporal dementia may show up as personality changes long before memory problems appear. New obsessive behaviors or hoarding can also be warning signs.

Alcohol is often seen as harmful mainly for the liver or heart, but its impact goes much deeper—reaching down to our DNA. Even moderate drinking can silently cause changes at a cellular level, raising long-term health risks that may not be immediately visible. According to Dr. Amit Miglani, Director & HOD – Gastroenterology, Asian Hospital, the breakdown of alcohol in the body produces a toxic chemical called acetaldehyde, which can directly damage DNA inside our cells.

Alcohol Can Damage Your DNA, Not Just Your Liver And Heart

This damage disrupts the body’s natural repair mechanisms, allowing mutations to accumulate over time. Such mutations are linked to several cancers, including cancers of the mouth, throat, liver, breast, and colon. The insidious nature of this damage means that even when you feel healthy, harmful changes may be occurring beneath the surface.

How Alcohol Interferes With DNA Repair

DNA damage can be complex to understand, but its consequences are serious, explains Dr. Arun Kumar Giri, Director – Surgical Oncology, Aakash Healthcare. Normally, the body constantly repairs minor DNA errors. However, alcohol disrupts this repair process, leaving cells vulnerable to mutation and abnormal growth.

Dr. Giri adds that some people have genetic variations that make them break down alcohol more slowly. For these individuals, alcohol stays in the body longer, increasing the likelihood of DNA damage. Over years of repeated exposure, this can lead to uncontrolled cell growth and eventually cancer.

No Completely Safe Level of Alcohol For DNA Health

One of the most important points, Dr. Giri emphasizes, is that there is no entirely safe level of alcohol when it comes to DNA. The risk increases with both the frequency and quantity of drinking. Even occasional binge drinking can be harmful, meaning that how often you drink can be as important—or even more so—than how much you drink at one time.

This perspective shifts the discussion from asking “How much alcohol is too much?” to “How often am I exposing my cells to alcohol-induced damage?” Protecting DNA health requires regular monitoring and mindful drinking habits, even for those who feel healthy today.

Alcohol: Long-Term Health Implications

Alcohol-induced DNA damage is not just a short-term concern. Over time, the accumulation of mutations can significantly increase cancer risk and other serious diseases. Regular health check-ups, a balanced lifestyle, and moderation, or complete avoidance of alcohol are crucial steps for safeguarding your genetic health and overall well-being.

Dr. Amit Miglani highlights that “It’s not just about the organs you can feel being affected today; it’s about protecting your long-term health, especially your DNA, for the future.”

Dr. Arun Kumar Giri advises, “Understanding the cellular impact of alcohol helps people make informed choices about their drinking habits. Even small changes can significantly reduce the risk of long-term damage.”

New research suggests that menopause may be linked to a loss of grey matter in the brain, which could help explain why women face a higher risk of dementia compared to men. Scientists from the University of Cambridge analysed data from 124,780 women to explore how menopause affects the brain and whether hormone replacement therapy (HRT) might help protect against cognitive decline.

Menopause May Be Linked to Changes in Brain Structure

The researchers found that menopause was associated with reduced levels of grey matter, an essential part of the brain involved in thinking, memory, emotional processing and movement. The findings also noted that this stage of life is often accompanied by anxiety, depression and sleep problems. Previous research has already shown that menopause can affect cognitive abilities such as attention, language, learning and memory.

How Menopause And HRT Affect Thinking Speed

Published in the journal Psychological Medicine, the research divided participants into three groups: women who had not yet reached menopause, post-menopausal women who had never used HRT, and post-menopausal women who were taking HRT. Participants answered questions about sleep patterns, anxiety and depression, and some completed cognitive tests measuring memory and reaction time.

Around 11,000 women also underwent magnetic resonance imaging (MRI) scans, allowing scientists to closely examine brain structure. On average, menopause began at age 49 among the participants, and women who started HRT typically began treatment at around the same age.

Sleep, Fatigue and Mental Health Changes

The findings showed that post-menopausal women were more likely to struggle with insomnia, get less sleep overall and feel more fatigued. Interestingly, women using HRT reported the highest levels of tiredness across all three groups, even though they slept for a similar amount of time as those not taking HRT.

All post-menopausal women, regardless of whether they were using hormone therapy, reported greater fatigue compared to women who had not yet experienced menopause. Researchers also observed that this stage of life had an impact on cognitive function.

Dr Katharina Zuhlsdorff, from the psychology department at the University of Cambridge, explained: “As we age, our reaction times naturally slow down. This happens to both women and men and is part of normal ageing. You might still reach the right answer to a quiz question, but younger people tend to respond faster. Our findings suggest menopause speeds up this slowing process, while HRT seems to slow it down slightly.”

Brain Regions Linked to Memory and Emotion Affected

The study identified significant reductions in grey matter volume among post-menopausal women. These changes were seen in the hippocampus, which plays a key role in learning and memory, the entorhinal cortex, which supports memory formation and spatial awareness, and the anterior cingulate cortex, which helps regulate attention and emotions.

Menopause As A Period of Increased Vulnerability

Professor Barbara Sahakian, the senior author of the study from the department of psychiatry, said: “The brain areas where we observed these changes are the same regions commonly affected by Alzheimer’s disease. Menopause may make women more vulnerable later in life. While it does not explain everything, it could help clarify why dementia affects nearly twice as many women as men.”

Michelle Dyson, chief executive of the Alzheimer’s Society, noted that women account for roughly two-thirds of people living with Alzheimer’s disease in the UK. “Although we do not yet fully understand why women are more affected than men, hormones are thought to play a role,” she said.

“This large-scale study strengthens evidence that menopause has an impact on the brain, including physical changes such as reduced brain volume. However, without long-term follow-up to see whether participants later develop dementia, we cannot be certain that these menopause-related brain changes directly increase dementia risk.

“There are steps people can take today to lower their dementia risk, including regular exercise, avoiding smoking and cutting back on alcohol. Anyone concerned about themselves or a loved one can use the Alzheimer’s Society dementia symptoms checklist as a starting point before speaking to a GP.”

The research also found that women taking HRT were more likely to report mental health challenges. However, the analysis suggested these women already had poorer psychological wellbeing before starting hormone treatment.

Dr Christelle Langley, from the psychiatry department, said: “Menopause is something most women will experience, and it can be a major life change whether or not HRT is used. During this time, healthy habits such as staying active, exercising regularly and eating a balanced diet become especially important to help reduce some of its effects.”

Dr Louise Newson, a GP and women’s hormone specialist, added: “Many women notice changes in memory and concentration around menopause. This study suggests these symptoms may have a biological explanation rather than being brushed off as stress or ageing, highlighting menopause as a key window for protecting brain health and providing personalised care.”