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.

Awareness about mental health has grown, but access to care remains a challenge. For women, stigma is only one barrier. Social and family responsibilities, financial dependence, caregiving, geographical gaps, and the tendency to dismiss symptoms as “hormonal” can also delay care, said experts on World Suicide Prevention Day 2026.

HealthandMe spoke to mental health experts about why awareness has not translated into equitable access to care.

WHO estimates that 6.9% of adult women globally have depression, compared with 4.6% of adult men — making depression about 1.5 times more common among women.

“Awareness has grown faster than access, but this isn't a gap women are failing to close on their own; it's a reflection of where women are placed in our social and family structures to begin with,” Dr Kavita, Child and Adolescent Psychiatrist, Founding Cohort Member, India Mental Health Alliance and Co-founder, Children First, told HealthandMe.

She said the gaps extend across diagnosis, research, interventions and care pathways. “Currently, care pathways, definitions, interventions and policies do not center women,” she said.

Why Women Delay Mental Healthcare

Dr Mimansa Singh Tanwar, Senior Clinical Psychologist and Head of the Fortis School Mental Health Program, said stigma is compounded by social and cultural barriers.

“Gender roles, unequal distribution of power, financial dependence, even the caregiving responsibilities, safety concerns, all of these are some of the social and cultural factors that affect women's access to mental health care,” she said.

Women may also put family responsibilities ahead of their own health.

“Women still tend to forego care because of the added responsibility that they continue to have when it comes to taking care of family and other responsibilities,” Tanwar told HealthandMe.

Dr Priyanka Mittal, Clinical Psychologist and Lead, IMHA, said financial dependence can limit women's ability to seek care.

“When a woman doesn't control her own finances, seeking help for her mental health isn't a decision she gets to make independently,” she said.

The expert highlighted how women's distress are often minimized.

“She's called ‘sensitive,’ ‘hormonal,’ or ‘going through her problems’ — rather than recognized as someone with a mental health concern worth addressing,” Mittal told HealthandMe.

When Symptoms Are Dismissed As ‘Hormonal’

Pregnancy, postpartum, perimenopause and menopause can involve biological changes that affect mood. But experts caution against treating persistent distress as simply hormonal.

WHO estimates that about 10% of pregnant women and 13% of women who have recently given birth experience a mental disorder, primarily depression.

“While there are biological changes that can affect our mood and can lead to anxiety, depression, irritability, and emotional exhaustion, these biological changes should not be only connoted as being hormonal and phase-like,” Tanwar said.

Dr Jothi Neeraja, Founder, Chairwoman and MD, Maarga MindCare Hospitals, said women's distress is often attributed to life circumstances rather than recognised as a mental health concern.

“During pregnancy, after childbirth and around menopause, symptoms may also be attributed only to hormonal changes,” she said.

Dr Kavita said even well-meaning explanations can delay care.

“A lot of it comes from genuinely well-meaning explanations,” she said. “Mood changes after childbirth are common, so families, and sometimes clinicians, default to ‘it's just hormones’ or ‘every new mother feels this way.’”

“Duration, severity and functional impact matter more than the explanation someone reaches for,” she said.

Rural Women Face Another Care Gap

The experts noted that access to mental health can be even more limited outside urban centers.

“If a woman reaches a medical system at all, it's usually a PHC, and usually for an emergency or childbirth — not for mental health,” Mittal said.

Tele-services such as Tele-MANAS and other free or affordable services have started helping bridge some of the gap, particularly in tier-two and rural areas, she said.

Dr Kavita also pointed to gaps in community-level mental health infrastructure, saying services closer to women may be too limited to provide meaningful care.

Access Is Not Enough

Starting treatment does not guarantee continuity of care. “Even if, let's say, care is started, the continuity with which one is able to maintain that may not be there again because of the multiple responsibilities that they have to bear,” Tanwar said.

Neeraja said mental healthcare must extend beyond helplines. “For women, however, access cannot end with a helpline,” she said.

She called for continuity of care, affordable specialists, screening through reproductive and primary healthcare services, privacy and stronger referral systems.

“Mental healthcare becomes meaningful when seeking help is easy, safe and followed by appropriate care,” she said.

Mittal described treatment as a chain in which every step matters.

