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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People using injectable weight loss drugs may need long-term medical and lifestyle support, researchers have warned, after a large study found that weight is regained far more quickly than with traditional diet and exercise plans. Scientists at the University of Oxford found that people taking medications such as semaglutide (Wegovy) and tirzepatide (Mounjaro) lose weight while on treatment, but typically regain it within around 20 months after stopping the injections.
The study also showed that improvements in blood sugar control, cholesterol levels, and blood pressure fade once the drugs are discontinued, leaving patients back at their original health markers. By comparison, people who lose weight through structured diet and exercise programmes tend to maintain the loss for longer, close to four years on average, although most eventually regain weight as well.
The findings come alongside separate research from University College London and the University of Cambridge, which suggests that people prescribed newer weight loss drugs could face risks such as nutrient deficiencies and loss of muscle mass. Under current NHS rules, Wegovy can only be prescribed for up to two years, while Mounjaro has no set time limit.
Most people using these medications pay for them privately, due to strict NHS eligibility criteria. Research indicates that around half stop treatment, often because of cost, side effects, or because they feel they have reached their target weight.
The Oxford analysis, published in the British Medical Journal, reviewed 37 studies involving more than 9,000 participants. On average, people stayed on medication for 10 months and were followed up for eight months after treatment ended.
Across all weight loss drugs, participants lost an average of 8.3 kg during treatment, but regained 4.8 kg within a year, returning to their starting weight within about 1.7 years. Those taking Wegovy or Mounjaro lost nearly 15 kg, but regained around 10 kg in the first year after stopping. Based on projections from one year of data, full weight regain occurred within roughly 1.5 years. Measures linked to heart and metabolic health, including blood glucose and cholesterol, also returned to baseline within about 1.4 years.
Professor Susan Jebb, professor of diet and population health at the University of Oxford and an adviser to ministers and the NHS on obesity, said the findings were clear. “What we’ve shown is that weight regain after medication is common and happens quickly. The benefits for blood sugar and cholesterol closely track weight changes, so when weight comes back, those benefits disappear too.”
She noted that weight regained after medication happens almost four times faster than after behaviour-based programmes, regardless of how much weight was initially lost. Professor Jebb said long-term solutions may be necessary, whether through ongoing medication, behavioural support, or a combination of both.
“Obesity is a chronic, relapsing condition,” she said. “It’s reasonable to expect that treatment may need to continue for life, much like medicines for high blood pressure. We should think of this as long-term treatment for a long-term condition.”
She added that combining diet and exercise programmes with drug treatment helps people lose more weight initially. However, once medication stops and appetite returns, those strategies alone often fail to prevent regain. In contrast, people in behavioural programmes without drugs may practice these habits more consistently, which could explain why weight regain is slower.
Professor Jebb said it is clear that some form of ongoing intervention is needed if the benefits of weight loss drugs are to last. Some patients try tapering doses or using medication intermittently, while others rely on lifestyle support alone, but she said evidence on what works best remains limited.
Sam West, a postdoctoral researcher at the University of Oxford and co-author of the study, said: “People on medication lose more weight than those in behavioural programmes, but they regain it about four times faster.”
The researchers also questioned whether long-term drug treatment is cost-effective for the NHS. They concluded that since obesity is a long-term, relapsing condition, extended use of weight management medications may be needed to maintain health benefits.
Separate findings published in Obesity Reviews highlighted gaps in nutritional guidance for people taking semaglutide and tirzepatide. Dr Marie Spreckley from the University of Cambridge said many patients receive little structured advice on diet quality, protein intake, or micronutrient needs, despite significant appetite suppression.
“If nutritional care isn’t built into treatment,” she said, “there’s a real risk of trading one health problem for another, through avoidable nutrient deficiencies and unnecessary muscle loss.”
An NHS spokesperson said that while these drugs are a valuable addition to weight loss treatment, they are not a quick fix. “They must be combined with lifestyle and behavioural support, including advice on healthy eating and physical activity, to help people maintain weight loss over time,” the spokesperson said.
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Long COVID should be viewed as a web of overlapping symptoms rather than a single, uniform condition, according to a new systematic review published in eClinicalMedicine and reported by the Center for Infectious Disease Research and Policy (CIDRAP). The review highlights several recurring symptom patterns linked to long COVID, including neurological, respiratory, smell and taste-related, cardiopulmonary, and fatigue-driven clusters.
Researchers led by a team from Lanzhou University in Gansu, China, examined data from 64 studies conducted across 20 countries, covering nearly 2.4 million people. They grouped long COVID patients into subtypes using different approaches: symptom overlap in 30 studies, affected organ systems in 16 studies, symptom severity in nine, clinical markers in three, and other classification methods in the remaining research.
