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.
Credits: Canva
We all indulge in tasty meals from time to time and with the holiday season approaching, many of us will be enjoying larger-than-usual meals. But going overboard can raise the risk of certain health problems, including heart attacks, especially for those with chronic health conditions.
“If you’re young and healthy, a single large meal is unlikely to trigger a heart attack, but for the right population, it can certainly increase the risk,” said Ameya Kulkarni, a cardiologist at Kaiser Permanente, as per The Washington Post.
Heart disease is the top cause of death in the United States, with someone experiencing a heart attack roughly every 40 seconds. That adds up to over 800,000 people annually, according to the CDC.
In 2000, a study abstract presented at an American Heart Association conference revealed that an “unusually heavy meal” may increase the risk of a heart attack by about four times in the two hours after eating, which the authors called the “hazard period” - particularly in those with pre-existing heart disease.
The participants described their meals as “heavy.” The abstract wasn’t published in a peer-reviewed journal.
Similarly, a 2005 analysis of 17 studies found that heavy physical activity, eating, and emotional stress were some of the common triggers reported before a heart attack. Men were more likely to report exertion and eating, while women often reported emotional stress.
Eating a large, high-fat, high-calorie meal is similar to extreme physical exertion for your heart. To digest all that food, blood is redirected to your digestive system. Blood vessels tighten, heart rate and blood pressure rise, and blood flow to the heart can be limited, said Steve Kopecky, a cardiologist and professor at Mayo Clinic.
That spike in blood pressure can rupture cholesterol plaques in the arteries, forming clots. Even the fatty meal itself — think buttered potatoes, gravy, and heavily marbled meats — can make your blood more prone to clotting.
“These factors together can lead to a heart attack a few hours later,” Kopecky explained.
Certain conditions raise heart attack risk, including diabetes, high cholesterol, high blood pressure, and obesity, as well as lifestyle habits like poor diet, inactivity, or smoking history. For people with these risk factors, a large meal could act as a trigger, just like emotional stress or heavy physical activity, such as shoveling snow, said Kulkarni, also president of the AHA’s Greater Washington Region Board of Directors.
Large meals high in saturated fats, calories, and processed carbs can increase heart attack risk for people with underlying health conditions. But with moderation, adding healthy foods to your plate, and skipping extra servings, you can enjoy your meals while lowering your risk.
Credits: Canva
Bird flu viruses pose a particular danger to people because they can continue multiplying even at temperatures that would normally stop most infections. Fever is one of the body’s natural ways to slow viruses, yet new research from the universities of Cambridge and Glasgow shows that avian strains can survive what should be a hostile environment.
The study, published in Science, identifies a key gene that influences how well a virus copes with heat. This same gene moved into human flu strains during the 1957 and 1968 pandemics, allowing those viruses to spread more easily.
Human influenza viruses infect millions each year. The seasonal strains we see most often fall under influenza A and tend to do well in the cooler temperatures of the upper respiratory tract, which is close to 33°C. They are less suited to the warmer, deeper parts of the lungs, where temperatures reach about 37°C.
As per Science Daily, when the body cannot slow an infection, the virus continues to multiply and spread, which can lead to more serious illness. Fever acts as a protective response, pushing body temperature as high as 41°C. Until now, the exact reason why fever slows some viruses but not others has been unclear.
Avian influenza behaves differently. These viruses usually grow in the lower respiratory tract, and in their natural hosts, such as ducks or seagulls, they often infect the gut. Temperatures in these areas can reach 40°C to 42°C, which helps explain their greater tolerance to heat.
If left unchecked, a virus can move through the body and cause significant harm. Fever is one of the body’s most familiar defence responses and can raise the core temperature to levels that inhibit many pathogens. Scientists have long known that some viruses withstand these temperatures, but the reason behind this resistance has remained uncertain.
Avian flu strains show a clear advantage in hotter environments. They thrive in the lower airways and, in birds, survive in the high heat of the gut. These features distinguish them from human influenza strains, which prefer cooler tissue.
