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.

Vaccinated for human papillomavirus (HPV)? Now, take that Pap smear test. This is the most common advice women hear to prevent the risk of cervical cancer that annually causes around 6,60,000 new cases and around 350,000 deaths worldwide.

However, it's easier said than done for most of the fairer sex.

A Pap smear is typically a gynecological examination where a speculum is inserted to collect cells from the cervix.

Although the procedure is brief and generally safe, the discomfort discourages many from getting screened. Fear of pain, anxiety of the results, form the common psychological barriers worldwide, and is followed by shame, cultural attitudes, and concerns with male clinicians.

A study in Iran, published in the BMJ Open journal in January 2024, showed that psychological stress, cultural issues, and fear, along with limited information and health services, were the biggest hindrances to getting Pap tests.

Another research published in the BMC Women's Health in December 2022, focusing on Africa, Asia, and South America, reported that many women avoided or delayed Pap smears because they are afraid the procedure will hurt. Many also reported being embarrassed about the pelvic exam or fear of having a stranger see their private areas. Some also worried that the test could damage the uterus.

A Pap Smear test, however, is proven to be safe and is recommended for every woman above the age of 21 years.

“A Pap smear is a rapid, safe, and painless screening procedure that detects irregular cellular changes well before they become malignant. The ability to treat at this pre-cancerous stage of disease provides an excellent outcome,” Dr. Tirathram Kaushik, Senior Consultant GI, HPB, Gastrointestinal & Thoracic Oncology and Robotic Surgery, HCG Cancer Centre, Borivali, told HealthandMe.

A 2025 study, published in the Journal of Contemporary Clinical Practice, showed that pap smears are excellent at ruling out precancerous risks. It also remains a valuable screening tool where molecular testing is limited.

There are many myths about Pap smears that make people anxious or avoid screening. Let’s clear up the most common ones:

Pap Smears Are Painful

The Pap smear procedure, which takes only a few minutes, is often described as uncomfortable. While some feel like a quick pinch, others experience slight discomfort or spotting. Severe pain is not considered normal.

“From an oncology perspective, this myth results in a delay in diagnosis. Cervical cancer often occurs silently in its early stages, without any noticeable symptoms,” Kaushik said.

I Am Healthy, So I don’t need A Pap Smear

While individuals may feel completely well, they still have abnormal cells developing silently. As a result, regular Pap smear screening is important because it detects these changes early -- before they turn into cervical cancer.

“The HPV infection and subsequent changes that lead to cervical cancer happen slowly over many years. HPV infection is also very common, and one in two women is likely to get infected. Regular screening by a Pap smear will help to catch infection early before it can convert into cancer,” Dr. Deepak Jha, Chief - Breast Surgery & Sr. Consultant Surgical Oncology, Artemis Hospitals, told HealthandMe.

I Have Only One Partner, So I don’t need Screening

“HPV doesn’t need penetrative sex for infection. It can be transferred if there is any contact of bodily fluid. It’s always safe to test and be assured rather than repent later,” Dr. Jha said.

Testing Means Cervical Cancer

“Even if HPV is detected, it usually indicates a pre-cancerous stage that is highly treatable,” Dr. Parminder Kaur, Consultant Gynecologic Oncologist at CK Birla Hospital, Delhi, told HealthandMe.

Moreover, a Pap smear only screens for cervical cancer; it can’t detect other gynecological cancers such as cervical, ovarian, uterine (endometrial), vaginal, and vulvar cancers. So, screening and appropriate tests for those will be required, irrespective of the Pap smear.

I Am old, So I don’t need A Pap Smear

I Got Vaccinated, So I Do Not Need A Pap Smear

Irrespective of vaccinated status, a woman should go for regular screening between the ages of 25 and 79. Also, if a woman already had HPV exposure before being vaccinated, she would not benefit, the experts said.

“Screening is not just a routine procedure - it is a preventive measure. In the treatment of cancer, early detection alters the disease course, whereas waiting for symptoms to develop means the disease is likely to be already advanced,” Dr. Kaushik said.

Dr Kaur called for more awareness and stated that open discussion are key to help more women take the important screening test.

When To Get Screened

The United States Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS) recommend getting your first Pap test at age 21, followed by Pap testing every 3 years. Even if you are sexually active, you do not need a Pap test before age 21.

• Individuals must start getting Pap tests at age 21. If the result is normal, repeat the test after three years.
• For individuals aged between 30 and 65 years old, doctors are likely to recommend an HPV test along with a Pap test. If both are normal, repeat after five years.

In women older than 65, you don't need to be screened anymore if:

• You have had at least three Pap tests or two HPV tests in the past 10 years, and the test results were normal or negative, and
• You have not had a cervical precancer in the past, or
• You have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids.

Are you still experiencing brain fog, fatigue, and mood changes even after years of a mild COVID-19 infection? A new study showed that the SARS-CoV-2 virus, behind the COVID infection, can cause persistent brain inflammation and lung injury, according to a study.

Researchers from Tulane University, in Louisiana, US found that the brain inflammation lasts long even after the virus was no longer detectable.

Their study, published in Frontiers in Immunology, can answer why long COVID often includes neurological symptoms such as brain fog, fatigue, and mood changes.

"Long-term effects on the brain were unique to SARS-CoV-2. That distinction is critical to understanding long COVID," said lead author Dr. Xuebin Qin, professor of microbiology and immunology at the Tulane National Biomedical Research Center. Qin also mentioned "lasting lung injury" among COVID patients.