“It's a series of events... you need to know it exists, then know where to go, then know the steps that follow. Miss any link, and the cycle of treatment or intervention breaks,” she said.

Building Women-Centered Mental Healthcare

The experts said mental healthcare should be integrated into services women already use.

“It would meet women where they already are, rather than expecting them to seek out psychiatry or therapy separately,” Dr Kavita said.

This could include mental health screening during antenatal and postnatal visits, training obstetricians and gynecologists to identify concerns, and helping primary-care providers recognise warning signs.

Families and partners can also play a role in recognizing changes and encouraging women to seek help.

Awareness, the experts said, must ultimately translate into accessible, affordable and continuous care. “Women-centered care isn't a separate track; it's the standard track for care, done well,” Dr Kavita said...

Not all of us are able to drift off soundly in a completely blacked-out bedroom. So, if you need a little light to fall asleep, you may need to reconsider the habit as a new study suggests that it could be harmful for your heart.

The study does not recommend a minimum amount of light that could be suitable for sleeping and indirectly heart health. It says that even the dimmest light may not work in your favour.

Researchers have found that people exposed to higher levels of light while sleeping showed changes in the structure and function of their hearts several years later. The findings has therefore raised concerns that nighttime light exposure may be another cardiovascular risk factor that could be modifiable.

More About The Study

The research, led by Professor Lu Qi of Tulane University, involved more than 11,000 UK adults. Participants wore light sensors on their wrists for a week, allowing researchers to estimate how much light they were exposed to during nighttime sleep.

Around three years later, participants underwent cardiac MRI scans. Researchers then compared their heart structure and function with their previous nighttime light exposure.

People exposed to 3 lux or more of light during sleep showed greater changes in their hearts compared with those sleeping in darker environments.

These included thickening of the wall of the left ventricle, the heart's main pumping chamber. The researchers also observed early signs of impaired heart function and changes involving the right ventricle and left atrium.

Also read: Are GLP-1 Drugs Actually Changing Asthma Biology, Or Are People Simply Having Fewer Attack Due To Weight Loss?

'Cardiac Remodelling'

The changes identified by researchers fall under the term called 'cardiac remodelling'. Professor Qi explained that cardiac remodelling typically occurs when the heart biologically adapts to chronic stress or injury.

Over time, these structural changes can affect how efficiently the heart pumps blood and may contribute to heart failure.

“Light pollution has emerged as a new risk factor for cardiovascular disease,” Qi said, adding that reducing nighttime light exposure could become one strategy for preventing cardiovascular disease.

But this does not mean that every person who sleeps with a light on is damaging their heart. The study was observational, meaning researchers could identify a relationship but could not establish that light itself caused the cardiac changes.

Also read: This Common Heart Attack Risk Starts Silently In Healthy People In Their 20s

How Could Nighttime Light Exposure Affect Heart?

A possible explanation that could explain the association between heart and nighttime light exposure is is the body's circadian rhythm. It is our internal 24-hour clock that regulates sleep, hormones and other physiological processes.

Light at night can signal the brain that it is still daytime, which could interfere with melatonin production and normal sleep-wake regulation. Poor or disrupted sleep can, in turn, affect multiple processes connected to cardiovascular health, including blood pressure and metabolism.

Previous research has also linked greater nighttime light exposure with higher risks of cardiovascular disease.

How Dark Should Your Bedroom Be?

The researchers and an accompanying editorial suggest reducing unnecessary light exposure during sleep.

Simple measures include using blackout curtains, covering bright electronic LEDs and avoiding unnecessary screens or strong lighting close to bedtime. The editorial also recommends warmer-coloured bedside lighting if illumination is necessary.

“I wish I could disappear.” “I don’t want to wake up tomorrow.” “I can’t do this anymore.”

Not every expression of wanting to disappear means a person wants to die. But experts say changes in the frequency, intensity and nature of these thoughts can indicate suicide risks.

Everyday, we hear people around tossing such statements around when they are overwhelmed by emotional pain. They may be spoken during a period of intense stress, grief, relationship conflict, professional pressure or what feels like an unbearable phase of life. But what exactly do they mean?

On World Suicide Prevention Day, mental health experts say there is an important difference between wanting to escape a painful situation, contemplating about death in a passive manner and actively thinking about ending one's life.

