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.

People with a brain age that exceeds their actual age may be at a higher risk of developing dementia, according to a new JAMA Open study.

Brain aging is the natural, progressive process of structural and chemical changes in the brain over time, resulting in typical age-related cognitive decline, such as slower processing speeds, reduced brain volume (atrophy) and memory lapses.

A machine-learning study by University of California San Francisco and Beth Israel Deaconess Medical Center that was published in March 2026 has now found that a higher brain age for every 10-year gap with the actual age increased dementia risk by nearly 40 percent.

Senior author Yue Leng, MBBS, PhD, associate professor of psychiatry at the UCSF School of Medicine said: "Brain age is calculated from sleep brain waves. We know that brain activity during sleep provides a measurable window into how well the brain is aging."

Leng noted that earlier studies have found treating sleep disorders can change sleep-related brain-wave patterns.

"Better body management, such as lowering body mass index and increasing exercise to reduce the likelihood of apnea, may have an impact. But there's no magic pill to improve brain health.," first author Haoqi Sun, PhD, assistant professor of neurology at Beth Israel Deaconess Medical Center also added.

The researchers noted that the results suggest that improving sleep health could influence brain aging.

What Is Dementia?

Dementia is an umbrella term used to describe a significant decline in mental function that is serious enough to affect everyday life. It commonly impacts memory, thinking, and reasoning skills.

Dementia itself is not a single disease but a collection of symptoms caused by underlying conditions such as Alzheimer’s disease or vascular dementia.

Common signs include memory problems, confusion, difficulty finding words, changes in mood or behaviour and trouble completing familiar tasks.

These symptoms usually worsen over time and are not considered a normal part of ageing. Although there is no cure, treatment options can help manage symptoms, and early diagnosis plays an important role in care planning.

Alzheimer’s Disease: The Leading Cause of Dementia

Alzheimer's disease is one of the most common forms of dementia and mostly affects adults over the age of 65.

About 8.8 million Indians aged 60 and above are estimated to be living with Alzheimer's disease. Over seven million people in the US 65 and older live with the condition and over 100,00 die from it annually.

Alzheimer's disease is believed to be caused by the development of toxic amyloid and beta proteins in the brain, which can accumulate in the brain and damage cells responsible for memory.

Amyloid protein molecules stick together in brain cells, forming clumps called plaques. At the same time, tau proteins twist together in fiber-like strands called tangles. The plaques and tangles block the brain's neurons from sending electrical and chemical signals back and forth.

Over time, this disruption causes permanent damage in the brain that leads to Alzheimer's disease and dementia, causing patients to lose their ability to speak, care for themselves or even respond to the world around them.

While there is no clear cause of Alzheimer's disease, experts believe it can develop due to genetic mutations and lifestyle choices, such as physical inactivity, unhealthy diet and social isolation.

Early symptoms of Alzheimer's disease include forgetting recent events or conversations. Over time, Alzheimer's disease leads to serious memory loss and affects a person's ability to do everyday tasks.

There is no cure for this progressive brain disorder and in advanced stages, loss of brain function can cause dehydration, poor nutrition or infection. These complications can result in death.

While it is commonly known that drinking alcohol heavily can lead to multiple chronic conditions, a new global study suggests that moderately drinking wine can decrease your risk dying from cardiovascular disease by 21 percent.

A group of Chinese researchers who analyzed 340,924 adults in the UK between 2006 and 2022 classified a 12-ounce beer, a 5-ounce glass of wine or a 1.5-ounce shot of liquor each contains about 14 grams of pure alcohol.

Those who consumed less than 20 grams per week, about 1.5 standard drinks, were classified as never or occasional drinkers. The low alcohol consumption group included men who drank more than 20 grams per week but no more than 20 grams per day, and women who drank between 10 grams per day and 20 grams per week.

They found those with high alcohol consumption were 24 percent more likely to die from any cause, 36 percent more likely to die from cancer and 14 percent more likely to die from heart disease.

Additionally, even low intake of spirits such as beer or cider was associated with a nine percent higher risk of dying from cardiovascular disease compared with drinking never or occasionally.

Dr Zhangling Chen, a professor at the Second Xiangya Hospital, Central South University in China and the study’s senior author said: “These findings can help refine guidance, emphasizing that the health risks of alcohol depend not only on the amount of alcohol consumed, but also on the type of beverage."

Talking about how wine could lower death risk, the scientists noted that several factors may account for the differences by alcohol type.

Certain compounds present in red wine, such as polyphenols and antioxidants, may have benefits for cardiovascular health. Wine is also more likely to be consumed with meals and by people who have higher-quality diets and healthier behaviors in general, while spirits, beer and cider are more likely to be consumed outside of meals and were associated with lower overall diet quality and other lifestyle risk factors.

"Taken together, these factors suggest that the type of alcohol, how it is consumed and the associated lifestyle behaviors all contribute to the observed differences in mortality risk," Dr Chen said.

