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.

A study of more than 700 individuals found distinct differences in the mix of bacteria in the mouths and lungs of those with severe long COVID.

Published in the European Respiratory Journal, the study found that differences in the lung microbiome were linked to respiratory problems, cognitive difficulties and digestive symptoms associated with long COVID.

The findings may help researchers understand why some people develop long COVID and identify potential treatments, according to the team from the University of Dundee, UK.

"The microbiome is important to maintain health throughout the body, so it is a strong candidate for something that may contribute to long COVID,” said lead author Dr. Daniela Alferes de Lima Headley.

What Did The Study Find?

The observational study included 771 adults who had been hospitalized for COVID-19 between February 2020 and March 2021. Researchers grouped participants according to the severity of their ongoing health problems and symptoms.

The participants had an average age of 57.5 years, and 38.5% were women.

Six months after hospital discharge, researchers collected saliva samples to examine microbes in the mouth and sputum samples to study the lung microbiome. They used DNA sequencing to identify the microbes and analyze their diversity. Participants also completed questionnaires about their symptoms.

The results showed that people with very severe long COVID had distinct differences in their oral and lung microbiomes compared with those who had fewer ongoing symptoms.

Microbiome differences were also associated with:

• • Respiratory problems: Reduced lung function.
  • Cognitive symptoms: Brain fog, memory problems, and difficulty with attention and concentration.
  • Digestive issues: Abdominal pain, nausea, diarrhea and loss of appetite.

Bacterial Changes Linked To Inflammation

Further, the changes associated with long COVID symptoms also included an increased abundance of bacteria that produce lactic acid. These changes were also linked to signs of inflammation in participants' blood samples.

James Chalmers, chair of respiratory research at the University of Dundee, said the greatest microbiome changes were found in people with the most severe symptoms five to six months after COVID-19.

"We also found that changes in the airway microbiome were linked not just to lung problems, but also to symptoms like brain fog and gut symptoms, suggesting the lung microbiome could have effects on health more broadly," he added.

However, the researchers do not yet know whether these microbiome differences existed before COVID-19 or developed after infection. The long-term effects of these changes also remain unknown.

Could The Findings Lead To New Treatments?

Chalmers said more research is needed to understand what causes long COVID, which continues to affect many people worldwide.

Because the microbiome can be altered through interventions such as antibiotics and probiotics, understanding its role could help researchers explore potential treatment options.

What Is Long COVID?

Long COVID refers to new, returning or ongoing health problems that persist four or more weeks after the initial COVID-19 infection. Symptoms can last for months or even years.

Common symptoms include fatigue, brain fog, memory problems, difficulty concentrating and slowed thinking.

Research has also suggested that brain inflammation may persist even after the virus is no longer detectable.

For some women with endometriosis, getting a diagnosis is only the beginning of a long struggle to access treatment and navigate management.

In Canada, long waitlists for specialist appointments are pushing patients to consider expensive surgery abroad, highlighting how delays in care can prolong pain and disrupt everyday life.

Noelle Menu, 37, from Calgary, said her symptoms intensified after she stopped taking birth control while trying to conceive at 26.

Years of pain, emergency room visits, surgery and delays in specialist care eventually led her and her husband to seek private treatment in Tijuana, Mexico.

After being told that waiting several years to see a specialist in Canada was possible, Menu said: “We can’t deal with it in Canada.”

The couple used their savings and went into debt to pay for treatment at EndoGlobal in Mexico. The total cost was approximately $35,000, including travel, accommodation and other expenses, according to CBC News.

Her experience highlights the delay in addressing endometriosis that can intensify debilitating symptoms.

What Is Endometriosis And Why Can It Be Difficult To Diagnose?

Endometriosis is a chronic condition in which tissue similar to the lining of the uterus grows outside it, potentially affecting the ovaries, bowel, bladder and other areas. The resulting inflammation and scar tissue can cause severe menstrual cramps, persistent pelvic pain, painful sex, bowel or urinary symptoms and difficulties conceiving.

The World Health Organization estimates that endometriosis affects around 10% of reproductive-age women worldwide, or approximately 190 million people.

Diagnosis can be challenging because symptoms vary and may overlap with other conditions. There is no single definitive test that identifies every case. Doctors may use a detailed medical history, pelvic examination, ultrasound or MRI, with surgery sometimes needed to investigate or treat suspected disease.

The WHO estimates that diagnosis commonly takes between four and 12 years, leaving many patients managing symptoms without a clear explanation for prolonged periods.