At the same time, such statements should not automatically be brushed aside as something a person said “in the moment”. Understanding what lies behind those words, how often such thoughts occur and whether they are becoming more intense can help determine when emotional distress may be moving into a higher-risk state.

Not Every Thought About Disappearing Is A Wish To Die

In a conversation with HealthandMe, Dr. Shiv Prasad, Head of Department, Psychiatry, Lady Hardinge Medical College & Smt. Sucheta Kriplani Hospital, says statements expressing a wish to disappear can reflect different degrees of psychological distress.

“These statements can show different levels of distress which a person might be going through. Sometimes a person is expressing a wish to escape from overwhelming emotional pain rather than a wish to die. This can be different from a passive wish for death, such as “I wish I would not wake up,” and different again from active suicidal thinking, where the person is actively thinking about ending their life.”

Talking to HealthandMe, Dr. Samant Darshi, Psychiatrist & De-Addiction Specialist, Director- Psymate Healthcare, Noida, also stresses the need to distinguish between these experiences. He says such statements may indicate different levels and intensity of pain and suffering.

“I want to vanish" statements can indicate different levels of suffering and distress. It is essential clinically to differentiate among transient escape wishes, passive thoughts of death, and suicidal ideas. They do not necessarily indicate that someone wishes to kill himself but should be addressed properly and discussed considering the patient's situation.”

The experts say that a person saying they want to disappear may be expressing a desire to escape from overwhelming circumstances rather than a desire to die. Passive thoughts of death represent another level of concern, while active suicidal thinking involves thoughts of ending one's own life.

Also read: Eclectic Therapy: Why Mental Health Treatment Cannot Follow a One-Size-Fits-All Approach

When Do Suicidal Thoughts Become More Concerning?

Experts say one of the key things to watch for is escalation. A thought that was fleeting may become recurrent. A vague wish wanting things to stop may become a persistent desire to die. The person may begin thinking about how, when or where they could end their life.

Dr. Prasad explains, “We as clinicians become more concerned when these thoughts become more frequent, more intense, more persistent, or harder for the person to control and these thoughts move from “I want my suffering to end” to “I want to die” and then towards thinking about how, when or where to do it.

He adds, “The situation is even more concerning when there is suicidal intent, a plan, access to the means to carry it out, or any preparation to act. A previous suicide attempt along with severe mental illness, substance use, and major recent stressors can further amplify the risk.”

Dr. Darshi similarly points to changes in the nature of suicidal thinking as a major concern. Questions around frequency, intensity, persistence, control, intent, planning and preparation can provide a clearer picture.

“Suicide becomes more worrisome when suicidal thoughts occur frequently, persistently, intensively, specifically, or uncontrollably. The development of increased interest in death, creation of suicide plans and methods, inability to resist suicidal impulses, and increase in hopelessness are indicative of increasing risk. Any changes in these aspects require urgent expert intervention and help.”

Also read: Teachers' Day 2026: How Teachers Shape Students’ Mental Health

Signs May Appear Before The Person Talks About Suicide

There is no single behavioural change that can reliably predict suicide. However, family members and friends may notice changes that suggest a person is struggling more than they are letting on.

Dr. Prasad says, “Family and friends may start to notice social withdrawal, loss of interest, major changes in sleep or appetite, increased alcohol or drug use, irritability, agitation, or a sudden worsening of mood. The person may also repeatedly talk about feeling hopeless, trapped, helpless or like a burden. They may even start to verbalise that they want to die, or life seems worthless to them so these are few statements which we should be vigilant about.”

Withdrawal, disturbed sleep, irritability or loss of interest can occur with depression, anxiety, burnout, grief, physical illness or ordinary periods of stress. None of these signs, by itself, proves that someone is suicidal. What should prompt concern is a noticeable change in behaviour or emotional state.

Dr. Darshi adds, “One's friends and relatives can observe withdrawal, loss of interest in things and people around, emotional changes, irritation, changes in sleep or appetite, decreased effectiveness, giving away personal belongings, unusual farewells, increased use of drugs, or unusual calmness after serious mental pain. None of these symptoms proves suicidal ideation, but any change is worth paying attention.”

