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.

Schizophrenia is a severe mental disorder characterised by significant disruptions in thought, perception, emotion and social interaction. Classic symptoms of this neurological condition include jumping to conclusions or difficulty adjusting to new information. According to scientists, the symptoms are a result of poor communication between the cerebral cortex and thalamus, which is known as the brain's central switchboard.

Recently, a team of researchers from Tufts University School of Medicine and Vanderbilt University School of Medicine found that the neural pathways of schizophrenics work differently as compared to those without the condition when faced with conflicts in decision making. The discovery was made by measuring brain cell activity between the cerebral cortex and thalamus, as volunteers completed ambiguous tasks.

How Was The Research Performed?

For the research, scientists asked about 40 participants—a mixture of neurotypical individuals and patients with schizophrenia—to correctly choose a target's location based on a sequence of cues. However, the scientists made these cues more or less conflicting. For healthy people, performance was very good even when the conflict was high. But for schizophrenics, there were two different behaviours. They had comparable behaviour to controls when there was little conflict, however, they made many more errors with higher conflict levels, which were tolerated well by controls.

The study is important because over the course of evolution, the human brain has developed a system to make decisions in complicated situations. The prefrontal cortex, specifically the dorsolateral and orbitofrontal areas, is responsible for making decisions. His region integrates information from various brain areas, allows for reasoning and judgment, and ultimately guides decisions that align with our goals and desires.

How Is Brain Impacted During Schizophrenia?

In schizophrenia, the brain experiences structural and chemical changes that disrupt normal thinking, emotions, and behaviour. Research shows that people with schizophrenia often have reduced grey matter volume, particularly in areas involved in memory, emotion, and decision-making, like the hippocampus and prefrontal cortex. Abnormalities in neurotransmitters, especially dopamine and glutamate, also play a key role, leading to symptoms such as hallucinations, delusions, and cognitive difficulties. Connectivity between different brain regions may become impaired, affecting the brain's ability to process information smoothly. These changes typically emerge gradually, often beginning in late adolescence or early adulthood, and vary significantly from person to person.

How To Identify Schizophrenia?

Schizotypal Personality Disorder is part of Cluster A personality disorders. Other disorders in this cluster include paranoid personality disorder and schizoid personality disorder. Individuals with this condition struggle with social and interpersonal skills, especially when forming close relationships. This occurs alongside eccentric behaviour and perceptual or cognitive distortions.

According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), schizophrenia is diagnosed based on a set of specific symptoms. Here's the list of core symptoms:

• Delusions – strong false beliefs not based in reality (e.g., believing you are being persecuted or have special powers).
• Hallucinations – hearing, seeing, or sensing things that aren't actually there (most commonly auditory hallucinations).
• Disorganised speech – frequent derailment, incoherence, or illogical conversation.
• Grossly disorganised or catatonic behavior – unpredictable agitation, inappropriate behaviour, or lack of movement/responsiveness.
• Negative symptoms – diminished emotional expression, reduced motivation (avolition), reduced speech (alogia), social withdrawal, or inability to experience pleasure (anhedonia).

Irritable Bowel Syndrome (IBS) is a complex, often misinterpreted and even misdiagnosed gastrointestinal condition that disproportionately affects women. With symptoms of diarrhea, constipation, bloating, gas, and cramping in the abdomen, IBS may cause life to be significantly altered. However, despite its familiarity, social stigma tends to deter women from seeking needed assistance. Familiarization with the symptoms, risks, and treatments is required for enhancing physical and mental health.

According to the International Foundation for Functional Gastrointestinal Disorders, between 25 to 45 million Americans have IBS, two-thirds of them women—young adults and often. Though no one yet fully understands the underlying cause for the gender disparity, hormonal fluctuations clearly seem to play a strong factor. According to studies, GI symptoms usually get worse at some point during the menstrual cycle, and post-menopausal women with IBS experience worse symptoms, increased fatigue, anxiety, and diminished quality of life.

