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.

The current treatment course for high cholesterol is taking a daily tablet or regular injections over a long period. But instead, could a single treatment change the way high cholesterol is treated?

This possibility is being explored after a small first-in-human trial conducted by Cleveland Clinic found that one infusion of an experimental CRISPR gene-editing therapy lowered LDL, also called bad cholesterol, by about half and that the effect was still present a year later.

The treatment, called CTX310, is still experimental. The study involved just 15 people, so the findings are premature, not evidence that CRISPR can replace statins or other cholesterol medications.

About The Study

The Phase 1 trial included people with lipid disorders who had not responded adequately to existing medications.

Participants received a single infusion of CTX310, at different doses, and researchers followed them for 12 months.

At the highest dose, LDL cholesterol was reduced by 52.5% after one year, while triglycerides fell by 47.8%. The reductions seen earlier in the trial therefore persisted for at least 12 months.

Additionally, no serious adverse side effects related to the treatment were reported during the one-year follow-up. However, the researchers plan to continue monitoring participants for 15 years, as recommended for gene-editing therapies.

Also read: Inflammation May Be Quietly Changing Your Heart: Study Finds 43% Higher Risk Of Heart Attack & Stroke

How Does The CRISPR Treatment Work?

CTX310 operates differently compared to conventional cholesterol medicines. The treatment uses CRISPR-Cas9 gene editing to target ANGPTL3, a gene involved in regulating fats circulating in the blood.

The therapy delivers the gene-editing machinery to the liver, where it switches off ANGPTL3. Lower activity of this gene can reduce levels of LDL cholesterol and triglycerides.

The idea is that instead of using daily medicines to keep cholesterol in check, doctors could make a long-lasting genetic change.

Also read: Preeclampsia May End With Pregnancy. Your Heart Risk May Not

What Does It Mean For Statins?

Statins remain a reliable treatment approach for lowering LDL cholesterol and reducing cardiovascular risk. CTX310 has only been tested in a very small Phase 1 trial. Also, the study was primarily designed to examine the safety and explore whether the gene-editing treatment could produce a meaningful effect.

The fact that LDL remained lower after one year is promising and encouraging, but researchers still need to determine whether the treatment can safely maintain its effects over many years and, crucially, whether it reduces heart attacks, strokes and other cardiovascular events.

There is also a fundamental difference between cholesterol tablets and permanently altering a person’s DNA.

Promising Cholesterol Treatment Approach

High cholesterol is often a long-term condition. Depending on their risk, patients may need cholesterol-lowering treatment for many years.

If CRISPR becomes a reality, people may no longer have to stick to a chronic treatment strategy for managing cholesterol.

"Building upon the initial data presented in November 2025, the durability of the lipid-lowering effect was impressive," said Cleveland Clinic cardiologist Luke Laffin, M.D., first author of the study. "It is encouraging that there were no serious safety events related to CTX310 in the trial and in the year following treatment. We look forward to continuing to investigate this therapy in a larger number of patients."

At 22, the young woman had little reason to think she would soon be facing a major cardiac surgery. Newly married and otherwise healthy, she suddenly lost movement in her right arm and leg. Her family was devastated and struggled to understand how a young, healthy woman could have suffered a stroke.

Investigations revealed an unusual cause: a tumour in her heart, with a small piece believed to have broken away and travelled into the blood vessels supplying her brain. She was advised to undergo immediate open-heart surgery to remove the tumour.

But the prospect of open-heart surgery frightened her. Despite repeated counselling, she refused the procedure. Two months later, she suffered a second stroke. This time, she lost much of her ability to speak and eat, while her heart function had also fallen to 35%. Once again, open-heart surgery was advised. Once again, she refused.

Her Condition Worsened As Treatment Was Delayed

Over the next three months, her condition continued to deteriorate. She weighed only 35 kg, was weak and withdrawn, and required feeding through a Ryle's tube. Her husband continued looking for another option.

A neighbour eventually suggested that the family consult a doctor in Kolkata who performed robotic heart surgery. The family approached Dr Soumya Guha, Cardiothoracic and Vascular Surgeon, BM Birla Heart Hospital, initially through an online consultation, as the young woman was unwilling to visit a hospital.

This was an extremely high-risk case. She had already suffered two strokes, her heart function had come down to 35%, she was severely underweight at 35 kg and was physically very weak. The tumour was also large. Given her condition and the complexity of the surgery, I was initially reluctant to take up the case for robotic heart surgery. But the family was desperate, and we felt that if we could first improve her physical condition and prepare her psychologically, we could give her a chance. She needed to be built up before we could think of taking her safely through such a major procedure.