Also read: Endometriosis: Repurposed Anti-Parasite Drug Shows Promise In Mouse Study

How Do Delays Affect Patients?

For patients with severe disease, waiting for specialist care can mean continuing to live with pain that interferes with work, relationships, sleep and fertility plans.

Another Canadian patient, identified in CBC's report as Papiernik, described discovering that endometriosis had infiltrated her colon after a colonoscopy detected a mass. She was referred for specialist care but faced further waits for an appointment and surgery.

“Living like this for two years was just not an option for me,” she said.

Canada's House of Commons health committee has identified gaps in endometriosis care, while the condition's economic impact includes lost productivity and healthcare costs. The issue is not simply whether treatment exists, but whether patients can access appropriate care before symptoms and complications become harder to manage.

Also read: Urine & Vaginal Samples May Help Detect Womb Cancer: Lancet Study Suggests Less Invasive Way To Triage Patients

Does Surgery Cure Endometriosis?

Surgery can remove endometriosis lesions, adhesions and scar tissue, reducing pain and treating complications. However, it is not a guaranteed cure. Symptoms may persist or return, and treatment decisions depend on disease severity, the organs involved, fertility goals and previous treatment.

Hormonal medicines and pain management can also help control symptoms. Some patients benefit from a combination of medical treatment, surgery and ongoing follow-up.

Travelling abroad may offer faster access to specialist treatment, but it comes with financial costs and other challenges. Patients should consider the surgeon's experience, the facility's standards, the possibility of complications and arrangements for follow-up after returning home.

A routine heart scan helped doctors detect pancreatic cancer in a 72-year-old US woman before it was too late. Vicky Titcomb, a Cape Cod bookstore owner and great-grandmother, underwent the scan at Mass General Brigham in March 2025, before traveling to New York City to visit her son.

Although she felt healthy, the scan revealed an abnormality on her pancreas. Further testing confirmed pancreatic cancer, one of the deadliest forms of cancer, CBS News reported.

“I felt like my life just switched in that moment,” Titcomb said. “It was a very weird feeling.”

Titcomb had undergone treatment for breast cancer in 2012.

In 2025, she was diagnosed with stage 1 breast cancer as well as pancreatic cancer. Doctors also found a mass on her ovary, which proved benign after the ovary was removed.

Why Early Detection Matters In Pancreatic Cancer

Pancreatic cancer is often diagnosed after it has spread to other organs. Its five-year overall survival rate is 13%.

The American Association for Cancer Research noted in its 2026 Cancer Progress Report that pancreatic cancer survival rates have shown little improvement despite advances in cancer care.

Doctors at Mass General Brigham planned chemotherapy and radiation to shrink Titcomb’s pancreatic tumor before surgery.

“I was told the size of the (pancreatic) cancer was about the size of a grape. The goal, to me, was trying to make this cancer a raisin,” she said. “That's the way I visualized it.”

The plan was to perform a Whipple procedure, a complex operation that removes the head of the pancreas, part of the small intestine, the gallbladder and the bile duct. Only about one in five pancreatic cancer patients is eligible for this surgery.

Titcomb’s early diagnosis made the operation possible.

“If I had not had that scan when I did, the outcome would have been bad,” she said.

Chemotherapy, Radiation And Surgery

Titcomb began chemotherapy in June 2025, receiving eight doses over four months. She then underwent three weeks of radiation and additional chemotherapy.

Surgical oncologist Dr. Thomas Clancy said she tolerated the treatment “very well.” The therapy shrank the pancreatic tumor enough for surgery.

On November 4, Titcomb underwent surgery to treat her breast cancer. Just over two weeks later, Clancy performed a robotic Whipple procedure to remove the affected part of her pancreas and other structures.

The operation was successful, and Titcomb said she was walking that night. She returned home after several days in the hospital.

Although she was recovering well, Clancy recommended two more months of chemotherapy because pancreatic cancer can be aggressive.

“There was a lot going on,” Titcomb said. “I just tried to cope with the day-to-day.”

No Evidence Of Cancer After Treatment

In March 2026, after further treatment, Clancy told Titcomb she had no evidence of cancer. She will continue to undergo scans every three months.

“She’s living her life. I generally tell patients at this point, ‘You’re done with therapy ... you go about your days,’” Clancy said. “The goal is to not be thinking about it all the time.”

Titcomb is returning to running her bookstore, which family members helped manage during her treatment. She is also spending time with her children, grandchildren and great-grandchildren, keeping in touch with those who live far away through photos, videos and phone calls.