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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Changes in voice pitch, volume or clarity in older adults could be an early warning sign of cognitive decline, according to a new analysis.
The study, published in the Journal of Voice, found that older adults who experienced a decline in voice quality had a higher risk of cognitive impairment or dementia than those without a voice disorder.
The study tracked the health of more than 833,000 older Americans. Researchers found that people with a voice disorder had a 58% higher risk of cognitive impairment or dementia than those without voice problems.
The risk was even higher among people who had both a voice disorder and hearing loss, a well-recognized risk factor for Alzheimer’s disease.
A brief episode of hoarseness does not mean that a person is developing dementia.
However, persistent or noticeable changes in the voice, particularly when accompanied by hearing loss, may warrant a medical evaluation and, where appropriate, an assessment of cognitive health.
“We found the strongest link with dementia among patients experiencing a voice disorder and hearing loss,” said study author Dr. Robert Sataloff, a professor and chair at Drexel University’s College of Medicine.
“Importantly, we found that those with a voice disorder and no hearing loss were at greater risk than patients who experience hearing loss only. It may be valuable for many of these patients to talk with an otolaryngologist who can arrange a cognitive assessment to help patients develop an appropriate care plan.”
Read More: Muscle Loss In Middle Age May Signal Dementia Risk, Study Finds
The researchers speculate that voice disorders may contribute to cognitive decline by limiting social interaction, which can also be affected by hearing loss.
People who have difficulty speaking or hearing may avoid social gatherings or group activities because they feel embarrassed or uncomfortable about their limitations. However, social engagement can help keep the ageing brain active by providing ongoing mental stimulation.
“If you have a voice disorder that impacts how your voice sounds or if it’s painful when you attempt to talk or sing, it’s only natural to participate less often in brain-supporting social or other engaging activities,” Dr. Sataloff said.
Speaking less may mean less social and cognitive stimulation, which could potentially contribute to dementia risk. However, the researchers also noted another possibility: changes in the brain associated with dementia could themselves contribute to voice problems. However, this has not been directly studied.
Most people with voice disorders will not go on to develop Alzheimer’s disease. Voice changes can have several other causes, including thyroid problems and cysts on the vocal cords, some of which can be treated effectively.
Speech therapists can also help people with impaired speech communicate more effectively and confidently.
Seeking medical attention for persistent voice changes can therefore help identify treatable causes and determine whether further evaluation, including a cognitive assessment, is needed.
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As the 2026-27 flu season begins in the US, doctors are reminding people that influenza can cause more than just cough, fever and a runny nose. Symptoms can come on suddenly and affect the entire body, with some patients also developing gastrointestinal symptoms.
During the 2025-2026 flu season, influenza caused at least 32 million illnesses, 390,000 hospitalizations and 24,000 deaths in the US, according to preliminary data from the Centers for Disease Control and Prevention (CDC).
According to the World Health Organization, from February through August 2026, influenza A(H1N1)pdm09, A(H3N2) and influenza B viruses circulated across regions. Influenza A viruses predominated in most regions, while influenza B dominated in Northern and Western Africa, North America and Eastern Asia.
While it is too early to know what the season ahead will look like, knowing the range of flu symptoms can help people recognize the infection. These include the classic symptoms of sudden fever, chills, body aches and extreme fatigue, as well as vomiting and diarrhea in some children.
Also read: WHO Sets 2027 Flu Vaccine Strains; US States Can Now Order Free COVID Shots For Kids
Influenza commonly affects the nose, throat and lungs, but its symptoms can be widespread.
The most common symptoms include:
Family physician Carlos Galindo at Texas Health Family Care said fever, chills and body aches are the classic flu combination. People may also develop a sore throat, runny nose and headache, according to the American Medical Association.
Unlike the gradual tiredness that can accompany a cold, flu-related fatigue can be intense.
Galindo described it as significant lethargy and malaise, with some patients feeling completely drained.
One of the key features doctors want people to recognize is how quickly influenza can make someone feel unwell.
