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.

Alpha-gal syndrome (AGS) is a potentially life-threatening allergy to red meat and other products derived from mammals. Unlike typical food allergies that cause immediate reactions, AGS symptoms can appear several hours after consumption. These range from hives and nausea to anaphylaxis and, in rare cases, heart attacks. The syndrome is triggered by a sugar molecule called galactose-α-1,3-galactose (or alpha-gal), which is introduced into the human body through the bite of a lone star tick.

Why are lone star ticks spreading?

Lone star ticks, named for the white dot found on the backs of females, have long been native to the southeastern United States. But in recent years, their range has expanded dramatically — now reaching as far north as Maine and westwards toward the central US. Experts say this is largely due to the warming climate, which has made previously inhospitable regions more suitable for tick survival and reproduction.

This spread is also helped by other factors such as:

• Increased deer populations (which host ticks)
• Urban development that pushes human dwellings closer to wild habitats
• Lack of natural barriers, such as mountain ranges, in some regions

How common is AGS?

The true number of alpha-gal syndrome cases is difficult to determine due to inconsistent data collection and lack of awareness. The Centers for Disease Control and Prevention (CDC) has documented about 110,000 cases since 2010, but estimates suggest the actual number could be as high as 450,000. Many people may never realise their allergic reactions are linked to a tick bite.

What makes these ticks dangerous?

Lone star ticks are notoriously aggressive. They are capable of detecting humans by sensing heat and carbon dioxide and will actively pursue a host. They can even move quickly over short distances, increasing the chances of biting.

The concept of a “tick bomb” — a cluster of tiny juvenile ticks that swarm over anything they encounter — adds another terrifying element to their behavior.

Living with alpha-gal

For those diagnosed with AGS, life can change dramatically. Aside from cutting out red meat (beef, pork, lamb), many patients also have to avoid dairy, gelatin, and even some medications, toothpaste, and medical products derived from mammals. Food choices become limited and dining out risky. In severe cases, even airborne particles from cooking meat can trigger a reaction.

Support groups are growing rapidly, especially in affected regions like Virginia, where community members share coping strategies and advocate for clearer food labelling.

What’s next?

As the climate warms and tick populations expand, AGS may affect millions more. Other tick-borne illnesses like Lyme disease, Babesia, and the deadly Powassan virus are also on the rise.

Yet, despite this growing threat, researchers warn that US funding for tick-borne disease research is shrinking. Experts stress the urgent need for better surveillance, education, and treatment options to confront what could become a nationwide health crisis.

The choice of quitting oral contraceptives is a personal one, usually related to shifting life priorities—whether it's switching to another type of birth control, getting pregnant, or just needing a break from hormone synthetics. But for many women, going off the pill isn't only about changing periods. For some, it can also mean the return of unwanted acne—sometimes more stubborn and long-lasting than the breakouts of your teenage years.

If you assumed your days of fighting breakouts were over, stopping the pill can be a rude shock. Why does this occur, and how can you prevent it? As a health editor to a worldwide audience, I've spoken to dermatologists and sifted through the most recent evidence to give you an in-depth guide to managing post-pill acne.

Why Does Acne Suddenly Break Out After Stopping the Pill?

The birth-control pill is not only a pregnancy-prevention tool—it's also a hormone controller that has a major impact on skin health. Some women are put on the pill simply to manage acne due to its effect of inhibiting androgens (male hormones) and sebum (skin oil) production. When you discontinue the pill, your body needs to re-balance its hormones, which often means a short spike in androgens. This hormonal storm can put the oil glands in your skin into overdrive, producing clogged pores and breakouts.

The transition phase has been likened to "hormonal chaos." Your ovaries, which had been maintained with artificial estrogen and progesterone, suddenly take over their natural role, sometimes compensating by producing more androgens than previously. This rush of oil production sets the stage for the acne-causing bacteria to thrive.

The birth control pill, particularly combination pills containing estrogen and progestin, inhibits this androgen activity. When the pill is discontinued, the body's natural hormonal cycles return, including the production of androgens, which can overburden the skin's oil-controlling systems—especially if your body is genetically predisposed to be sensitive to these hormones.

Not necessarily. How your skin reacts after coming off the pill depends heavily on your genetics and any underlying hormonal imbalances. For instance, some women start the pill in their teens before acne ever truly develops. In these cases, the pill may be silently suppressing a genetic predisposition to acne, which becomes apparent only after discontinuation.

In some women, the recurrence of acne can indicate a pre-existing covered-up hormonal issue, such as polycystic ovary syndrome (PCOS)—a prevalent endocrine disorder that involves high levels of androgens. In these women, the pill corrects PCOS's evident signs, but when it is withdrawn, the underlying imbalance reappears.

Where and How Does Post-Pill Acne Appear?

Hormonal acne tends to appear in the lower third of the face—jowl, chin, neck—and sometimes the shoulders, chest, or back. It tends to be made up of cysts or inflamed, painful pimples that are deep, not blackheads or whiteheads you may have experienced in puberty.

This pattern is related to sites of increased androgen receptor concentration and oil gland function. But everyone's experience is different: some people have solo flare-ups, others experience more widespread outbreaks.

