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.
Credit: iStock
GLP-1 drugs such as Ozempic, Wegovy, Mounjaro and liraglutide, best known for regulating appetite and aiding weight loss, may also help reduce symptoms of binge eating disorder (BED), which affects more than 17 million people worldwide, according to a new study.
The systematic review and meta-analysis, published in the journal eClinicalMedicine, found that GLP-1 drugs, with semaglutide as its key ingredient, reduced binge eating episodes, loss-of-control eating and emotional eating, highlighting their potential role in treating binge eating disorder alongside obesity.
Binge eating disorder affects over 17 million people globally, and around two-thirds of people with the condition also live with overweight or obesity. It is also common among individuals seeking weight-loss treatment.
"Binge eating disorder, where people regularly eat an excessive amount of food while feeling they have lost control, is common and highly impairing, affecting over 17 million people worldwide," said lead author Dr Ilaria Costantini from the Psychiatry Department at University College London (UCL), UK.
"But treatment options are limited and there are currently no approved medications, so there remains a need for better ways to help people living with this condition. We found evidence that weight loss drugs may help to manage some key symptoms of binge eating disorder," Costantini added.
Also read: Babies Without Vitamin K Shot At Higher Risk Of Brain Bleeding: Study
The researchers analyzed 25 randomized controlled trials conducted across 12 countries on four continents, involving 8,069 participants.
The trials evaluated GLP-1 drugs that target the appetite-regulating hormone GLP-1, including semaglutide (marketed as Ozempic or Wegovy), tirzepatide (Mounjaro) and liraglutide.
These medications suppress appetite by acting on the central nervous system and insulin secretion, delay stomach emptying, and may also influence brain pathways involved in reward and impulse control.
Compared with placebo or other treatments, people taking GLP-1 drugs reported:
Read More: Obesity-Driven CKM Syndrome A Growing Public Health Threat, Warns American Heart Association
The researchers also found that participants taking GLP-1 drugs reported greater cognitive or dietary restraint, meaning they made more deliberate efforts to limit what they ate.
The benefits extended beyond weight loss, with improvements seen in several behaviors associated with binge eating disorder.
While increased dietary restraint was observed, the researchers cautioned that it remains unclear whether this represents healthy self-regulation or a more rigid, potentially harmful eating pattern that could worsen binge eating over time.
"From the evidence available, we cannot say whether the increase in dietary restraint reflects a positive and helpful form of self-regulation or if it is a more dysfunctional pattern of eating. We hope that future research can clarify whether or not taking weight loss drugs might contribute to more pathological forms of eating restriction such as meal skipping," said Izzy Emptage from UCL Psychiatry.
The researchers said GLP-1 drugs could become an important addition to treatment plans for binge eating disorder when used alongside psychological therapies and social support.
However, they also highlighted important limitations. Most of the studies included in the review had a high risk of bias, were funded by pharmaceutical companies, and rarely included participants with a clinical diagnosis of binge eating disorder, reducing the certainty of the findings.
"GLP-1s may offer a promising additional treatment option for people living with both binge eating and obesity," the researchers said, while stressing that these drugs "should not be viewed as a standalone solution to binge eating disorder."
They added that larger, independently funded clinical trials are needed before these medications can be routinely recommended for treating binge eating disorders.
Credit: AI
What if staying younger has less to do with expensive anti-aging products and more to do with spending time appreciating the culture. A new study suggests that regular cultural outings may be linked to slower biological aging.
Expect an unexpected addition to the list of healthy lifestyle habits. Researchers recently found that older adults who frequently visited museums, theaters, cinemas, concerts, and art galleries physically functioned as if they were about three years younger than those who didn’t take part in such activities.
Published in the Journal of Epidemiology and Community Health, the researchers say that cultural interaction appears to be associated with a younger physiological age, although the study does not prove that cultural activities directly contribute to slow aging.
The study analyzed data from 1,899 adults aged 50 years and older who participated in the English Longitudinal Study of Ageing. Participants reported how often they:
Researchers also assessed 10 health indicators, including:
These measures were combined to ascertain each participant's physiological age.