Family physician Christopher Zipp of Atlantic Health in Morristown, New Jersey, said flu symptoms can develop over just a few hours, with fever, chills and body aches appearing suddenly.
However, flu symptoms can overlap with those of other respiratory infections, so symptoms alone cannot always confirm that someone has influenza.
Read More: Fall Vaccines 2026: US Doctors Issue COVID, Flu And RSV Jab Guidance
Flu symptoms can also differ between children and adults. While fever, chills, body aches and respiratory symptoms are common, children may also develop gastrointestinal symptoms such as vomiting and diarrhea.
These symptoms can occur alongside cough, sore throat or other signs of respiratory infection.
For most people, influenza is an unpleasant but temporary illness. However, it can sometimes lead to complications such as pneumonia and hospitalization, particularly in people with underlying health conditions.
Symptoms that become severe or worsen rather than improve warrant medical attention, especially among people at higher risk of complications.
In the US, many flu cases are seen between January and March, although influenza can circulate outside the peak season as well.
Doctors generally recommend flu vaccination around September or October to build protection before activity increases. It takes about two weeks for the body to develop protection after vaccination. Flu vaccination has been shown to reduce flu-related doctor visits by about 40% to 60%.
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A mammogram is routinely used to detect early signs of breast cancer, but the imaging test may also provide clues about a woman’s cardiovascular health.
Cardiovascular disease is a major cause of death among women. Yet, experts say heart disease in women can be overlooked because symptoms and risk factors may differ from the patterns traditionally associated with men.
Prof Rob Galloway of University Hospitals Sussex NHS Foundation Trust, writing in the Daily Mail, highlighted the need to identify cardiovascular disease in women earlier.
Citing a 2021 The Lancet study, he noted that women with cardiovascular disease remain “understudied, under-recognized, underdiagnosed, and undertreated.”
Galloway said he regularly sees women, particularly those in their 60s, arriving in emergency care with heart attacks after earlier symptoms were attributed to less serious causes.
“If that had been recognized, she could have been admitted, and if needed, had a stent (a mesh tube) inserted to open the artery before it was blocked,” he wrote.
“The truth is doctors are not as good as we should be at recognizing heart disease in women, or understanding their risk,” he added.
Also read: New Breast Cancer Guidelines Recommend Mammograms Every Two Years for Women
Women may experience heart attacks differently, with symptoms such as breathlessness, nausea, fatigue, or back, neck and jaw pain. Galloway also highlighted female-specific risk factors, which include:
He said these factors are not always routinely included when assessing a woman’s long-term cardiovascular risk.
Read More: World Heart Day: You Feel Healthy. But Plaque May Already Be Building In Your Arteries In Your 20s
Prof Galloway suggested that routine breast screening could potentially offer another opportunity to identify cardiovascular risk.
When blood vessels are damaged, calcium can accumulate in their walls. Mammograms can sometimes detect calcium deposits in the arteries of the breast, known as breast arterial calcification (BAC).
BAC is different from calcium buildup in the coronary arteries, but its presence has been associated with a higher risk of cardiovascular events such as heart attack and stroke. Some radiologists may therefore flag the finding to the treating doctor.
Prof Galloway also discussed the potential role of artificial intelligence in identifying and measuring breast arterial calcification.
A European Heart Journal study used AI to assess mammograms from over 123,500 US women. Compared with no calcification, mild breast arterial calcification was linked to a 30% higher cardiovascular event risk, moderate to 75–80% higher risk, and severe to roughly three times higher risk.
The association persisted even after researchers accounted for established cardiovascular risk factors such as obesity and smoking.
Prof Galloway said that the potential advantage is that the mammogram has already been performed for breast screening. If arterial calcification is identified, that information could potentially be included with the screening result and prompt a broader cardiovascular risk assessment.
Depending on the woman's overall risk, doctors could then consider measures such as more intensive management of blood pressure or cholesterol.
A coronary artery calcium scan is another way to assess calcium buildup in the arteries supplying the heart. It uses a CT scan to detect and measure coronary artery calcium and can help inform cardiovascular risk assessment in appropriate patients.
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