Women with a history of acne in their families or those with naturally higher androgen levels are at increased risk. Stress, food intake, and even gut health can also determine the intensity and longevity of post-pill breakouts.

What Does Post-Pill Acne Look Like?

Hormonal acne tends to appear on the lower third of the face—chinion and jawline, basically—but can crop up on the chest, shoulders, or back. The eruptions can be as mild as blackheads and whiteheads, or as severe and painful as cystic acne. For some, the flare-up fades in a few months; for others, it can last for a year or more, particularly if there are strong genetic components involved.

The timeline is different. Most women see their acne flaring two to six months after stopping the pill. In some, it could improve a few months later as the hormones balance out. But for others—particularly those with a strong genetic inclination toward acne—it might continue for up to a year or even longer.

In the opinion of dermatologists, your acne's severity and duration will usually reflect your body's sensitivity to hormones. If your body responds strongly to even minor hormonal changes, post-pill acne can be more serious and persist for a longer period.

Can Skincare Alone Treat It?

Here's the bad news: skincare can't change your hormones or your genetic sensitivity to androgens. Although regular skincare can help maintain healthy skin, prevent breakouts, and downsize inflammation, in most cases, it is seldom sufficient to treat post-pill acne in moderate to severe forms.

Over-the-counter remedies such as salicylic acid, benzoyl peroxide, and retinoids might provide relief. But dermatologists sometimes prescribe stronger medications, such as:

• Topical antibiotics or retinoids to decrease bacteria and inflammation
• Oral antibiotics in moderate to severe cases
• Hormonal treatments such as spironolactone, which blocks androgen receptors
• Isotretinoin (Accutane) for severe, cystic acne that is nonresponsive to other treatment

Could This Be a Sign of a Bigger Hormonal Imbalance?

Yes. In many cases, post-pill acne acts as a window into your natural hormonal landscape. If your acne is accompanied by other symptoms—like irregular periods, excess facial hair, or unexplained weight gain—it might be worth exploring conditions like PCOS or insulin resistance with your healthcare provider.

Coming off the pill can reveal long-standing imbalances that were previously being managed rather than resolved.

When to See a Dermatologist?

If your acne is bad, ongoing, or emotionally distressing, see a dermatologist. They can diagnose underlying hormonal imbalances, provide effective treatments, and offer advice specific to your needs. Women with symptoms of PCOS—irregular menstruation, excessive hair, or weight gain—may need a referral to an endocrinologist.

Post-pill acne isn't your fault, and it's not permanent. Although it can be an infuriating obstacle, particularly if you thought you could put acne behind you after adolescence, it's also a chance to learn more about your body's individual hormonal map.

If you’re thinking of coming off the pill, talk to your healthcare provider about what to expect and how to prepare. Remember, you’re not alone—and with the right support, clearer skin is within reach.

Falling asleep to the gentle hum of white noise might seem like a good idea, but a brain doctor warns it could actually cause problems later on, especially if you make one big mistake. This expert, Dr. Baibing Chen (known as Dr. Bing online), suggests that trying to sleep better with loud white noise could raise your risk of getting dementia in the future. He personally avoids three things before bed, and making white noise too loud is one of them.

Hidden Danger of Loud White Noise

Dr. Bing explains that many people use white noise machines to block out annoying sounds like traffic, a partner's snoring, or even a dog licking its paw in the middle of the night. But he warns that if the machine is too loud, it can slowly damage your hearing. He highlights that losing your hearing is one of the biggest risk factors for dementia when you get older. While there's no strong proof that white noise itself directly causes dementia, some studies do suggest that being exposed to a lot of noise over time, including very loud white noise, might be linked to a higher chance of developing dementia.

What Exactly Is White Noise and Does It Help You Sleep?

The Sleep Foundation describes white noise as a type of "broadband noise" that includes all sounds our ears can hear. Think of the static hiss from an untuned radio or the gentle hum of a fan – these are common examples of white noise. Studies on whether white noise actually helps you sleep have shown mixed results.

Some research found that white noise helped newborn babies fall asleep faster, and also helped adults living in noisy parts of New York City drift off more quickly and get better sleep. However, in some cases, white noise actually made it harder for people to fall asleep. This suggests that whether it helps or not really depends on each person and their specific situation.

How to Use White Noise Safely

You can buy special white noise machines from stores, or you can use cheaper options like smartphone apps, which you can find in app stores. If you enjoy nature sounds, pink noise might be a better choice for you, as it includes calming sounds like rain, waterfalls, and flowing rivers. The Sleep Foundation says that some therapists often use pink noise to help treat hearing problems or ringing in the ears (like tinnitus). Here are some safety tips for listening to white noise.

Keep the volume low

Dr. Bing advises setting your white noise machine to a maximum of 50 decibels. This is similar to the quiet hum of a refrigerator.

Maintain a safe distance

Place the machine at least 30 centimeters (about a foot) away from your bed, especially for children.

Address hearing loss

Untreated hearing problems can lead to loneliness and a decline in thinking abilities, both of which increase dementia risk.

Get your hearing checked

The Alzheimer's Society recommends regular hearing tests, especially if you're between 40 and 65, as hearing loss can be an early sign of dementia or increase your risk.

Consider hearing aids

There's evidence that using hearing aids might help slow down thinking problems related to dementia.