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.

Hundreds of thousands of children are set to receive an additional vaccine under the NHS routine childhood immunisation programme. Health officials have confirmed it will be given alongside the existing MMR jab, which protects children in England against measles, mumps and rubella.

Chicken pox Vaccine Starts By NHS

The decision follows advice from the Joint Committee on Vaccination and Immunisation and will see the current MMR jab replaced with a combined MMRV vaccine. This single injection protects against measles, mumps, rubella and chickenpox. Studies estimate that chickenpox in childhood leads to around £24 million a year in lost earnings and productivity across the UK. Alongside reducing this impact, the rollout is expected to save the NHS about £15 million each year in treatment costs linked to the illness.

Dr Claire Fuller, National Medical Director for NHS England, said: “This marks a very positive step for children and families, offering protection against chickenpox for the first time and strengthening the range of routine vaccinations we already give to help shield children from serious diseases.

“From now on, the combined vaccine covering measles, mumps, rubella and chickenpox will be offered at children’s routine vaccination appointments. This will help keep children healthier, prevent illness caused by these highly infectious viruses, and support the NHS shift from treating sickness to preventing it, while keeping more children safe and in school.”

Recent figures show that around half of children will have chickenpox by the age of four, with nine in ten catching it before they turn ten. Children who develop chickenpox are usually advised to stay away from school until all spots have crusted over, which typically happens about five days after the rash appears.

With the new vaccine in place, fewer children are expected to miss time at nursery or school. This should also reduce the amount of work parents need to take off to look after them.

Who Can Get The Chickenpox Vaccine On The NHS?

Protection against chickenpox is being offered through a new combined vaccine known as MMRV, which replaces the existing MMR jab. The MMRV vaccine protects against measles, mumps, rubella and varicella, the virus that causes chickenpox.

• Children born after 1 January 2026 will automatically be offered two doses of the MMRV vaccine, given at 12 months and again at 18 months.
• A catch-up programme will also provide one or two doses for older children, depending on when they were born:
• children born on or after 1 January 2025 will be offered two doses, one at 12 months and one at 18 months
• children born between 1 July 2024 and 31 December 2024 will be offered two doses, one at 18 months and another at 3 years and 4 months
• children born between 1 September 2022 and 30 June 2024 will be offered one dose at 3 years and 4 months
• children born between 1 January 2020 and 31 August 2022 will be offered a single dose later in 2026
• GP practices will contact families directly to arrange vaccination appointments when they are due.

How Does The New Chickenpox Vaccination Work?

Specialists say adding the varicella vaccine to the NHS childhood immunisation schedule will significantly cut the number of people who get chickenpox, resulting in far fewer severe cases.

While the vaccine does not guarantee lifelong immunity, it greatly lowers the chances of catching chickenpox or developing a serious form of the illness. Serious side effects, including severe allergic reactions, are extremely uncommon.

The vaccine is a live vaccine, meaning it contains a weakened form of the chickenpox virus. Because of this, it is not recommended for people with weakened immune systems due to conditions such as HIV or treatments like chemotherapy.

The change brings the UK in line with countries that already include routine chickenpox vaccination, such as Germany, Canada, Australia and the United States.

In the past, there were concerns that vaccinating children against chickenpox could lead to an increase in shingles later in life, but a large long-term study from the US has since shown this is not the case.

The Joint Committee on Vaccination and Immunisation, which advises the government, recommended the introduction of the MMRV vaccine for all children in November 2023.

The government confirmed plans to roll out the MMRV vaccine in August 2025, after new figures showed that none of England’s main childhood vaccinations reached the 95 percent uptake target in 2024 to 2025.

According to the UK Health Security Agency, 91.9 percent of five-year-olds had received one dose of the MMR vaccine. This figure was unchanged from 2023 to 2024 and remains the lowest level recorded since 2010 to 2011.

Atenolol is widely prescribed for conditions such as high blood pressure and irregular heart rhythms. While it is suitable for many adults, some people need to be especially careful before starting the beta-blocker.

NHS guidance highlights that certain medical conditions and life stages mean a doctor should be consulted first. This includes people with low blood pressure, Raynaud’s phenomenon, or asthma, among others.

Who Should Be Careful Before Taking Atenolol?

The NHS advises speaking to a doctor before taking atenolol if you fall into any of the following groups:

• People who are trying to conceive, are already pregnant, or are breastfeeding
• People with Raynaud’s phenomenon, which can cause fingers or toes to tingle, become unusually pale, or turn blue
• People with metabolic acidosis, a condition where there is too much acid in the blood
• People with low blood pressure (hypotension) or a slower than normal heart rate
• People with lung disease or asthma
• People who have previously had an allergic reaction to atenolol or any other medicine

How Atenolol Works?

According to official NHS advice, atenolol works by slowing the heart rate, which helps the heart pump blood around the body more easily. In addition to treating blood pressure and heart rhythm problems, it is sometimes prescribed to help prevent migraines and ease symptoms of anxiety.

The NHS notes: “Atenolol is only available on prescription. It comes as tablets or a liquid that you swallow. It can also be given by injection, but this is usually only done in hospital.”