Hormones such as estrogen and progesterone may also affect the gut, but this relationship is under research. Further, women suffering from gynecological diseases such as endometriosis or PCOS (polycystic ovary syndrome) typically experience increased pelvic and abdominal pain, which points to similar mechanisms for reproductive and gastrointestinal health.

Why IBS Feels More Than Just an Upset Stomach?

IBS is not limited to painful bowel habits- diarrhea and constipation can aggravate or lead to hemorrhoids, and diet restriction for symptom relief can result in nutritional deficiencies. Psychologically, the disease's impact tends to cause isolation, discouragement, and depression, severely impairing quality of life.

New research also points to the gut-brain axis—a communication network between the gut and the brain—that is crucial to IBS. Persistent stress, a widespread problem in women, may worsen symptoms by disrupting this important link. Not surprising, therefore, are anxiety and depression as both risk factors for, and consequences of, IBS.

IBS Symptoms To Watch For

While IBS in itself is not usually troublesome, long-term change in bowel habits may indicate a more serious disorder, like cancer of the colon or rectum. Specialists at Mayo Clinic recommend undergoing medical assessment if the symptoms involve bleeding in the rectum, unexplained loss of weight, or regular change in the bowel movement. Diagnosis usually takes a "diagnosis of exclusion" approach, excluding other gastrointestinal disorders before diagnosing IBS.

Perhaps the most infuriating part of IBS is how it's diagnosed. There's no test to give a firm answer; doctors make educated guesses based on symptom patterns and excluding other possibilities. In a nationwide study conducted at Cedars-Sinai in December 2023, researchers found that IBS is more prevalent than once thought, an observation that speaks volumes about a desperate need for more effective diagnostic testing and education of patients.

While IBS can impact anyone, it tends to be more prevalent among women. Studies show a higher prevalence rate of 12% in women compared to 8.6% in men. Hormonal fluctuations, particularly around the menstrual cycle, appear to play a significant role in how symptoms manifest and intensify.

In fact, many women with IBS report a noticeable worsening of gastrointestinal symptoms during their menstrual periods. This pattern highlights the connection between hormonal changes and gut health. Beyond typical digestive distress, women with IBS frequently encounter a broader set of complications that can affect their overall well-being.

Common Symptoms of IBS in Women:

• Constipation and/or diarrhea, often alternating
• Persistent bloating and abdominal discomfort
• Fatigue and low energy levels
• Exacerbation of menstrual symptoms, such as cramping and pain
• Urinary symptoms, including urgency and frequency
• Chronic pelvic pain that overlaps with gynecological conditions
• Pelvic organ prolapse, especially in severe or long-standing cases
• Painful sexual intercourse (dyspareunia)
• Increased incidence of migraines
• Higher rates of depression and anxiety disorders

Are Your Hormones Making Your Digestive Symptoms Worse?

Hormone Replacement Therapy (HRT) in postmenopausal women does not seem to significantly relieve IBS symptoms, but it can change the gut microbiome—an ecosystem increasingly seen as vital to digestive well-being. Some early data also indicate that the immune systems of women might contribute to IBS development. Since women are more prone to autoimmune disorders, these results present yet another potential explanation for the gender disparity of IBS cases.

Stress isn't solely an issue of mental health—it appears physically, particularly in the stomach. Women, being more susceptible to anxiety and stress, are thus more susceptible to stress-related IBS attacks. The gut-brain axis makes this interaction possible, with distress signals going back and forth between the intestines and the brain. Tackling mental health is thus a necessary part of IBS management.

Why a One-Size-Fits-All Treatment Doesn't Work for IBS in Women?

IBS management is individualized because symptoms and exacerbating factors differ greatly. Gastroenterologists, functional medicine physicians, and nutritionists tend to work together to develop tailored treatment plans. Diet continues to be a fundamental aspect of IBS management, with the low FODMAP diet becoming the gold standard. This entails limiting consumption of certain fermentable carbohydrates that may worsen symptoms.