The team therefore spent time preparing her for surgery, working to improve her nutritional and physical condition while counselling her repeatedly to help her overcome her fear of surgery. Once she was considered ready, she was brought to Kolkata.

Also read: From 365 Shots To 52: How Could Lilly’s Newly-Approved Weekly Insulin Injection Change Diabetes Care

Two Tumours Found During Robotic Heart Surgery

The surgery presented another unexpected finding. What had been thought to be a single cardiac tumour turned out to be two tumours in the heart. Both were removed using robotic heart surgery.

Given her small body size, weakness and small blood vessels, the procedure required additional precautions during cardiopulmonary bypass. The team used artificial conduits to establish bypass and employed NIRS monitoring along with multiple filtration modes to support her during the procedure.

Rehabilitation Helps Her Regain Movement, Speech And Swallowing

Her recovery was also a major part of the treatment. Following surgery, she underwent extensive physical rehabilitation along with speech and swallowing therapy. Nursing, intensive care, physiotherapy, dietary support and ward care were all part of the recovery process, with the hospital administration also providing financial assistance to the family.

Today, the young woman is able to stand and walk on her own. She has begun speaking a few words and has progressed from Ryle's tube feeding to eating small amounts of mashed food.

For her family, the change has been remarkable: from watching a young woman suffer two strokes and gradually lose her ability to speak and eat, to seeing her prepare to return home on her own feet.

The surgery was only one part of this patient's journey. Given how weak she was, getting her through the operation safely was important, but helping her regain movement, speech and swallowing afterwards was equally important. This required the efforts of the surgical and anaesthesia teams, perfusionists, nursing staff, ICU and ward teams, physiotherapists, speech and swallowing rehabilitation and the dietician. The support from the hospital administration also made a difference to the family. Every one of these teams had a role to play in getting her to where she is today.

While dementia is generally associated with older age, its onset can begin much earlier, including in middle age. A new study led by an international team of researchers found that muscle loss as people age may be an important warning sign for dementia risk.

The study, published in the International Journal of Food Sciences and Nutrition, also found a surprising difference in how obesity was linked to dementia depending on a person’s age.

What Did The Study Find?

Researchers analyzed more than 80 studies examining the links between body weight, body fat, muscle health and dementia.

They found that people with sarcopenia — the loss of muscle mass and strength — had a 42 per cent higher risk of dementia.

People with obesity in middle age, or before 65, had a nine per cent higher risk of dementia. In contrast, obesity in people aged 65 and over was linked to a 17 per cent lower risk.

The findings showed that body weight alone did not tell the full story when it came to dementia risk.

“It’s not just about how much you weigh – maintaining muscle strength and function also appears to be important as we age,” said lead researcher Dr Uraiporn Booranasuksakul from Burapha University, Thailand.

“Our findings suggest losing muscle could be an important warning sign for dementia risk.”

Why Muscle Health Matters

Sarcopenia is a condition where people lose a greater amount of muscle mass, strength and physical function, often as they get older.

Dr Booranasuksakul said the findings highlighted the importance of looking after muscle health throughout life.

“Maintaining muscle is an important part of healthy ageing, and regular physical activity and good nutrition can help support muscle strength and function,” she said.

Obesity And Dementia Risk Change With Age

Corresponding author Professor Mario Siervo from Curtin University’s School of Population Health said the findings also challenged the idea that dementia risk could be understood simply by looking at a person’s weight.

“We found that obesity in middle age was linked to a higher risk of dementia, but this relationship changed in later life,” Professor Siervo said.

“This does not mean people should gain weight as they get older. Rather, it shows us that the relationship between body weight, ageing and dementia is complex.”

What About Sarcopenic Obesity?

The researchers also looked at sarcopenic obesity, where a person has both low muscle mass or function and excess body fat.

Only four studies met the criteria for this part of the analysis, and researchers found no statistically significant link between sarcopenic obesity and dementia.

Professor Siervo said more research was needed to understand whether the combination of muscle loss and excess body fat affected dementia risk.

“There is still a lot we don’t know about how changes in muscle and body fat interact over time,” Professor Siervo said.

“More long-term research is needed to understand whether having both low muscle mass and excess body fat increases dementia risk.”

A Lifelong Approach To Healthy Ageing

The researchers said the findings reinforced the importance of taking a lifelong approach to maintaining healthy body composition, including preventing unhealthy weight gain during middle age and maintaining muscle strength and function as people get older.