Atenol: Medicines That May Interact With Atenolol

People who take other medicines should also check with a doctor before starting atenolol, as some drugs can affect how well it works or increase the risk of side effects. This applies not only to prescription medicines but also to herbal remedies, vitamins, and supplements.

You should speak to a doctor if you take:

• Other medicines for high blood pressure, as using them with atenolol can sometimes lower blood pressure too much and cause dizziness or fainting
• Medicines for irregular heartbeats, such as amiodarone or flecainide
• Medicines for asthma or chronic obstructive pulmonary disease (COPD)
• Medicines for diabetes, especially insulin. Atenolol can make it harder to notice the usual warning signs of low blood sugar. If you experience low blood sugar without symptoms, speak to your doctor and monitor your levels carefully, particularly after exercise or before driving
• Medicines for nasal or sinus congestion, or other cold remedies, including those bought over the counter
• Medicines for allergies, such as ephedrine, noradrenaline, or adrenaline

The NHS also states: “There’s not enough information to say that herbal remedies and supplements are safe to take with atenolol. They’re not tested in the same way as pharmacy and prescription medicines, and they’re generally not tested for how they affect other medicines.”

Atenolol Dosage And How Long Can It Be Taken?

The dose of atenolol you need depends on the condition being treated. For high blood pressure, the usual adult dose is between 25mg and 50mg once a day, but you should always follow your doctor’s instructions. Your medication packaging will also provide guidance on how to take it.

How long you stay on atenolol varies as well. For long-term conditions such as high blood pressure, it is often taken for many years and, in some cases, for life.

Furosemide is commonly prescribed in the UK to help manage conditions such as heart failure and high blood pressure. The diuretic medication is used by people of all ages, including children and infants. In 2024 alone, it was dispensed around 11 million times, making it one of the 20 most frequently prescribed medicines in the country.

Although it is widely used, doctors stress that furosemide must be taken carefully and in line with medical advice, as misuse can lead to serious health problems.

Furosemide: Why The NHS Is Warning Furosemide Users About Dehydration

To ensure safe use, the NHS has issued guidance urging certain people to speak to a doctor before taking furosemide. This is particularly important for anyone showing signs of dehydration, which can include feeling unusually thirsty, having a dry mouth, or noticing dark-coloured urine. Because furosemide increases urine output, it can raise the risk of fluid loss if not managed properly.

Who Should Speak To A Doctor Before Taking Furosemide?

The NHS advises the following people to consult a doctor before using furosemide:

• Anyone who has previously had an allergic reaction to furosemide or any other medicine
• Anyone with low blood pressure, also known as hypotension
• Anyone showing signs of dehydration, such as thirst, dry mouth, or dark urine
• Anyone diagnosed with liver disease
• Anyone living with diabetes
• Anyone who has difficulty passing urine
• Anyone diagnosed with Addison’s disease, a rare disorder affecting the adrenal glands
• Anyone diagnosed with gout

Furosemide: When Should Users Contact A Doctor Or Delay Treatment

Beyond these groups, the NHS also says furosemide users should seek medical advice if:

• You are due to have a glucose test
• You are scheduled for a scan or X-ray that involves an iodine-based dye being injected into your blood
• You are preparing for major surgery or a procedure that requires a general anaesthetic

How Furosemide Works And Why It Is Called A ‘Water Tablet’

Official NHS guidance explains that diuretics are often referred to as “water tablets” because they increase how often you urinate. This helps the body remove excess fluid.

“Furosemide is only available on prescription,” the NHS states. “It comes as tablets and a liquid that you swallow. It can also be given by injection, but this is usually only done in hospital.”

Medicines That Can Interfere With Furosemide

The NHS also warns that certain medicines can reduce how well furosemide works or increase the risk of side effects. This includes some commonly used over-the-counter treatments, such as paracetamol, co-codamol, and remedies for heartburn or indigestion.

Common Painkillers And Remedies To Use With Caution

Anyone prescribed furosemide is advised to speak to a doctor before taking:

• Medicines used to treat mental health conditions, including amisulpride, lithium, pimozide, or risperidone
• Medicines used to treat high blood pressure, or drugs that may cause low blood pressure as a side effect
• Sucralfate, a medicine used to treat stomach ulcers. Patients should leave around two hours between taking sucralfate and furosemide
• Non-steroidal anti-inflammatory drugs, known as NSAIDs, such as diclofenac, ibuprofen, or naproxen

Why Potassium Supplements Can Affect Furosemide?

Other medicines can also interfere with how furosemide works, including:

• Potassium supplements, steroids, or other diuretics that affect potassium levels
• Medicines used to treat, or that may cause, irregular heart rhythms, such as amiodarone, digoxin, disopyramide, flecainide, or sotalol
• Soluble paracetamol
• Soluble co-codamol

Certain Treatments For Heartburn And Indigestion

The NHS advises patients to tell their doctor if they are taking potassium supplements, as these can alter potassium levels in the blood and affect how furosemide works.

The health service also cautions against combining furosemide with herbal remedies or supplements. According to NHS guidance, there is not enough evidence to confirm they are safe to take alongside the drug.

Unlike prescription and pharmacy medicines, herbal products are not tested to the same standards and are generally not assessed for how they interact with other medications.