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.

Women are spending thousands of pounds to address an intimate and largely unexpected side effect linked to rapid weight loss caused by so-called “fat jabs.” As these injections grow quickly in popularity, doctors say sudden and significant weight loss is leading some women to notice changes in their labia or vulva.

This has resulted in a rise in private cosmetic procedures commonly referred to as “labia puffing.” For those unversed, the vulva refers to the external female genital area, which includes the labia. The labia are the folds of skin that surround the vaginal opening.

Weight-Loss Injections Go Mainstream

Originally developed to manage Type 2 diabetes, weight-loss injections have entered the mainstream at remarkable speed. As per Mirror, in the UK alone, about 2.5 million people are now using these drugs, according to figures reported by The Telegraph in October. That means roughly one in every 20 adults. Most users access the injections privately, as they are rarely available through the NHS. The report also noted that sales of medications such as Mounjaro and Wegovy reached 2.5 million in July, marking a sevenfold increase compared to the previous year.

While headlines have largely focused on visible changes such as slimmer bodies and faces, including among celebrities like Sharon Osbourne and Serena Williams, medical professionals say other, less discussed effects are starting to emerge.

Changes Beyond Common Side Effects

Along with widely known side effects such as nausea, diarrhoea, constipation, abdominal pain, and vomiting, some women are now reporting noticeable changes in the appearance of their vulvas and labia.

Doctors explain that the issue is not weight loss itself, but the speed at which it happens. Rapid weight loss strips fat from many areas of the body, including the vulval region. For some women, this leads to a loss of volume in the labia, causing loose or sagging skin. This can result in irritation and discomfort during everyday activities such as sitting, cycling, or exercising.

Women Share Their Experiences

Many women have taken to online forums to describe what they are experiencing. As per Mirror, one Reddit user shared, “She [the gynaecologist] told me my vulva is saggy and I will continue to experience pain when biking or sitting unless I have surgery or fillers.”

Doctors say these outcomes are not surprising. Dr Michael Tahery, writing on his women’s health website, explained that “the rapid weight loss that occurs throughout the body may result in visible sagging of the labia or vagina because of overall fat and volume loss.”

He added that this sagging can be caused by loose labia, excess skin in the vaginal area, wrinkles, or a combination of these factors. “It’s also common for rapid weight loss to cause the labia to suddenly feel out of proportion compared to how it previously felt,” he noted.

Not Just a Cosmetic Concern

For many women, the impact goes beyond appearance. The loss of natural cushioning can increase friction and sensitivity, turning once-comfortable activities into painful experiences. As a result, more women are seeking help from private clinics, where corrective procedures can cost around $2,000, or approximately £1,479. The treatment, often called labia puffing, focuses on restoring volume to the outer lips of the vulva.

What Is Labia Puffing?

Speaking to The Daily Star, Dr Shazia Malik, consultant gynaecologist at The Portland Hospital, explained how the procedure works. “Labia puffing uses dermal fillers, such as hyaluronic acid or fat, to restore volume to the labia majora, which are the outer lips of the vulva,” she said. “It is a minimally invasive procedure designed to improve appearance by increasing fullness, smoothness, and symmetry.”

Dr Malik also pointed out that the demand is not limited to women using weight-loss injections. “The procedure is most commonly sought by women who want to regain a more youthful, fuller appearance due to ageing, weight loss, or childbirth,” she explained.

A Wider Impact of Rapid Weight Loss

The growing interest in these procedures highlights how dramatically weight-loss injections can change the body. Unlike gradual weight loss achieved through diet and exercise, the speed at which fat can disappear with these drugs means changes can occur in areas people do not expect. For some women, these sudden shifts are significant enough to push them toward cosmetic interventions to feel comfortable again.

Alzheimer’s disease and other types of dementia affect memory, thinking ability, and day-to-day functioning. While certain risk factors such as age and genetics cannot be altered, others are within our control. One such factor is obstructive sleep apnea, a condition that is both common and treatable.

Obstructive sleep apnea, or OSA, occurs when breathing repeatedly stops and restarts during sleep. Growing evidence suggests that untreated sleep apnea may raise the risk of memory loss, cognitive decline, and dementia, including Alzheimer’s disease. The encouraging part is that timely treatment may help safeguard brain health.

What Is Obstructive Sleep Apnea?

During sleep, the muscles at the back of the throat naturally relax. In people with obstructive sleep apnea, these muscles relax excessively and block the airway. As a result, breathing pauses briefly until the brain signals the body to wake up just enough to resume breathing. Nebraska Medicine neurologist Dr Daniel Murman explains that this cycle can occur dozens or even hundreds of times each night. Although a person may spend six to eight hours in bed, the repeated interruptions mean the sleep remains shallow and unrefreshing.

Symptoms Of Sleep Apnea

Many people live with sleep apnea without realising it. According to the Cleveland Clinic, some common signs to watch for include:

• Loud and persistent snoring
• Pauses in breathing during sleep, often noticed by a partner
• Gasping or snorting sounds at night
• Excessive sleepiness during the day
• Difficulty concentrating or staying alert
• Morning headaches or waking up feeling unrested

In more serious cases, repeated breathing pauses can lower oxygen levels during sleep. Over time, this oxygen deprivation can damage several organs, including the brain.

