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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New research suggests that menopause may be linked to a loss of grey matter in the brain, which could help explain why women face a higher risk of dementia compared to men. Scientists from the University of Cambridge analysed data from 124,780 women to explore how menopause affects the brain and whether hormone replacement therapy (HRT) might help protect against cognitive decline.
The researchers found that menopause was associated with reduced levels of grey matter, an essential part of the brain involved in thinking, memory, emotional processing and movement. The findings also noted that this stage of life is often accompanied by anxiety, depression and sleep problems. Previous research has already shown that menopause can affect cognitive abilities such as attention, language, learning and memory.
Published in the journal Psychological Medicine, the research divided participants into three groups: women who had not yet reached menopause, post-menopausal women who had never used HRT, and post-menopausal women who were taking HRT. Participants answered questions about sleep patterns, anxiety and depression, and some completed cognitive tests measuring memory and reaction time.
Around 11,000 women also underwent magnetic resonance imaging (MRI) scans, allowing scientists to closely examine brain structure. On average, menopause began at age 49 among the participants, and women who started HRT typically began treatment at around the same age.
The findings showed that post-menopausal women were more likely to struggle with insomnia, get less sleep overall and feel more fatigued. Interestingly, women using HRT reported the highest levels of tiredness across all three groups, even though they slept for a similar amount of time as those not taking HRT.
All post-menopausal women, regardless of whether they were using hormone therapy, reported greater fatigue compared to women who had not yet experienced menopause. Researchers also observed that this stage of life had an impact on cognitive function.
Dr Katharina Zuhlsdorff, from the psychology department at the University of Cambridge, explained: “As we age, our reaction times naturally slow down. This happens to both women and men and is part of normal ageing. You might still reach the right answer to a quiz question, but younger people tend to respond faster. Our findings suggest menopause speeds up this slowing process, while HRT seems to slow it down slightly.”
The study identified significant reductions in grey matter volume among post-menopausal women. These changes were seen in the hippocampus, which plays a key role in learning and memory, the entorhinal cortex, which supports memory formation and spatial awareness, and the anterior cingulate cortex, which helps regulate attention and emotions.
Professor Barbara Sahakian, the senior author of the study from the department of psychiatry, said: “The brain areas where we observed these changes are the same regions commonly affected by Alzheimer’s disease. Menopause may make women more vulnerable later in life. While it does not explain everything, it could help clarify why dementia affects nearly twice as many women as men.”
Michelle Dyson, chief executive of the Alzheimer’s Society, noted that women account for roughly two-thirds of people living with Alzheimer’s disease in the UK. “Although we do not yet fully understand why women are more affected than men, hormones are thought to play a role,” she said.
“This large-scale study strengthens evidence that menopause has an impact on the brain, including physical changes such as reduced brain volume. However, without long-term follow-up to see whether participants later develop dementia, we cannot be certain that these menopause-related brain changes directly increase dementia risk.
“There are steps people can take today to lower their dementia risk, including regular exercise, avoiding smoking and cutting back on alcohol. Anyone concerned about themselves or a loved one can use the Alzheimer’s Society dementia symptoms checklist as a starting point before speaking to a GP.”
The research also found that women taking HRT were more likely to report mental health challenges. However, the analysis suggested these women already had poorer psychological wellbeing before starting hormone treatment.
Dr Christelle Langley, from the psychiatry department, said: “Menopause is something most women will experience, and it can be a major life change whether or not HRT is used. During this time, healthy habits such as staying active, exercising regularly and eating a balanced diet become especially important to help reduce some of its effects.”
Dr Louise Newson, a GP and women’s hormone specialist, added: “Many women notice changes in memory and concentration around menopause. This study suggests these symptoms may have a biological explanation rather than being brushed off as stress or ageing, highlighting menopause as a key window for protecting brain health and providing personalised care.”
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More than 10 million adults, young people, and children in the UK are currently living with arthritis, according to a 2025 report by Arthritis UK. The NHS states that osteoarthritis is the most common form of the condition nationwide.
As per Cleveland Clinic, osteoarthritis develops gradually as joints become stiff and painful due to wear and tear. Symptoms can vary depending on the joint affected and the extent of damage, but pain, swelling, and reduced movement are common. While medication is often prescribed to manage symptoms, the NHS cautions that some commonly used treatments can carry health risks if taken long-term or without proper guidance.
One of the most frequently used pain relief options is non-steroidal anti-inflammatory drugs, commonly known as NSAIDs.
NSAIDs, or non-steroidal anti-inflammatory drugs, are commonly prescribed by GPs to help relieve pain, swelling, and inflammation. They are available in several forms, including tablets, capsules, suppositories, creams, gels, and injections. Some NSAIDs can be purchased over the counter, while stronger versions require a prescription.
These medicines are often relied upon for day-to-day pain relief by people with osteoarthritis, particularly during flare-ups.
The NHS advises that NSAIDs may not be suitable for everyone. Extra caution is recommended for people with asthma, a history of stomach ulcers, angina, or those who have previously experienced a heart attack or stroke. The NHS also advises that individuals taking low-dose aspirin should always consult their GP before using NSAIDs.
Long-term or incorrect use can increase the risk of stomach bleeding, cardiovascular problems, and kidney issues, making it important to review pain management plans regularly.
Consultant Rheumatologist Dr Rod Hughes explains that natural compounds are increasingly being explored as supportive options for joint health.
