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.

Fatty liver disease, as a term, has been used for several years to describe a state of excess fat accumulation in the liver. However, the perception is changing—once known as non-alcoholic fatty liver disease (NAFLD), the condition is now referred to as metabolic dysfunction-associated steatotic liver disease (MASLD). The new term, according to leading diabetologist Dr V Mohan, offers more clarity because fatty liver is often associated with alcohol intake. However, even people who do not drink alcohol can develop this condition, and it has a metabolic angle to it. Despite the new name, the concern around fatty liver disease remains the same—can it be reversed?

Can MASLD be reversed?

In an interview with Health and Me, Dr Tushar Madake, consultant in the Department of Transplant Hepatology at Ruby Hall Clinic in Pune, spoke about the new name for fatty liver disease and why the metabolic angle is important.

Fatty liver disease may have a new name, but the concern around it has not changed. The current medical nomenclature identifies this as steatotic liver disease (SLD), with the previously identified NAFLD referred to as metabolic dysfunction–associated steatotic liver disease (MASLD). This classification places emphasis on the true source of the disease—metabolic health—and not necessarily alcohol intake.

Symptoms and diagnosis of MASLD

One of the reasons why fatty liver disease is challenging to diagnose is the fact that it does not exhibit noticeable symptoms in its early stages. The organ functions without issues, and individuals might not suspect a problem. Unlike common assumptions, this condition affects people who are not necessarily overweight or who consume alcohol.

Some of the early symptoms include constant fatigue, an increase in abdominal fat storage, and a feeling of heaviness in the upper right quadrant of the abdomen. Changes in the skin, such as discolouration around the neck and armpits and skin tag development, can also be among the symptoms of the condition. Individually, these signs do not necessarily indicate any cause for concern. However, when present together with metabolic issues such as type 2 diabetes, obesity, high levels of cholesterol, and high blood pressure, they might signify liver impairment in the early stages.

Therefore, early diagnosis and monitoring are crucial. If you have these risk factors or experience these symptoms, it is recommended that you undergo tests for liver dysfunction and ultrasonography. In some cases, you may also need to undergo a scan, for instance, a FibroScan, for early detection of liver fibrosis.

Reversing MASLD is possible

Dr V Mohan, one of India’s leading diabetologists, said, “The encouraging news is that early-stage fatty liver is not a permanent condition. With consistent lifestyle changes, reversal is possible. Weight loss, regular physical activity, reduced intake of refined carbohydrates and fats, and higher protein consumption can all contribute to improved liver health.”

Many people follow what appears to be a reasonable eating pattern—meals at irregular hours, a light breakfast skipped in the name of time, and dinner pushed late into the evening. Yet the body, particularly the liver, does not respond well to such improvisation. What feels like a manageable routine on the surface can quietly accumulate into something more serious over months and years. The liver needs a consistent flow of nutrients to do its job, which includes managing blood sugar, breaking down fats, and supporting digestion. Long gaps between meals disrupt that rhythm.

Dr Babu U V, Director of R&D, Research & Development Centre, Himalaya Wellness Company, in an interview with Health and Me, spoke about the early symptoms of liver damage and explained how herbs can play a role in reversing it.

Symptoms of Early Liver Damage

Before most people realise that something is wrong with their liver, they may already be experiencing symptoms that indicate potential liver issues. These symptoms may include fatigue, bloating, digestive discomfort, or feeling heavy after eating. Most of the time, these signs are dismissed as minor concerns.

When these issues are ignored or go unnoticed, it becomes difficult to recognise that the liver may be weakened by stress and not functioning optimally. If these problems persist over time, fat can begin to accumulate in the liver, along with other types of metabolic imbalances throughout the body.

To restore balance in the body, small changes in daily habits can lead to significant improvements. For example, eating at regular intervals helps the body maintain a consistent metabolism. Similarly, having lighter dinners and avoiding late-night eating can support better digestion and metabolism of food.

Herbs That Strengthen Liver Health

Some herbs commonly used in Indian households and traditional medicine may help support the liver’s healing process, especially when it is under stress.