People who participated in cultural activities every few months or more had an average physiological age of 66.9 years, compared with 69.9 years among those with lower levels of cultural engagement, a difference of roughly three biological years.
The researchers also found that every one-point increase in a person's cultural engagement score was associated with approximately a 31-day reduction in physiological age, even after accounting for income, employment, and chronic health conditions.
Although the study wasn't designed to identify a direct cause, the researchers suggest several possible explanations that can help reduce biological age. Cultural activities may help:
Interestingly, the researchers noted that the association between cultural engagement and slower aging was comparable to the benefits seen with frequent physical activity, highlighting that healthy aging may involve much more than exercise alone.
The latest findings add to a growing body of research suggesting that spending time on cultural activities may benefit both the brain and the body as people age.
Previous studies have found that older adults who regularly visit museums, art galleries, theaters, concerts, and similar cultural spots may have a lower risk of dementia, experience slower cognitive decline, and even live longer than those who rarely engage in such activities.
For example, a 2019 study published in The BMJ reported that adults over 50 who participated in cultural activities every few months or more had a 31% lower risk of death during a 14-year follow-up compared with those who never took part.
Another study from University College London found that frequent museum visits were associated with a reduced risk of developing dementia over the following decade.
Credit: AI
The growing trend of medical tourism or cosmetic tourism has become increasingly popular in the age of social media. The dramatic before-and-after results, the thrill of returning home with a new look, and a quenched wanderlust have only contributed to this trend.
While the appeal is evident, we cannot help but ignore the risks and complications one can face while traveling overseas for a cosmetic procedure. On World Plastic Surgery Day, take a look at what you are in for if you are planning to fly off for a procedure.
One of the biggest reasons why people travel abroad for cosmetic procedures is the cost. Procedures like liposuction, tummy tucks, breast enhancement, rhinoplasty, and dental veneers can cost almost 30% to 70% less in some countries than in the United States, United Kingdom, or Australia.
Many cosmetic packages also come with other attractive deals like luxury recovery packages, airport transfers, and hotel stays, combined vacation and surgery experiences, among others.
For some patients, these deals make cosmetic procedures more affordable and convenient. However, lower prices do not always necessarily mean lower quality. But the concern is that patients do not adequately evaluate the standards of clinics before they travel.
Also read: Plastic Surgery Myths Debunked: Experts Explain Cosmetic vs Reconstructive Surgery
Here are some risks and complications that one ought to be aware of before booking those flight tickets.
Patients who fly home too soon may experience wound breakdown, excessive swelling, or bleeding that requires urgent medical attention.
Dr Banodkar says, “Unqualified practitioners, who perform these procedures, may not be adequately trained; they might cause a permanent scar on the skin, or they might even cause a simple infection of the skin that can result in sepsis.”
Every surgery carries the possibility of asymmetry, scarring, implant problems, or the need for revision surgery due to unqualified or unskilled practitioners. This could incur hidden costs of corrective surgeries.
Dr. Pravin Banodkar, Consultant Dermatologist, Saifee Hospital, Mumbai, told HealthandMe, “There are hidden costs of any corrective treatment which can obviously be much more than what is actually spent for the procedure.”
Many cosmetic procedures require multiple follow-up visits, wound checks, suture removal, and monitoring complications.
Patients returning home shortly after surgery may have limited access to the operating surgeon. Local doctors may also be unfamiliar with the exact techniques or implants used, making management more challenging.
Also read: How Reconstructive Plastic Surgery Transforms Lives After Trauma And Cancer
Dr Banodkar explains, “Many times, the people who are not trained don't know how to manage complications, and as a result, they are unable to diagnose the problem. Due to this, the adverse effects of the procedure will only increase.”
If complications occur, seeking compensation or legal action across international borders can be difficult and expensive, as medical regulations, malpractice laws, and patient protections vary widely between countries.
© 2024 Bennett, Coleman & Company Limited