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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Parkinson’s disease is characterized by slowness of daily activities, rigidity, and tremors with gait issues, commonly seen after the age of 45-50 years.
It is two times more common in men than women, though clinical features, response to the treatment, and prognosis are different in women as compared to men. From subtle early signs to how the condition develops over time, gender can shape the Parkinson’s journey in important ways.
Women usually experience Parkinson’s disease at a later age, but with faster progression of symptoms as compared to men. There is a need for more research in this space; however, we will try to shed light on these differences in Parkinson's trajectories in men and women based on available evidence.
Estrogen, a group of primary female sex hormones, is neuroprotective and protects dopaminergic neurons in women; women also have a higher baseline reserve of dopaminergic neurons. Hence, Parkinsonism is less common in women.
In the post-menopausal period, once this estrogen-related neuroprotective effect disappears, Parkinson’s symptoms progress rapidly. Motor symptoms emerge later in women with tremors, rigidity, and gait disturbances being more common and severe. Freezing of gait and postural instability with falls are more common in women.
Non-motor symptoms like pain, fatigue, autonomic disturbances, sleep disorders, constipation, and mood disorders, including depression and anxiety, are more common and severe in women. Men with Parkinson’s disease have worse general cognitive abilities; however, women have worse visuospatial abilities.
Women with Parkinson’s receive less social support, lower quality care, attend medical appointments alone, and report more psychological stress. Women have a lower body mass index and higher bioavailability of levodopa, which makes them more susceptible to the side effects of levodopa, such as motor fluctuations and dyskinesia, which entail involuntary movements like fidgeting and writhing.
There is a clear need for personalized and tailored treatment. The different and distinctive clinical features in women, like later onset, higher tremors and rigidity, higher dyskinesia and motor fluctuations from drugs, and worse non-motor symptoms, require tailored, sex-specific treatment strategies rather than a “one-size-fits-all” approach.
Clinicians must give importance to the screening and management of non-motor symptoms in women, which are the main factors of their decreased quality of life. Women with this ailment go through longer delays in diagnosis and less access to specialists, highlighting a need for better healthcare access for women.
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While HPV vaccines are most known for preventing cervical cancer, a top US doctor says they can also help curb the rising incidence of head and neck cancers.
According to Mikkael A. Sekeres, Chief of the Division of Hematology and Professor of Medicine at the Sylvester Comprehensive Cancer Center at the University of Miami, Human papillomavirus (HPV) — the same sexually transmitted virus that can infect the genital area and lead to cervical cancer — is now the greatest risk factor for head and neck cancer.
Writing in The Washington Post, Sekeres noted that HPV accounts for about 30 per cent of oropharyngeal cancer worldwide.
HPV is believed to be responsible for the recent rise in head and neck cancers, which include malignancies affecting the mouth and throat (oral cavity and pharynx), voice box (larynx), sinuses and nasal cavities, and salivary glands.
Sekeres said the US records about 60,000 new cases of head and neck cancers each year, while the global incidence is expected to rise by 30 per cent by 2030.
The expert noted that men develop oral cavity and pharynx cancers at approximately 2.5 times the rate of women.
Major risk factors include:
Also read: PM Modi Launches Nationwide Free HPV Vaccination Drive; A Landmark Step, Says WHO
The Centers for Disease Control and Prevention (CDC) estimates that the high-risk HPV subtypes most associated with head and neck cancers are detectable in the mouths of 4 per cent of adults aged 18 to 69.
While a pap test detects early-stage cervical cancer in women, no such test exists for penile, anal, or head and neck cancers in men, which can worsen their survival rate.
Thus, Sekeres said: “The best way to prevent the most common types of HPV is through vaccination, with two doses of the vaccine recommended for children at age 11 or 12, or starting as early as 9 years and up to age 26 for those who missed it as a child".
He noted that although the vaccine is approved for use up to age 45, it is generally less beneficial after age 26 because many individuals may have already been exposed to HPV. However, doctors can help determine whether vaccination may still be beneficial for adults.
Earlier this year, the European Cancer Organization also urged broader HPV vaccination regardless of gender.
“HPV affects everyone, regardless of gender. It can lead to cancers of the cervix, mouth and throat, anus and penis. This is why universal protection is so important,” the organization said in a social media post.
Read More: Who Needs HPV Vaccine? Guide For Every Parent, Teen And Adult
A 2026 study published in JAMA Oncology found that boys and men who received the HPV vaccine between the ages of 9 and 26 were nearly 50 per cent less likely to develop cancers of the head and neck, esophagus, anus, or penis.
The findings, based on data of more than 510,000 boys and men, highlight the importance of vaccinating all children and adolescents against HPV, said Taito Kitano, first author of the study and a researcher at Nara Prefecture General Medical Center in Japan.
“Children, adolescents, parents and health care workers should be more informed about the expected benefits of the HPV vaccine, not just cervical cancer,” Kitano said.
Credit: FIFA
FIFA has launched a groundbreaking initiative aimed at advancing research and knowledge to boost health and performance of female athletes.
The FIFA Female Health and Performance Project comes ahead of the tenth edition of the FIFA Women's World Cup, which is scheduled to take place in Brazil next year.
The initiative aims to provide specialist, science-based educational resources tailored to the preparation and development of female athletes. It also seeks to close long-standing gaps in understanding the unique health and performance needs of female players, many of whom still lack access to the scientific data needed to support their development and optimize performance.
“FIFA’s aim is to optimize every female footballer’s health, well-being and performance, and to improve knowledge around women and girls in football at every level of the game,” said Sarai Bareman, FIFA’s Chief Women’s Football Officer.
“Collectively, we can do so much more to better support our growing number of female players and ensure they are trained, supported and understood according to their specific needs as women.”
Also read: Can Running Marathons Or Ultramarathons Raise Colon Cancer Risk?
A study analyzing 5,261 research articles published in sport and exercise science journals between 2014 and 2020 found that only 34% of study participants were female, while just 6% of sport science research focused exclusively on women.
Only 8% of elite female athletes have sufficient knowledge about how the menstrual cycle may affect training and performance.
Many training methodologies, workload models and performance benchmarks used in sport have historically been derived from male athlete data, requiring female athletes to adapt to systems that may not accurately reflect their physiological characteristics.
The initiative is designed to provide a comprehensive understanding of the female athlete, her individual needs, her environment and the tailored support required to optimize health and performance.
The educational modules cover universal topics in football and elite sport science, including sleep, recovery, strength and conditioning, all examined through the lens of the female athlete.
Female-specific topics such as physiology, pregnancy, postpartum health and menopause are also included.
Four separate learning levels — from “Introduction” to “Integrated” — provide tailored information for a wide range of audiences, from sports professionals to members of the general public.
Read More: Hepatologist Recommends 9 Most Effective Exercises For Better Liver Health
In addition to improving access to knowledge and education, the initiative aims to break taboos, normalize language, eliminate social stigma, encourage open communication and establish a supportive environment in which female athletes can thrive.
“We need to normalize conversations around female health and embrace this, using it to our advantage instead of ignoring it or being fearful of discussing it,” Bareman added. “It is not a weakness; it is a strength.”
Key areas covered by the project include:
Available to all through FIFA’s Training Centre platform, the FIFA Female Health and Performance education modules are the result of collaboration with leading experts to generate, curate and apply the scientific evidence underpinning the program.
All 211 FIFA Member Associations will have access to specialised, peer-reviewed, science-based information through 13 tailor-made educational modules.
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