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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Waking up at night can make it difficult to fall back asleep, especially when the mind becomes alert and starts racing. Neuroscientist Andrew Huberman has suggested a simple eye-movement routine that he says may help people drift back to sleep. But does it actually work?
The routine is performed with the eyes closed:
Huberman suggests repeating the sequence two to three times.
His theory is that the movements may interact with brain circuits involved in tracking the body's position, including pathways involving the eyes, brainstem and cerebellum.
Also read: Struggling With Sleep? Neurologist Shares 3 Simple Tips For Better Sleep Health
Shelby Harris, a psychologist and board-certified sleep expert, says there are reasonable grounds to try it, Women's World magazine reported.
“I think it’s a very reasonable thing to try. It’s free, low effort, carries essentially no risk and has solid reasons it could help,” Harris was quoted as saying.
She notes that sleep tends to become more fragmented with age.
“Sleep naturally becomes more fragmented with age, with less time in deep sleep and more time in the lighter stages where it’s easy to wake up,” Harris said.
Hormonal changes with age can also contribute to more fragile sleep in women. But a plausible explanation does not mean the technique has been proven.
Michael Grandner, a clinical psychologist and sleep researcher at the University of Arizona, told Inc.com that eye movements, balance signals, the brainstem and cerebellum all contribute to how the brain tracks the body's position in space.
However, he said he is “not aware of studies that have directly tested that chain of events, or clinical trials showing that this particular eye-movement exercise reliably shortens sleep onset.”
Brant Hasler, co-director of the Behavioral Sleep Medicine Training Program at the University of Pittsburgh School of Medicine, added that the technique does not resemble a validated behavioral sleep intervention.
According to Grandner, the exercise may be better understood as a relaxation or focused-attention technique.
He said he would place it “closer to a relaxation, focused-attention, or mindfulness exercise than to an established treatment for insomnia.”
The repetitive movements could give the mind something neutral to focus on instead of worrying, planning for the next day or checking whether sleep has returned.
Further, Hasler said bedtime activities can be useful when they occupy the mind without becoming stimulating. The eye exercise could work in that way, he said, “regardless of any additional effects via proprioception.”
The slow breathing paired with the exercise may also help with relaxation.
Hasler said expectancy effects could explain some positive experiences with the technique. Grandner also cautioned against repeatedly checking whether the trick is working.
If the exercise becomes another task to perform perfectly, “it could become another form of sleep effort, which can actually perpetuate insomnia,” he said.
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Rabies is most often associated with dog-mediated transmission in humans, but the virus can infect a wide range of mammals. In 2026, unusual cases involving farm goats, beavers and Cape fur seals raised fresh questions about how rabies moves between species.
Since July 2026, multiple US jurisdictions have reported human rabies exposures involving known rabies vectors or animals in which rabies is less commonly reported. The CDC issued a health advisory on September 10 “in response to recent reports of increases in human exposures to rabid or possibly rabid animals.”
The concern is not limited to North America. At least 176 people had been bitten by rabid Cape fur seals along South Africa’s coastline by the end of 2025, while researchers have warned that the disease could spread to other marine mammal species.
In North Carolina in 2026, a wild skunk entered a pen containing baby goats, some of which later tested positive for rabies. Of the 284 people evaluated by local health departments, post-exposure prophylaxis (PEP) was recommended for 213. In Maryland, a 13-year-old boy was attacked by a beaver while swimming at a state park and required surgery for his injuries.
These cases raise a bigger question: Are unusual infections simply spillover from established rabies hosts, or can the virus establish sustained transmission in a new species? To understand this better, HealthandMe spoke to two experts.
Also read: US CDC Warns Of Rising Human Rabies Exposure Risk: How To Stay Safe
Dr Anish T S, Professor at the School of Public Health, Kerala University of Health Sciences, told HealthandMe that rabies can infect mammals, but an infected animal is not necessarily a reservoir host.
Genetic sequencing can help establish where an unusual infection came from and whether the virus is changing.
“So one thing that we can do is genetic analysis. If we are able to pick up these animals infected by rabies, we find what kind of rabies virus it is and do maybe a sequencing of the genome of this virus.”
“These kinds of analysis could be done still, but it is a question that whether this particular virus is changing its host or the virus is accumulating some kind of genetic mutations so that it can get maybe involved with some other animals. It can choose some other animals also as their host. It is actually a very pertinent question.”
The Cape fur seal cases add another dimension to this question, with sustained rabies transmission reported within the marine mammal population.
Dr NK Ganguly, former Director General of the Indian Council of Medical Research (ICMR), told HealthandMe that rabies in goats is rare, while beaver exposures need particular caution.
“Beaver is one animal where we have to be very careful.”
Dr Anish said rabies can also present as paralytic or “dumb” rabies, which may not show classic signs and could lead people to handle or treat an infected animal without recognizing the risk.
