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.

A 27-year-old woman in US' state of Arizona suffered a cardiac arrest after using kratom, an over-the-counter supplement she purchased at a local gas station.

Amanda Goodsell, who had never taken kratom before, suffered a cardiac arrest after nearly a week of using the supplement and is now on life support, according to her family.

The mother of 3½-year-old twins tried the kratom gummies at the suggestion of her husband, Mike Goodsell, while seeking relief from persistent leg pain.

“Everybody knew what Kratom was. So I was like, well, okay, well, here, just take this. You could just buy it at the gas station. It’s not going to hurt you,” Mike Goodsell was quoted as saying to the media.

Nearly a week later, Mike found his wife unresponsive in their bed, and rushed her to the hospital, where she was placed on life support

“She like, was like red and her lips were blue, and she was foaming. So I like jumped out of bed. I grabbed her, and then (I) was trying to wake her up,” he said.

“They had to have her on a ventilator to help her breathe. And then they had to put her on a bunch of medications because her heart percentage was at 15%,” Mike added.

After spending two weeks in the hospital, Amanda Goodsell's condition began to improve. Although she has shown significant improvement, as per the doctors she will need a defibrillator and heart medication for the rest of her life.

Also read: Legionnaires' Disease Claims 5th Life In New York City: Health Officials

What Is Kratom?

Kratom is a plant-based substance derived from the Mitragyna speciosa tree, native to Southeast Asia. Traditionally used in countries such as Thailand and Malaysia for pain relief and increased energy, it has gained popularity in the US as an over-the-counter supplement.

Kratom is sold in multiple forms, including powders, capsules, teas, drinks and gummies.

Although it remains legal in many parts of the US, the Food and Drug Administration (FDA) has classified kratom as a "drug of concern" and has not approved it for any medical use.

According to the Substance Abuse and Mental Health Services Administration's National Survey on Drug Use and Health, an estimated 1.7 million Americans aged 12 and older used kratom in 2021.

The substance, sometimes referred to as "gas-station heroin," is banned in at least eight US states—Alabama, Arkansas, Connecticut, Indiana, Louisiana, Tennessee, Vermont and Wisconsin. Several other states, including Iowa and Idaho, are considering restrictions or outright bans.

Why Does The FDA Warn Against Kratom?

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According to a University of Virginia study, there were 43 hospitalizations linked solely to kratom in 2015. By 2025, that number had risen to 538. Researchers said the increase coincided with the emergence of highly concentrated synthetic products, including 7-OH.

The FDA has stated that kratom should not be used as a dietary supplement.

"Kratom is not appropriate for use as a dietary supplement. FDA has concluded from available information, including scientific data, that kratom is a new dietary ingredient for which there is inadequate information to provide reasonable assurance that such ingredient does not present a significant or unreasonable risk of illness or injury."

The agency has warned consumers not to use kratom because of the risk of serious adverse events, including liver toxicity, seizures and substance use disorder (SUD).

The FDA also notes that, in rare cases, deaths have been associated with kratom use, although these cases usually involved other drugs and the contribution of kratom remains unclear.

The agency is also aware of cases involving neonatal abstinence syndrome, in which newborns experienced withdrawal symptoms such as jitteriness, irritability and muscle stiffness following prolonged exposure to kratom during pregnancy.

Brain health is often associated with old age, but according to neurologists, the foundation for healthy cognitive function is laid much earlier.

On World Brain Day, they warned that the 30s and 40s are a crucial period to protect the brain, as lifestyle habits and underlying health conditions can quietly affect memory, concentration, and overall cognitive health.

Brain Ages Alongside the Heart

Speaking to HealthandMe, Dr. Gurucharan Adoor, Neurologist, Apollo Hospitals Bannerghatta Road, Bengaluru, said brain health is closely linked to cardiovascular health. High blood pressure, high cholesterol, and elevated blood sugar can silently damage the brain years before noticeable symptoms appear.

His advice? Make preventive health checks a routine by monitoring blood pressure, blood glucose or HbA1c, cholesterol, weight, and waist circumference—especially for people with a family history of diabetes, stroke, or early heart disease.

Brain Fog A Warning Signal

Also read: Neurological Disorders Emerging As India's Next Major Public Health Challenge, Say Experts

Dr. Adoor said sleep is often the first thing people sacrifice during their busiest years, but the brain pays the price.