How Sleep Apnea Affects The Brain

Untreated sleep apnea can impact the brain in both immediate and long-term ways. “In the short term, disrupted sleep makes clear thinking more difficult,” says Dr Murman. “People may notice problems with attention, reaction time, multitasking, and memory. These issues can resemble early signs of dementia but may improve once sleep apnea is treated.”

Over longer periods, frequent drops in oxygen levels combined with poor sleep quality may lead to lasting brain changes. Research has consistently shown a strong association between untreated sleep apnea and an increased risk of:

• All forms of dementia
• Alzheimer’s disease
• Vascular cognitive decline linked to blood vessel damage

Although studies are ongoing, scientists believe sleep apnea may harm the brain through multiple biological pathways.

Having Sleep Apnoea Increases Risk Of Anxiety And Dementia: Study

A long-term ageing study published in JAMA Network Open also found that sleep apnoea is linked to a higher risk of mental health conditions over time. Researchers from the Ottawa Hospital Research Institute analysed data from more than 30,000 adults aged 45 to 85, who were followed for an average of three years. Around 7,500 participants had sleep apnoea.

“In this national Canadian cohort study of 30,097 individuals, those at high risk of obstructive sleep apnoea had about 40 per cent higher odds of mental health conditions at both the start of the study and follow-up,” the authors wrote. “Over time, a high risk of OSA remained linked to a 44 per cent increase in the likelihood of developing new mental health conditions.”

The researchers also noted that middle-aged and older adults at high risk of sleep apnoea consistently reported poorer mental health outcomes. Women, people with lower incomes, and those with poorer overall health and life satisfaction were more likely to develop new mental health concerns. The findings underline the need for routine mental health screening among older adults at risk of sleep apnoea.

Previous research has already connected sleep apnoea with a higher risk of cognitive impairment and dementia. The study’s authors emphasised that future research should explore whether combining screening and prevention strategies could improve both mental wellbeing and long-term brain health.

Winters can be especially demanding for many women going through menopause or perimenopause. As the colder months arrive, concerns like dry, irritated skin, unexpected hair fall, and increased joint pain become more common. This rise in symptoms is not caused by cold weather alone. It is largely driven by the way seasonal changes interact with the hormonal transitions of menopause. To understand this better, we spoke to Tamanna Singh, Co-founder of Menoveda and a Certified Menopause Coach, who explained why these changes happen.

What Is Menopause?

Menopause is a natural biological phase when a woman’s menstrual cycles stop permanently, signalling the end of her reproductive years. It is officially diagnosed after 12 consecutive months without a period and usually occurs between the ages of 45 and 55, as the ovaries gradually reduce estrogen production.

The phase leading up to this, called perimenopause, involves fluctuating hormones that can trigger symptoms such as hot flashes, mood changes, and sleep disturbances. Postmenopause refers to the stage after menopause, according to the Mayo Clinic.

How Long Does Menopause Last?

Menopause itself is a single milestone rather than a prolonged phase. Once a woman has gone a full year without a menstrual period, she is considered menopausal. After this point, she enters postmenopause, which continues for the rest of her life.

Menopausal Symptoms Worsening During Winters

One of the key changes during menopause is the steady decline in estrogen levels. Estrogen supports skin moisture, collagen formation, healthy hair growth cycles, and joint lubrication. As this hormone decreases, the body becomes more reactive to environmental factors, with winter dryness having a stronger impact.

Menopause In Winters: Why Skin Feels Drier in January

Tamanna Singh explains, “Cold air contains less moisture, and indoor heating further removes the skin’s natural oils. Lower estrogen levels weaken the skin’s protective barrier, increasing water loss. This leads to dryness, flaking, itching, and in some cases, eczema-like conditions. The skin also takes longer to repair itself, which makes winter-related irritation more difficult to manage.”

The Hair Fall Connection

Hair follicles respond closely to hormonal changes. Tamanna notes, “During menopause, shifting estrogen levels and increased androgen activity shorten the hair’s growth phase, leading to more shedding. Winter adds further stress through reduced blood flow to the scalp, dietary imbalances after festive eating, and low Vitamin D levels due to limited sunlight. Combined, these factors make January a common time for noticeable hair thinning and hair fall.”

Why Joint Pain Worsens During Menopause?

Estrogen also plays a role in reducing inflammation and keeping joints well-lubricated. As estrogen levels fall, women may experience stiffness, swelling, and discomfort, which tend to worsen in cold weather. Lower temperatures cause muscles and connective tissues to tighten, reducing flexibility. Staying less active during winter months further adds to joint stiffness and pain.

What Can Help?

Managing these concerns calls for a well-rounded approach. Tamanna recommends:

• Skin: Use rich, oil-based moisturisers regularly and maintain good hydration.
• Hair: Ensure sufficient intake of protein, iron, and biotin, and practice gentle scalp massage to improve blood circulation.
• Joints: Engage in light strength training, yoga, and regular movement to support flexibility. Adequate Vitamin D and calcium intake is especially important during winter.

Winter does not create menopausal symptoms. It simply intensifies what the body is already dealing with. With the right awareness, consistent care, and small seasonal adjustments, women can navigate the colder months with more ease and confidence.