In a mouse model, the team found that immune cells in the lungs failed to fully stand down and also spiked the buildup of collagen -- a protein associated with scarring.

The changes stiffened lung tissue, making breathing feel more labored -- a possible answer to breathlessness faced by COVID survivors.

Further, the researchers also noted no repair to the injury, suggesting the virus may interfere with the lung's natural healing process.

On the other hand, in the brain, the mice with COVID showed signs of persistent brain inflammation weeks later. The team also reported tiny areas of bleeding.

Conducting a gene expression analysis, the team found ongoing inflammatory signaling and disruption of pathways involved in serotonin and dopamine regulation -- brain functions linked to mood, cognition, and energy levels.

What Is Long COVID?

Long COVID is a collection of symptoms that last three months or longer after your first COVID symptoms. They include fatigue, brain fog, headaches, breathlessness, altered sense of smell or taste, headaches, and more.

While many of the Long conditions remain to be fully recognized, some people have more than one symptom.

mRNA Vaccine Against COVID

As per recent data from the World Health Organization, more than 43,000 new cases have been reported from 61 countries, between January and February.

Vaccination that prevents SARS-CoV-2 infection is the most effective way to prevent long COVID.

Recently, the European Medicines Agency (EMA) recommended a marketing authorisation in the European Union (EU) for mCombriax -- a messenger RNA vaccine for protecting people aged 50 years and older against COVID-19 and seasonal influenza (flu).

Co-infection with the influenza virus and SARS-CoV-2 can result in more severe disease than would occur with either SARS-CoV-2 or influenza virus infection alone.

mCombriax works like other vaccines by preparing the body to defend itself against infection. It contains messenger RNA with instructions for making proteins found on SARS-CoV-2 and the following seasonal influenza viruses: influenza type A-H1N1, influenza type A-H3N2, and influenza type B of the Victoria lineage.

Vitamin B12 might sound like just another nutrient on a health label but it plays a major role in how your body works. The vitamin is crucial in helping the body produce red blood cells, supports your nervous system and essential for making DNA, which is the genetic material inside all your cells.

Symptoms of a Vitamin B12 deficiency often appear slowly. You may not notice them at first, or may blame them on stress, lack of sleep or a busy schedule. However, if this deficiency continues for too long, it could lead to serious health problems.

Here are three key signs to look out for:

1. Ongoing Fatigue and Weakness

Vitamin B12 is extremely crucial for making red blood cells who are responsible for carrying oxygen from your lungs to the rest of your body. Oxygen is what your cells need to produce energy.

Without adequate levels of B12, the body cannot produce enough healthy red blood cells, leading to a condition called anemia.

This can make you feel constantly exhausted, even after getting enough sleep. You may also feel weak, short of breath or find that everyday tasks feel harder to do than they generally are.

If the fatigue feels persistent and does not improve with rest, it is important to seek a consultation with a doctor.

2. Tingling or Numbness in the Hands and Feet

Vitamin B12 is also essential for maintaining the myelin sheath, a protective covering around your nerves. You can think of it like the protective plastic that we see around electrical wires. It helps nerve signals travel quickly and correctly between your brain and the rest of your body.

When B12 levels are too low, this protective layer can become damaged and subsequently lead to nerve signals slowing down or misfiring. This may lead you to feel pins and needles, tingling or numbness in your hands and feet. Some people also experience burning sensations or difficulty with balance.

At first, it may seem minor, such as your foot ‘falling asleep’. But if these sensations happen often or without a clear reason, they should not be ignored. Long-term B12 deficiency can cause permanent nerve damage, which is why early medical consultations are important.

3. Brain Fog, Memory Problems or Mood Changes

Your brain also depends on vitamin B12. It helps your body produce neurotransmitters, which are chemicals that allow brain cells to communicate with each other. These chemicals influence memory, focus and mood.

When B12 levels are low, communication between brain cells may not work as efficiently. You may notice difficulty concentrating, forgetfulness or a feeling of mental fog. Some people feel more irritable, anxious or unusually low in mood.

As these symptoms are common during stressful times, they are often dismissed. However, if you feel mentally different from your usual self for a long period, it is important to investigate the cause.

Why Does B12 Deficiency Happen?

Vitamin B12 is mainly found in animal-based foods such as meat, fish, eggs and dairy products. People who follow vegetarian or vegan diets may need fortified foods or supplements to get enough.

Absorption is also a key factor. Vitamin B12 needs a special protein in the stomach called intrinsic factor to be absorbed properly. Certain medical conditions, medications, or aging can reduce absorption. This means that even if someone eats enough B12, their body may not absorb it efficiently.

When to See a Doctor

If you experience ongoing fatigue, tingling sensations or noticeable changes in memory or mood, consult a healthcare professional. A simple blood test can measure your B12 levels.

The good news is that Vitamin B12 deficiency is usually treatable. Treatment may include dietary changes, oral supplements or, in more severe cases, injections. When identified early, most people recover well.

The Bottom Line

Vitamin B12 supports your blood, nerves and brain. A deficiency can quietly affect your energy, sensation and thinking over time.

Pay attention to persistent changes in your body. If something feels consistently wrong, it is important to seek medical advice. Early detection can prevent long-term complications and help restore your health.