Earlier studies in cell cultures hinted that avian flu copes better with fever-range temperatures than human strains. The new research offers direct evidence from animal experiments, helping explain why fever is effective against some types of influenza but far less useful against others.
Researchers from Cambridge and Glasgow recreated fever-like conditions in mice to examine how different viruses responded. They worked with a lab-adapted human influenza strain known as PR8, which does not pose a threat to people.
Mice do not typically develop a fever from influenza A, so the scientists raised the temperature of the environment to lift the animals’ body temperature.
The findings were striking. When body temperature rose to fever levels, the human-origin virus struggled to replicate, and the infection weakened. Avian influenza behaved very differently. Raising the temperature did not stop the virus from multiplying, and a small increase of only 2°C was enough to turn a normally severe human-origin infection into a mild one.
The study also identified the PB1 gene as a major reason why bird flu can tolerate heat. PB1 helps the virus copy its genetic material inside infected cells. When viruses carried an avian-type PB1 gene, they were able to endure high temperatures and still cause severe disease in mice. This matters because avian and human flu viruses can exchange genes when they infect the same host, such as pigs.
Dr. Matt Turnbull, the study’s first author from the Medical Research Council Centre for Virus Research at the University of Glasgow, explained that this gene swapping remains a major concern for emerging influenza strains. He noted that similar exchanges occurred in 1957 and 1968, when human flu viruses replaced their PB1 gene with one from an avian strain. According to the researchers, this may help explain why those pandemics were so severe.
Credits: Gemini
In moments where life seems to slip away, many people describe seeing a bright tunnel with a strong light shining at the end. The image feels almost otherworldly. Whether it happens during major surgeries, car crashes, or sudden accidents, people from different places and backgrounds share accounts that sound strikingly alike. Films, novels, and personal stories often mention this same vision during a near-death experience. While some link it to a glimpse of the afterlife, there may be a scientific explanation for why the mind creates this scene.
Is it a sign of something beyond the physical world, a reaction of the mind in distress, or part of how the brain behaves as it shuts down? Here is what researchers have learnt.
Yes. Scientists agree that many people do report seeing a tunnel of light when death is close. Even though death is certain, much about it still feels unclear. For generations, people have tried to understand what takes place in those last moments. Only in recent years, as medical care has advanced, have researchers been able to look more closely at near-death experiences, also known as NDEs, which occur when someone comes dangerously close to dying.
One of the most repeated features of NDEs is the bright tunnel, a sight described by millions. It is not a quick trick of the mind. People often speak of it as deeply emotional and unforgettable. This leads to difficult questions. Does this vision suggest something beyond physical life, or is the brain responding to extreme stress in its final effort to survive?
When someone nears death, the body begins to change very quickly. Vital functions start to drop. The heart may slow, reducing the amount of oxygen that reaches the brain. Body temperature can fall, and breathing may become weak or uneven. Along with these physical changes, the brain also reacts in its own way.
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A team at the University of Michigan studied what happens in the brain as a person dies. They examined four people who were removed from life support and found that two of them showed a strong surge of brain activity right before death.
The pattern of activity was similar to what occurs when a person is awake and using higher thought. These bursts were produced by gamma waves, which are linked to conscious processing. In one patient, the rise in gamma activity was nearly three hundred times higher than normal.
Jimo Borjigin of the University of Michigan suggested that this might show a form of hidden awareness that becomes active just before death.
Professor Borjigin explained that some people near death may recall seeing or hearing things or may feel as though they are watching their body from above, or even moving through space. She said her team may have identified the basic brain steps connected to this type of hidden consciousness.
She added that future research needs to involve people who survive such events, so their brain activity can be compared with their own descriptions of what they experienced.
Another study in the Journal of the Missouri State Medical Association also explores how consciousness may shape near-death experiences. The researchers note that there is still much to learn about how the brain creates awareness and how that awareness influences what people see or feel as they approach death.
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