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Among studies that focused on how symptoms appear together, fatigue stood out as the most consistently reported issue. It often occurred alone or alongside problems such as muscle and joint pain, brain fog, or breathlessness. Other symptom pairings that appeared frequently included loss of smell and taste, anxiety with depression, and various forms of musculoskeletal pain.
When researchers classified patients based on affected organ systems, respiratory problems were the most widespread, seen in about 47% of long COVID patients. Neurological symptoms followed at 31%, while gastrointestinal issues were reported by 28%. The authors stressed that these percentages reflect how often these clusters appeared within long COVID cases studied, not how common they are in the general population.
A smaller number of studies sorted patients by how severe their symptoms were, dividing them into mild, moderate, or severe categories using symptom scores, symptom counts, or quality-of-life measures. Three studies used clinical indicators for classification, including abnormal triglyceride levels and signs of restricted lung function on imaging.
The review also found that long COVID subtypes vary based on demographic, socioeconomic, and medical factors. Women were more likely to report fatigue and neuropsychiatric symptoms, while men more commonly experienced respiratory issues. Older adults tended to show higher rates of respiratory, cardio-renal, and ear, nose, and throat symptoms.
Racial and ethnic differences also emerged. Black and Hispanic individuals were more likely to experience respiratory, cardiac, and neuropsychiatric symptoms, whereas White patients showed higher rates of fatigue and musculoskeletal complaints.
COVID-19 variants appeared to influence symptom patterns as well. The researchers noted that the Alpha variant was closely linked to smell-related and respiratory symptoms, while the Delta variant raised the risk of ENT-related problems. In addition, higher body mass index, socioeconomic disadvantage, and existing conditions such as chronic obstructive pulmonary disease were strongly associated with cardiopulmonary symptom clusters and a heavier overall long COVID burden.
Overall, the findings reinforce that long COVID rarely affects just one system in the body. Instead, it tends to involve multiple overlapping symptom groups, pointing to the need for more tailored, patient-specific care.
The authors call for future studies to focus on creating standardized ways to classify long COVID, identifying the biological mechanisms behind different symptom clusters, and testing targeted treatments for specific subtypes. They note that this approach will be essential for moving toward precision medicine and improving outcomes for people living with long COVID.
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Measles is one of the most infectious illnesses known, and as case numbers rise across the United States, health experts warn the country is close to losing its measles elimination status. The current surge marks the highest number of measles cases recorded since the disease was officially eliminated in the U.S. in 2000. In 2025 alone, more than 2,100 cases have been reported nationwide. Texas has emerged as the hardest-hit state, accounting for roughly two out of every five confirmed infections. So just how easily does measles spread?
As of January 8, a total of 2,065 measles cases had been confirmed across the country, according to the latest figures from the U.S. Centers for Disease Control and Prevention (CDC). The last time the U.S. recorded a higher annual total was in 1992, before the routine recommendation of two doses of the measles-mumps-rubella (MMR) vaccine for children, CNN reported.
Several major outbreaks remain active, including one in upstate South Carolina and another along the Arizona-Utah border. These clusters have renewed fears that the U.S. could lose its measles elimination status, which it has maintained for more than two decades. While measles spreads easily, vaccination remains highly effective. One dose of the MMR vaccine offers about 93% protection, and two doses increase effectiveness to 97%, according to the CDC.
Measles, also known as rubeola, is a highly contagious viral illness that typically causes fever, cough, a runny nose, red and watery eyes, and a distinctive red, blotchy rash that usually begins on the face and spreads downward. The virus spreads through the air when an infected person coughs or sneezes and can lead to serious complications such as pneumonia or brain inflammation. Despite its severity, measles is preventable through a safe and effective vaccine, as per the Mayo Clinic.
Measles is among the most contagious diseases in the world. The virus spreads through airborne droplets that can linger in the air or on surfaces for hours. Up to 90% of unvaccinated people who are exposed to measles will become infected. A single infected person can pass the virus to an estimated 12 to 18 others through close contact or shared spaces. People can transmit the virus days before symptoms become obvious and continue spreading it after the rash appears, according to the World Health Organization.
Someone infected with measles can spread the virus from four days before the rash develops to four days after it appears. The virus spreads so efficiently that about 90% of people who are unvaccinated or have never had measles will become infected after being exposed.
In November, Canada lost its measles elimination status following a significant outbreak, according to the Pan American Health Organization, which works closely with the World Health Organization.
“It’s important to say that all the other 34 countries in the region, they keep their certification as measles-free,” said PAHO/WHO Director Dr. Jarbas Barbosa at the time, as per NPR News.
U.S. health officials have also warned that genetic links between outbreaks in different states suggest continued spread.
“The trajectory that we’re looking at now is that we do anticipate more cases well into January,” Bell said. “What that means for us nationally in terms of how they are defining our designation in this country as having eliminated measles is unclear.”
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