“Natural compounds derived from plants have long been used in both traditional and modern medicine to support joint health. One such compound is GOPO, which is derived from rose hips (Rosa canina). Research indicates that GOPO can help relieve joint pain due to its anti-inflammatory properties,” he says.
“Rather than simply masking symptoms, GOPO works by helping to regulate the body’s inflammatory response, which is a key driver of joint stiffness, swelling, and discomfort. It offers a promising alternative to traditional painkillers, with fewer risks of side effects, making it a more sustainable option for managing joint discomfort.”
According to Dr Hughes, lifestyle measures form the foundation of osteoarthritis management.
“Lifestyle choices play a central role in relieving osteoarthritis pain and helping people stay active,” he explains. “Research shows that regular, gentle exercise supported by physiotherapy, such as walking, swimming, and yoga, can be highly effective.”
“These activities help keep joints mobile and strengthen the muscles and ligaments that support them, which reduces stiffness and eases pressure on painful joints. It is also important to balance activity with rest to avoid flare-ups caused by overuse.”
Weight management is another key factor in controlling osteoarthritis symptoms. “Maintaining a healthy body weight is especially important,” says Dr Hughes. “Extra weight places additional load on joints, particularly the knees and hips, which can worsen pain and accelerate joint damage. Even modest weight loss has been shown to significantly reduce pain and improve mobility.”
Interestingly, diet can also play a role in managing inflammation linked to osteoarthritis. “Eating plenty of fresh fruit and vegetables, whole grains, nuts, and seeds, along with at least two portions of oily fish each week, provides antioxidants and omega-3 fatty acids that help reduce inflammation and protect against cell damage,” Dr Hughes explains.
“In my practice, I often recommend combining these dietary changes with natural supplements such as turmeric or GOPO to provide additional support for joint health.”
For patients hoping to reduce their dependence on NSAIDs, Dr Hughes stresses the importance of medical supervision.
“Any reduction in NSAIDs should be done gradually and under the guidance of a healthcare professional. This helps ensure pain remains well controlled while avoiding sudden flare-ups or withdrawal issues,” he says.
“By combining regular movement, physiotherapy, supportive nutrition, and appropriate natural supplements, many patients can take a more balanced approach to managing chronic joint pain. Over time, these strategies may allow people to rely less on medication while maintaining a good quality of life.”
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A doctor has cautioned that certain people may need to cut back on their favourite fruits if they are taking specific heart or blood pressure medicines. Ignoring this advice could lead to a serious but preventable health issue. Speaking during a past appearance on ITV’s This Morning, as reported by the Mirror, GP Dr Chris Steele explained that some prescribed drugs can react poorly with everyday foods. Eating these foods in large amounts may interfere with how the medication works and, in some cases, cause dangerous side effects.
He drew attention to two common fruits that many households keep on hand. The doctor warned that anyone taking medicines known as ACE inhibitors should avoid bananas and oranges. During the interview, he said: “Bananas are high in potassium, which is not suitable for certain medications. People taking ACE inhibitors such as captopril, enalapril, fosinopril, and others should try not to eat bananas or oranges.”
ACE inhibitors are used to lower blood pressure and treat heart failure by relaxing and widening blood vessels, allowing blood to circulate more easily. They are often prescribed as a first-line treatment for high blood pressure, heart failure, and some kidney conditions, though regular monitoring is needed to watch for possible side effects.
High blood pressure, also known as hypertension, occurs when blood pushes too forcefully against artery walls. Over time, this can damage blood vessels as well as vital organs such as the heart, brain, and kidneys. The condition often has no obvious symptoms, but it can increase the risk of heart attacks, strokes, kidney failure, vision problems, and aneurysms. Constant pressure makes the heart work harder, which may eventually lead to heart failure or thickening of the heart muscle, according to the Mayo Clinic.
Hypertension is usually linked to lifestyle factors like a high-salt diet, excess weight, lack of physical activity, and smoking. Age, genetics, and underlying health problems such as kidney disease also play a role. The condition develops when pressure inside the arteries rises, sometimes due to stress, hormonal changes, or long-term poor eating habits.
Bananas, along with oranges and some salt substitutes, contain high levels of potassium. When combined with ACE inhibitors, these foods can cause potassium levels in the blood to rise too much. Mild increases may lead to symptoms such as stomach pain, diarrhoea, nausea, or vomiting. However, many people do not notice any symptoms until potassium levels become dangerously high, which can increase the risk of chest pain, heart palpitations, and an irregular, rapid, or fluttering heartbeat.
Patients are advised to inform their GP if they are taking potassium supplements or diuretics alongside blood pressure medication. Those on ACE inhibitors should avoid eating large quantities of foods that are high in potassium.
The NHS advises people in the UK to aim for five portions of fruit and vegetables each day. Since all fruits contain some potassium, no option is completely risk-free when eaten in excess. That said, some fruits are much lower in potassium than bananas and oranges. These include apples, berries, grapes, pineapples, and pears.
Watermelon is generally classed as low to moderate in potassium, making it a suitable choice for people following a low-potassium diet. One standard serving of diced watermelon contains roughly 170 to 180 mg of potassium, which is far lower than levels found in fruits like cantaloupe.
According to the NHS, adults aged 19 to 64 need about 3,500 mg of potassium each day, which can usually be met through a balanced diet. A doctor can help address individual concerns and offer guidance based on personal health needs.
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