1. Bhumi Amla (Bhumyamalaki) has been used for centuries in traditional remedies for liver health. It supports the body’s natural detoxification processes and liver function.
2. Punarnava is another well-known herb that promotes both liver and kidney health. It is believed to help reduce inflammation and restore balance in the body.
3. Turmeric (Haldi), found in almost every Indian kitchen, has anti-inflammatory and antioxidant properties. It supports metabolism and helps the body respond to oxidative stress.
4. Chicory (Kasani) has long been associated with liver support. It helps the body manage toxin-related stress and supports overall liver function.

Each of these herbs works in different ways—some aid digestion, while others help neutralise free radicals and reduce oxidative stress—thereby supporting a healthier lifestyle.

The liver is highly resilient; however, it requires consistent care. An irregular dietary pattern may not affect the liver immediately, but over time it can have a significant impact. Paying attention to simple habits—such as when and how you eat—and choosing foods that support liver health can go a long way in maintaining optimal liver function over the long term.

World Liver Day 2026 is observed every year on April 19 to raise awareness of the importance of liver health, focusing on preventing diseases such as cirrhosis and fatty liver through healthy lifestyles.

The liver is a key organ that filters blood, breaks down food, stores energy, and keeps the human body in balance.

However, rising metabolic risk factors, including high blood sugar and obesity, are increasingly driving cases of metabolic dysfunction-associated steatotic liver disease (MASLD).

Nearly one-third of the global adult population today lives with MASLD, which can remain asymptomatic for years but turn into deadly scarring (fibrosis), cirrhosis (advanced fibrosis and loss of some of the liver function), or even liver cancer.

World Liver Day: Origin

The European Association for the Study of the Liver (EASL) launched World Liver Day in 2010. The day was established on April 19 to commemorate the EASL's founding in 1966.

World Liver Day 2026: Theme

This year, 2026, the World Liver Day theme is “Solid Habits, Strong Liver”. It emphasizes building consistent lifestyle habits, such as balanced diet, regular exercise, avoiding alcohol, and routine check-ups, to strengthen liver health and prevent diseases.

Burden Of Liver Diseases

https://www.youtube.com/watch?v=zklb3ZCyX2o

From filtering toxins to aiding in digestion and metabolism, the liver silently performs over 500 crucial functions in the body. The organ is also blessed with the ability to regenerate itself.

Yet data shows that 2 million lives worldwide are lost each year to liver disease. About 1.5 billion people suffer from chronic liver disease.

MASLD, formerly known as non-alcoholic fatty liver disease (NAFLD), has emerged as the most common liver condition worldwide. These patients suffer from either obesity, diabetes, metabolic syndrome, hypertension, or cholesterol problems.

According to a recent study published in The Lancet Gastroenterology & Hepatology journal, MASLD affected 1.3 billion people around the globe in 2023.

The alarming study estimates the numbers to further spike by over 38 percent to reach 1.8 billion cases by 2050, causing substantial health and economic impacts worldwide.

MASLD remains one of the most prevalent and rapidly growing liver conditions worldwide, with its prevalence marking a 143 percent increase between 1990 and 2023.

Also read: Why Regular Scans Are Crucial for Liver Cancer Patients: Doctors Explain

People with obesity, diabetes, central or abdominal fat, dyslipidemia, hypertension, and insulin resistance are more likely to have MASLD. Obesity is the strongest risk factor, with the likelihood rising steeply from overweight to severe obesity.

Other signs to watch for include

• persistent fatigue
• Digestive issues and bloating
• Unexplained weight gain or difficulty losing weight
• Skin changes

Everyday Habits That Harm The Liver

Certain lifestyle choices can accelerate liver damage, such as:

• Overeating processed or fried foods
• High sugar intake (soft drinks, sweets, desserts)
• Physical inactivity or prolonged sitting
• Ignoring health issues like diabetes or hypertension
• Crash dieting or taking unprescribed supplements.

How To Improve Liver Health?

Early screening and detection are key to prevent irreversible stages. Yet liver disease can be prevented with lifestyle changes such as:

• Eating a balanced diet with vegetables, fruits, whole grains, and lean protein
• Engaging in at least 30 minutes of exercise daily
• Staying hydrated to help the liver flush out toxins
• Avoiding alcohol and smoking
• Avoiding self-medication and unnecessary pills
• Getting routine health screenings.