Alongside dietary treatments, the exploding gut health market provides new choices—from probiotics to fiber supplements—that are de-stigmatizing gut care. And with the global wellness market for gut supplements estimated to grow from $9 billion to $19 billion by 2033, it is unmistakable that both treatment opportunities and public knowledge are shifting.

What is The "Hot Girls Have IBS" Movement?

The catchphrase "Hot Girls Have IBS" came into vogue in 2019, illuminating the prevalence of the disease among young women. What was originally a joking meme has developed into a moving recognition that struggles with gut health are real, prevalent, and not something to be embarrassed about. As gut health becomes an important cornerstone of wellness culture, more women are speaking out, getting help, and initiating frank discussions about something previously considered shameful.

IBS is much more than an in-convenient digestive problem—it's a complex condition that affects physical well-being, emotional health, and overall quality of life. Particularly for women, disproportionately impacted, early recognition of the symptoms and personalized, holistic treatment can turn life with IBS from one of quiet agony to empowered control. As awareness increases and stigma decreases, the future promises well for millions living with this chronic but controllable condition.

“Heartbreaks happen to many people, it’s ok” or “You’ll move on, it’s a heartbreak, not the end of the world” and similar phrases as these are ones we have all heard. However, how much truth these sentences hold has been questioned. Many people experience mental health issues after experiencing heartbreak like depressive episodes and anxiety symptoms. However, did you know that heartbreaks can actually affect your heart?

The pain associated with heartbreaks is often thought of as psychological, but it can actually weaken the ability to pump blood effectively. This is a condition known as the broken heart syndrome, or Takotsubo Cardiomyopathy.

According to the Harvard Health Publishing, it is a sudden change in the shape of the heart's left ventricle, which is its primary pumping chamber. This is a concerning issue as it weakens the heart’s ability to effectively circulate blood throughout the body.

The British Heart Foundation explains that some people, like women over 50s are more susceptible to getting this issue. It could also be an issue if you have other mental health issues like anxiety or depression.

Symptoms Mimic A Heart Attack

Harvard explains that most cases of this syndrome occur in the age frames of 58 to 75. 5% of these women thought they were having a heart attack. The symptoms can indeed be very similar to those of a heart attack and may include:

• Sudden, intense chest pain
• A feeling of pressure or heaviness in the chest
• Difficulty breathing
• Heart palpitations (irregular or forceful heartbeat)
• Feeling faint or lightheaded
• Nausea

Can Stress Cause This Issue?

While the precise cause of Takotsubo cardiomyopathy remains under investigation, medical experts believe that a sudden surge of stress hormones, such as cortisol and adrenaline, triggered by intense emotional distress, plays a significant role. The syndrome often occurs following significant emotional events like bereavement, serious illness, or trauma, which is why it's commonly referred to as 'broken heart syndrome'. But that is not the only reason why you may experience this, other causes may include sudden drop in blood pressure, severe pain, asthma attack, intense fear, serious illnesses or surgery, etc.

When doctors are diagnosing this syndrome, they look for things like, no evidence of blockages in the angiogram, which helps them rule out heart attacks, they also use imaging techniques like echocardiogram, that will show abnormalities in the left ventricle.

Fortunately, it is temporary. The condition is typically managed with medications aimed at reducing the strain on the heart and minimizing the risk of complications. These medications can include:

• Diuretics (to reduce fluid buildup)
• Beta blockers (to slow heart rate and lower blood pressure)
• Blood thinners (to prevent blood clots)

Can You Prevent Broken Heart Syndrome?

While most people recover fully, approximately one in ten patients may experience a recurrence of broken heart syndrome. Additionally, some individuals may have persistent symptoms or lasting changes to the shape of their heart, potentially requiring long-term medication.

Once a person has fully recovered from broken heart syndrome, it is advisable to focus on managing stress levels, adopting a healthy diet, and maintaining regular physical activity to help prevent future episodes.