Irregular sleep schedules, untreated sleep apnea, and repeated nights of poor-quality sleep can lead to mental fatigue, difficulty concentrating, and persistent brain fog. If brain fog continues, he said, it should not be ignored, as it may indicate an underlying health issue that requires attention.

Dr. Bhushan Joshi, Consultant Neurologist, Manipal Hospital, Kharadi, Pune, told HealthandMe that he is "seeing more professionals in their 30s and 40s complaining of brain fog than ever before". According to him, hormonal changes and chronic inflammation are among the common but often overlooked causes.

Hormonal Changes Can Affect Cognitive Function

Dr. Joshi noted that hormonal fluctuations can significantly influence brain function. Women entering perimenopause may experience difficulty concentrating, while others may notice "word retrieval and short-term memory due to changing estrogen levels that influence brain function."

He added that it is not limited to women. Men also undergo age-related hormonal changes that can affect energy levels and cognitive performance. While these changes are often temporary, they can still be distressing.

Read More: Aspartame, Saccharin, Erythritol Linked To Faster Brain Ageing: Study

Chronic Inflammation May Reduce Mental Clarity

Dr. Joshi explained that chronic low-grade inflammation can also contribute to brain fog. Conditions such as obesity, diabetes, autoimmune diseases, and persistent infections can trigger inflammatory responses that interfere with the brain's ability to process information efficiently. In some people, inflammation has been linked to reduced attention, poor memory, and diminished mental clarity.

Small Lifestyle Changes Key

The good news: Simple daily habits can support long-term brain health. Regular physical activity—whether it's walking, cycling, dancing, or strength training several times a week—improves blood flow to the brain, boosts mood, and supports healthy ageing.

Dr. Adoor also recommends limiting unnecessary screen time, taking regular breaks from phones and digital devices, and focusing on one task at a time to reduce mental overload.

When Should You See A Doctor?

Occasionally feeling mentally sluggish is common, but worsening memory problems or cognitive changes that begin interfering with work or daily life should not be ignored, Dr. Joshi said.

He added that these symptoms may stem from treatable conditions such as thyroid disorders, vitamin deficiencies, anxiety, or depression, making timely medical evaluation important.

Insufficient sleep can impact the brain. A good night's sleep allows the brain to repair and even recharge. Poor sleep over time can increase the risk of several neurological disorders and affect overall brain health.

This article helps to understand how poor sleep can take a toll on neurological health. Read on to know more about this and get a sound sleep at night.

Currently, due to hectic schedules, people are now sacrificing sleep to meet work deadlines, study longer, or spend more time on screens. Missing a few hours of sleep once in 2-3 months is harmless.

However, chronic sleep deprivation can not only cause irritation and weight gain but also neurological issues. During sleep, the brain processes memories, repairs nerve cells, regulates emotions, and clears waste products that accumulate throughout the day.

When sleep is disturbed on a regular basis, there can be a risk of neurological problems over time.

How Poor Sleep Affects The Brain

Also read: The Silent Impact of Stress On Your Brain: How Chronic Stress Affects Memory, Focus, And Mental Health

If you are one of those who is unable to get a sound sleep at night, then beware. If you are a night owl, then you will have to ensure you sleep well now.

Sleep helps the brain store and organise new information. Lack of sleep can make it difficult to concentrate, learn new skills, and remember important details. Many will also experience poor decision-making.

Poor sleep, especially when associated with conditions like sleep apnoea, can increase blood pressure and reduce oxygen supply, raising the risk of stroke in the near future.

Long-term sleep deprivation may reduce the brain's ability to clear harmful proteins such as beta-amyloid, which are linked to Alzheimer's disease and other forms of dementia.

People who sleep too little or have poor-quality sleep can also suffer from constant headaches and migraine attacks. In people living with epilepsy, inadequate sleep is a common trigger for seizures. Poor sleep increases the risk of anxiety, depression, irritability, and emotional stress.

Tips For Better Brain Health Through Sleep

It is necessary to get at least 7-9 hours of sleep per day. Maintain a consistent sleep and wake-up schedule.

Avoid screens, caffeine, and heavy meals before hitting the sack. Exercise regularly but avoid intense workouts late at night.

Keep your bedroom quiet, cool, and dark so that you can sleep better. Seek help from the doctor if you snore loudly, stop breathing during sleep, or feel excessively sleepy during the day.

So, just like a balanced diet, exercise, and staying stress-free by doing yoga and meditation, getting a good night’s sleep is also important. Sleep well and prevent any neurological issues.