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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Your weight not only affects your heart health but also your brain health. A recent study published in the Journal of Clinical Endocrinology & Metabolism has revealed a powerful connection between your body weight, heart and brain.
After studying over 500,000 people, scientists discovered that having a high Body Mass Index (BMI) can nearly double your chances of developing brain-related illnesses later in life, which confirms that being overweight and having high blood pressure are not just general health concerns, they are direct causes of dementia.
The study focused heavily on vascular dementia, a specific type of memory loss that occurs when the brain is damaged because of a lack of blood flow.
Think of your blood vessels like a system of pipes. If those pipes are narrowed or blocked due to weight-related issues, the "engine" (your brain) doesn't get the fuel it needs. Over time, this lack of oxygen and nutrients leads to permanent brain damage and the loss of memory and thinking skills.
Researchers found that high blood pressure, often caused by carrying extra weight, is the main "middleman" in this process. Blood pressure is measured with two numbers, and both play a part in brain health:
This is the pressure when your heart beats. It accounts for about 18 percent of the link between obesity and dementia.
This is the pressure when your heart rests between beats. It accounts for about 25 percent of the link. When these numbers stay high, they constantly "batter" the delicate vessels in the brain, causing them to weaken or clog.
Beyond just blood flow, a high BMI impacts the brain in several other ways:
Obesity often causes the body to be in a constant state of "alarm" or inflammation. This can irritate the immune system and eventually damage brain cells.
When the body struggles to process energy and food properly, it changes how the brain uses energy, which can lead to cognitive decline.
A heart that has to work harder to pump blood through a larger body eventually becomes less efficient at sending blood all the way up to the brain. Your heart essentially has to do twice as much work as it would at a lower weight.
The most encouraging takeaway from this study is that dementia isn't always a matter of bad luck or "old age." Researchers call this an unexploited opportunity.
By managing your weight and blood pressure early in life, through a healthy diet, consistent exercise, and good sleep, you are essentially "dementia-proofing" your brain. The researchers suggested that intervening early, possibly even with weight-loss medications before symptoms start, could be a key strategy for protecting brain health in the future.
According to the World Health Organization, one in eight people in the world are living with obesity. In 2022, about 2.5 billion adults were overweight. Causes of it vary, from things like diseases or chronic conditions, to the kind of food that is available to consume.
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Heart attacks need immediate intervention and Dr. Balbir revealed one medicine that can save a life when this happens: Aspirin. In an interview with HealthandMe, Dr. Singh revealed that one does not need fancy equipment to help a person having a heart attack.
“If the history of the family history or cholesterol or diabetic. This patient is at risk, so what is the medicine if you get such a symptom? Aspirin.”
Dr. Singh points out that if you or someone near you begins to experience symptoms of a heart attack, such as heavy chest pain, pressure, or unexplained sweating, taking a dissolvable aspirin immediately can be a lifesaver.
By dissolving a tablet (like Dispirin) in a glass of water and drinking it, the medicine dissolves into the bloodstream much more quickly than simply ingesting it.
Aspirin works by thinning the blood and preventing further clotting in the arteries, which can stop a heart attack from getting worse before medical professionals arrive.
Before medical professionals arrive, performing CPR can also help save a person's life; however, one must know the right way to do CPR.
While speaking to HealthandMe, Dr Singh mentioned a viral video where a person collapses and someone attempts to give them CPR while they are still sitting in a chair, notng that this was 'a dangerous mistake' and people should steer clear away from such false videos.
He explained that you cannot perform CPR on someone who is sitting up as the body must be positioned correctly for the heart and lungs to receive the benefit of the chest compressions.
Without the proper technique, blood will not reach the brain and your efforts will not help the patient. Understanding the proper sequence of events is the difference between a failed attempt and a saved life.
If someone collapses, immediately place them flat on their back on a hard floor. You need the ground's resistance to pump the heart manually. In this position, the heart is "sandwiched" between the rib cage and spine. On a soft bed, your presses will fail to squeeze the heart effectively.
Dr. Singh emphasizes that restarting the heart is the absolute priority. Place both hands in the center of the chest and use your body weight to press firmly. By pushing the rib cage toward the spine, you force the heart to pump. Often, once circulation starts, the patient begins breathing again spontaneously.
If the person doesn't wake up, begin a rhythm of three chest presses followed by one mouth-to-mouth breath. Lock your elbows and press hard to ensure the heart is being squeezed between the bones. This specific cycle keeps oxygenated blood moving to the brain, preventing permanent damage during a cardiac emergency.
According to the Centers for Disease Control and Prevention, heart attacks claim a life every 34 seconds. In 2023, it caused nearly 920,000 deaths, one in every three recorded. Hence it is important to know not just the ways to help when someone has a heart attack but also how to prevent them.
(Credit-Canva)
Heart attacks need immediate intervention, and Dr. Balbir revealed one medicine that can save a life when this is happening: Aspirin. In an interview with HealthandMe, Dr. Balbir Singh revealed that one does not need fancy equipment to help a person having a heart attack.
“If the history of the family history or cholesterol or diabetic. This patient is at risk, so what is the medicine if you get such a symptom? Aspirin.”
Dr. Singh points out that if you or someone near you begins to experience symptoms of a heart attack, such as heavy chest pain, pressure, or unexplained sweating, taking a dissolvable aspirin immediately can be a lifesaver.
By dissolving a tablet (like Dispirin) in a glass of water and drinking it, the medicine enters the bloodstream quickly.
Aspirin works by thinning the blood and preventing further clotting in the arteries, which can stop a heart attack from getting worse before medical professionals arrive.
Before medical professionals arrive, doing CPR also helps; however, one must know the right way to do CPR.
There is a lot of misinformation online. Dr. Singh mentions a viral video where a person collapses and someone attempts to give them CPR while they are still sitting in a chair. This is a dangerous mistake.
He explained that you cannot perform CPR on someone who is sitting up. The body must be positioned correctly for the heart and lungs to receive the benefit of the chest compressions. If the technique is wrong, the blood will not reach the brain, and your efforts will not help the patient. Understanding the proper sequence of events is the difference between a failed attempt and a saved life.
If someone collapses, immediately place them flat on their back on a hard floor. You need the ground's resistance to pump the heart manually. In this position, the heart is "sandwiched" between the rib cage and spine. On a soft bed, your presses will fail to squeeze the heart effectively.
Dr. Singh emphasizes that restarting the heart is the absolute priority. Place both hands in the center of the chest and use your body weight to press firmly. By pushing the rib cage toward the spine, you force the heart to pump. Often, once circulation starts, the patient begins breathing again spontaneously.
If the person doesn't wake up, begin a rhythm of three chest presses followed by one mouth-to-mouth breath. Lock your elbows and press hard to ensure the heart is being squeezed between the bones. This specific cycle keeps oxygenated blood moving to the brain, preventing permanent damage during a cardiac emergency.
According to the Centers for Disease Control and Prevention, heart attacks claim a life every 34 seconds. In 2023, it caused nearly 920,000 deaths, one in every three recorded. Hence it is important to know not just the ways to help when someone has a heart attack but also how to prevent them.
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