Dr Ganguly stressed the need for prompt medical care after exposure.
“The rabies incubation period is around 10 days. So if somebody has been exposed, they should be immediately vaccinated. And if the exposure is with a bite or something at the upper limbs, then they need to be given an antiserum as well as vaccinated.”
“So depending on the exposure, you are given a vaccine which is available, and you are also given the cocktail of antibodies, the monoclonal antibodies, which act immediately.”
Dr Ganguly said rabies can also circulate in wild and feral animals, including foxes, while cats and other species can also be infected.
He said surveillance should extend beyond dogs to domestic animals that are in close contact with them and to wildlife where feasible.
“Surveillance should include domestic animals also which are in close contact with the dogs.”
“There should be surveillance. There should be sentinel surveillance. We should carry out, if it is affordable.”
He also pointed to dog vaccination and sterilization, as well as bait vaccination for wildlife and stray animals.
Dr Anish said unusual infections need investigation to determine whether they are isolated spillover events or linked to changes in the virus.
“The real issue is if the virus is changing much because of mutations. Because rabies virus is not that much notorious for mutations. That is why most of our vaccines are working.”
He said genetic studies could help answer whether existing vaccines and treatments would remain effective if significant mutations emerge.
“So the genetic studies of the virus may give us the answers to these questions.”
For India, the experts said the priority remains breaking established dog-mediated transmission chains before focusing on less common pathways.
“If you just look at the rabies situation in India, we are not even able to manage the pure dog-mediated rabies. That is, people are bitten by rabid dogs and people are getting infected, and we are not able to have maybe full coverage of vaccination, and all the other things are actually the biggest concern,” Dr Anish said.
Dr Ganguly added that surveillance should include domestic animals also which are in close contact with the dogs.
"But essentially, in the urban areas, the dog is the main animal, and we should—the Supreme Court has given now a lot of directions in this particular regard—that the dogs may be sterilized," the expert said.
The pet dogs need to be vaccinated and other stray dogs should be taken to facilities where they need to be sterilized and they need to be vaccinated, the experts said.
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The current treatment course for high cholesterol is taking a daily tablet or regular injections over a long period. But instead, could a single treatment change the way high cholesterol is treated?
This possibility is being explored after a small first-in-human trial conducted by Cleveland Clinic found that one infusion of an experimental CRISPR gene-editing therapy lowered LDL, also called bad cholesterol, by about half and that the effect was still present a year later.
The treatment, called CTX310, is still experimental. The study involved just 15 people, so the findings are premature, not evidence that CRISPR can replace statins or other cholesterol medications.
The Phase 1 trial included people with lipid disorders who had not responded adequately to existing medications.
Participants received a single infusion of CTX310, at different doses, and researchers followed them for 12 months.
At the highest dose, LDL cholesterol was reduced by 52.5% after one year, while triglycerides fell by 47.8%. The reductions seen earlier in the trial therefore persisted for at least 12 months.
Additionally, no serious adverse side effects related to the treatment were reported during the one-year follow-up. However, the researchers plan to continue monitoring participants for 15 years, as recommended for gene-editing therapies.
CTX310 operates differently compared to conventional cholesterol medicines. The treatment uses CRISPR-Cas9 gene editing to target ANGPTL3, a gene involved in regulating fats circulating in the blood.
The therapy delivers the gene-editing machinery to the liver, where it switches off ANGPTL3. Lower activity of this gene can reduce levels of LDL cholesterol and triglycerides.
The idea is that instead of using daily medicines to keep cholesterol in check, doctors could make a long-lasting genetic change.
Also read: Preeclampsia May End With Pregnancy. Your Heart Risk May Not
Statins remain a reliable treatment approach for lowering LDL cholesterol and reducing cardiovascular risk. CTX310 has only been tested in a very small Phase 1 trial. Also, the study was primarily designed to examine the safety and explore whether the gene-editing treatment could produce a meaningful effect.
The fact that LDL remained lower after one year is promising and encouraging, but researchers still need to determine whether the treatment can safely maintain its effects over many years and, crucially, whether it reduces heart attacks, strokes and other cardiovascular events.
There is also a fundamental difference between cholesterol tablets and permanently altering a person’s DNA.
High cholesterol is often a long-term condition. Depending on their risk, patients may need cholesterol-lowering treatment for many years.
If CRISPR becomes a reality, people may no longer have to stick to a chronic treatment strategy for managing cholesterol.
"Building upon the initial data presented in November 2025, the durability of the lipid-lowering effect was impressive," said Cleveland Clinic cardiologist Luke Laffin, M.D., first author of the study. "It is encouraging that there were no serious safety events related to CTX310 in the trial and in the year following treatment. We look forward to continuing to investigate this therapy in a larger number of patients."
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