Also read: Col Anurag Upadhyay’s Locked-In Syndrome: What The Rare Condition Means

Someone Can Look Completely Fine And Still Be At Risk

One of the most persistent misconceptions about suicide is that a person at risk will necessarily look visibly distressed. It may not be always true. Someone can continue working, studying, socialising, exercising or talking to friends while privately experiencing significant suicidal thoughts.

Dr. Prasad says, “A person can continue to work, study, meet friends and even appear cheerful while experiencing serious suicidal thoughts internally. People may hide their distress because of shame, fear of being judged, concern about family, or because they do not know how to ask for help. Therefore, appearing normal does not mean that a person is necessarily safe. If there are reasons for concern, it is better to ask directly rather than assume everything is fine.”

Expert says people may conceal their distress for many reasons, including shame, fear of judgement or concern about how others might react. Some may also feel pressure to continue fulfilling their responsibilities despite what they are experiencing internally.

Dr. Darshi explains, “Individuals might deliberately hide signs of distress, feel obligated to function, or look fine even with immense distress inside. This means that being "normal" outside cannot exclude a person from the risk. The experience that people report having inside is what counts in assessing their safety.”

Also read: Mental Health Emergency Visits Among Children Aged 6-9 Rise 62% In England

What Should You Ask If Someone Says They Are Suicidal?

When someone admits to having suicidal thoughts, the instinct of friends and family may be to panic, immediately reassure them or tell them that they have so much to live for. Experts say the first step should instead be to stay calm and listen.

Dr. Prasad says, “The first step is to stay calm and listen without judging. It is appropriate to ask directly: “Are you thinking about suicide?” “Have you thought about how you would do it?” “Have you made any preparations?” These questions can help us understand how urgent the situation is.”

He adds, “Someone with suicidal thoughts should be encouraged to seek professional help, especially when the thoughts are recurring or worsening. But any active suicidal intent, plan, access to the means, recent preparation, or a recent attempt should be treated as an emergency. In such a situation, the person should not be left alone and urgent emergency help should be sought.”

The difference between having suicidal thoughts and being in immediate danger cannot always be determined by a friend or family member alone. When there is active intent, a plan, preparation, a recent attempt or an inability to remain safe, the situation should be treated as an emergency.

Asking About Suicide Does Not Put The Idea In Someone's Head

There is a long-standing fear that directly asking a person about suicide could somehow introduce the idea or encourage suicidal behaviour. Both experts reject this.

Dr. Prasad says that it is a common myth. He said, “It can make it easier for someone to speak about thoughts they may have been hiding out of fear or shame. A calm question such as, “I’ve noticed that you seem to be struggling. Are you thinking about suicide?” can open the door to an important conversation and allow the person to get help.”

A direct but calm question can communicate that the person is being taken seriously and that they do not have to hide what they are experiencing.

When Should Someone Seek Professional Help?

Experts say people should not necessarily wait for suicidal thoughts to become severe before seeking help.

Dr. Prasad says, “I would advise people not to wait until suicidal thoughts become very severe. Professional help should be sought when suicidal thoughts are repeated, becoming stronger or more frequent, interfering with daily life, or occurring alongside significant mental illness, hopelessness, substance use, severe insomnia or other major changes in behaviour. If a person has suicidal intent, a plan, has started preparing, this is no longer a “wait and watch” situation. Urgent emergency help is needed.”

The message is not that every disturbing thought should be treated as an immediate emergency. Rather, repeated, worsening or increasingly difficult-to-control suicidal thoughts deserve professional attention, even if the person has never attempted suicide. And when there is intent, planning, preparation or an inability to stay safe, waiting is no longer appropriate.

Dr. Darshi says, “Thoughts of suicide should warrant professional help if they are recurring, if they are becoming intense, if the person is unable to control them, if they involve hopelessness, and if they interfere with everyday activities. Thoughts involving intent, plans, access to means, and past suicidal actions should definitely warrant professional help. When someone is unable to keep themselves safe, it is best to seek emergency help.”

A person repeatedly saying they want to disappear, cannot go on, does not want to wake up or feels that there is no way out may be trying to communicate distress that they do not know how to express differently. The response does not have to be panic or dismissal.

One should ask them directly and listen without judgement. One should also take recurring or escalating thoughts of self-harm seriously. And seek professional or emergency help when the level of risk demands it.