Coronary Artery Disease: The Silent Killer

Despite being as a common heart disease, coronary artery disease (CAD) develops over years and has no clear signs and symptoms apart from a heart attack. The illness begins due to a buildup of fats, cholesterol and other substances known as plaque in and on the artery walls.

Over time, this can cause narrowing or blockage of the coronary arteries and block the supply of oxygen-rich blood to heart which can lead chest pain (angina), shortness of breath and ultimately, heart attacks.

Typically, those above the age of 45, having a biological family member with heart disease, lack of sleep, smoking, consuming saturated fats along with other autoimmune diseases such as lupus and rheumatoid arthritis can increase the risk of developing CAD.

Treatment options may include medicines and surgery. Eating a nutritious diet, getting regular exercise and not smoking can help also prevent CAD and the conditions that can cause it.

Nearly one in 10 Indian adults suffer from CAD and about two million people die from the disease annually. Apart from this, about 18 to 20 million American adults aged 20 and older are also affected about the disease.

Strokes: A Rising Crisis In India

Additionally, heart strokes are also one of the leading global health burdens, causing significant deaths and disability worldwide, including in India. Compared to Western countries, stroke also tends to occur at a younger age and is associated with a higher case fatality rate in the country.

One in seven stroke patients in India are young adults aged below 45 years, with hypertension leading as the major risk factor, according to a study by the Indian Council of Medical Research (ICMR).

The Global Burden of Disease Study 2021 identified hypertension, air pollution, tobacco smoking, high cholesterol, increased salt intake, and diabetes as the leading risk factors of stroke.

Incidence of stroke is increasing significantly in low- and middle-income countries (LMICs), especially in India, due to population growth, aging, and greater exposure to risk factors.

If you think that injections of botulinum toxin -- commonly known as Botox -- are only used to make skin wrinkle-free, you may be mistaken.

A new study led by US researchers has shown that Botox injections can act as a “rescue therapy” to treat conditions such as finger ulcers, digital ischemia, and gangrene that are difficult to manage with standard therapies.

Finger ulcers (or digital ulcers) are painful open sores, while acute digital ischemia causes the fingers to become extremely painful, cold, and sometimes pale or bluish in color. Gangrene is the dangerous death of body tissue (necrosis), often turning skin black, green, or purple.

These debilitating complications, often associated with conditions like lupus, rheumatoid arthritis, systemic sclerosis, or bacterial infections, are caused by reduced blood flow to the fingers and heal poorly.

Botox injections, which work by reducing blood vessel constriction and improving circulation, may help achieve complete healing of lesions in more than 85 percent of such patients, according to a study recently published in JAMA Dermatology.

“These new findings are particularly important because therapeutic options remain limited for the cutaneous and vascular manifestations of systemic sclerosis and other autoimmune diseases,” said Dr. Netchiporouk, a scientist in the Infectious Diseases and Immunity in Global Health Program at the Research Institute of the McGill University Health Center.

Netchiporouk noted that the available vasodilator and immunosuppressive treatments are generally administered intravenously.

In contrast to Botox injections, these are also costly, minimally effective, and associated with significant adverse effects.

Also read: Botox Helped Her Burp: How Injectables Changed A 25-Year-Old's Life

The study also described the case of a 50-year-old man with a rare autoimmune disease that caused joint pain and digital necrosis (gangrene).

While traditional medications helped reduce his pain, he was forced to stop working, and the condition severely impacted his quality of life.

However, after receiving botulinum toxin injections, his pain was relieved, and sensation improved within 24 hours, and the necrosis began to improve within two weeks.

“This treatment has become an important tool, especially for patients with autoimmune vascular diseases that result in serious health consequences and for which there are few therapeutic options,” Netchiporouk said.

Also read: Why Regulatory Clarity Is Important for Safe Aesthetic Procedures in India

Botox: Safe, With Minimal Adverse Effects

The study, based on a systematic review and individual patient data meta-analysis of 30 published studies and one unpublished case involving 119 patients, found that only a few patients experienced adverse effects.

These were generally mild and short-lived, most commonly temporary muscle weakness or pain at the injection site.

“Our results show that botulinum toxin can improve blood circulation in the fingers and treat serious complications such as ulcers or gangrene, offering a safe and easy-to-administer alternative,” said Dr. Catherine Zhu, a dermatology resident at the McGill University Health Center.

Zhu added that the injections can be easily administered by rheumatologists and dermatologists in outpatient settings, reducing reliance on intravenous therapies that require hospitalization and increasing overall healthcare costs.

Importantly, in most cases, a single injection session was sufficient to achieve the desired response.

“Botulinum toxin can offer significant benefits with a favorable safety profile. It deserves further study to develop standardized protocols and optimize outcomes,” said Dr. Netchiporouk.