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.

Researchers at the National University of Singapore (NUS Medicine) have found a key protein in the brain which can help to regenerate neural stem cells and improve aging-associated memory decline.

Known as cyclin D-binding myb-like transcription factor 1 or DMTF1, the scientists found that this protein's levels are repressed in the “aged” neural stem cells and that restoring it is sufficient to restore the regeneration capabilities of such neural stem cells.

Assistant Professor Ong Sek Tong Derrick explained: "Impaired neural stem cell regeneration has long been associated with neurological ageing. Inadequate neural stem cell regeneration inhibits the formation of new cells needed to support learning and memory functions.

"While studies have found that defective neural stem cell regeneration can be partially restored, its underlying mechanisms remain poorly understood. Understanding the mechanisms for neural stem cell regeneration provides a stronger foundation for studying age-related cognitive decline."

How Does DMTF1 Protect Against Memory Decline And Dementia?

But DMTF1 seems to bypass this limit by helping neural stem cells to keep multiplying, even during brain aging. It does this by switching on helper genes that promote cell growth through a process called chromatin remodeling.

Importantly, this process can restore the growth of stem cells that had already been damaged by telomere shortening, showing that the effects of aging may not always be permanent.

The researchers plan to further explore if elevating DMTF1 expression can regenerate neural stem cell numbers as well as improve learning and memory under the conditions of telomere shortening and natural ageing, without increasing the risk of brain tumours.

What Is Alzheimer’s Disease?

Alzheimer's disease is one of the most common forms of dementia and mostly affects adults over the age of 65.

About 8.8 million Indians aged 60 and above are estimated to be living with Alzheimer's disease. Over seven million people in the US 65 and older live with the condition and over 100,00 die from it annually.

Alzheimer's disease is believed to be caused by the development of toxic amyloid and beta proteins in the brain, which can accumulate in the brain and damage cells responsible for memory.

Amyloid protein molecules stick together in brain cells, forming clumps called plaques. At the same time, tau proteins twist together in fiber-like strands called tangles. The plaques and tangles block the brain's neurons from sending electrical and chemical signals back and forth.

Over time, this disruption causes permanent damage in the brain that leads to Alzheimer's disease and dementia, causing patients to lose their ability to speak, care for themselves or even respond to the world around them.

While there is no clear cause of Alzheimer's disease, experts believe it can develop due to genetic mutations and lifestyle choices, such as physical inactivity, unhealthy diet and social isolation.

Early symptoms of Alzheimer's disease include forgetting recent events or conversations. Over time, Alzheimer's disease leads to serious memory loss and affects a person's ability to do everyday tasks.

There is no cure for this progressive brain disorder and in advanced stages, loss of brain function can cause dehydration, poor nutrition or infection. These complications can result in death.

Can You Detect Alzheimer's Early On?

The US Food and Drug Administration has approved the use of a blood test which can help diagnose Alzheimer’s disease in adults aged 55 and above.

The blood test, known as Lumipulse, can detect amyloid plaques associated with Alzheimer’s disease and has proven to be a “less invasive option” that “reduces reliance on PET scans and increases diagnosis accessibility.”

FDA Commissioner Martin A. Makary said of the landmark decision, "Alzheimer’s disease impacts too many people, more than breast cancer and prostate cancer combined.

"Knowing that 10 percent of people aged 65 and older have Alzheimer's, and that by 2050 that number is expected to double, I am hopeful that new medical products such as this one will help patients."

It remains unclear when this test will be available for commercial use across the world.

Dr Ambrish Mithal, endocrinologist in a podcast with Ranveer Allahbadia, highlighted the difference between the popular weight loss drug Ozempic and Mounjaro. Dr Mithal said that a person can lose around 10 kgs in four to six months. When Allahbadia asked Dr Mithal if there is any difference. To this, Dr Mithal said that while Ozempic is a GLP-1 drug, Mounjaro is a combination of GLP-1 and GIP. In simpler language, if one has to compare the two for only weight loss, Mounjaro can outweigh Ozempic by roughly 10 per cent.

What Is The Difference Between Ozempic and Mounjaro?

While both drugs are approved by FDA and requires prescription, and doses increases over time to a maintenance dose, experiences shortages, not FDA-approved for weight loss.

Although several studies suggest that Mounjaro may lead to greater weight loss than Ozempic, it is not currently approved by the U.S. Food and Drug Administration specifically for weight loss. That said, doctors may prescribe both Mounjaro and Ozempic off-label to support weight management in certain patients.

A real-world comparative effectiveness study by Truveta Research examined the active ingredients in both drugs among overweight and obese adults. The findings showed that tirzepatide, the active ingredient in Mounjaro, resulted in greater weight loss within one year of treatment. Individuals taking tirzepatide were more likely to achieve meaningful body weight reduction at three, six, and 12 months compared to those on semaglutide.

According to Eli Lilly, participants in Mounjaro clinical trials lost between 12 and 25 pounds. The trials reported an average weight loss of 21.1 percent after 12 weeks and a total mean weight loss of 26.6 percent over 84 weeks.

In contrast, clinical trials conducted by Novo Nordisk found that Ozempic users lost between 9.3 and 14.1 pounds. On average, participants lost about 15 percent of their body weight after 68 weeks of treatment.

Is Mounjaro More Effective Than Ozempic?

The answer depends on individual health goals and medical needs. Mounjaro is widely recognised for its strong impact on lowering A1C levels and promoting weight loss. Ozempic, meanwhile, not only helps control blood sugar but is also approved to reduce cardiovascular risk in people with Type 2 diabetes.

Head-to-head research suggests that Mounjaro may offer greater reductions in both blood sugar and body weight. In the SURPASS-2 trial, tirzepatide outperformed semaglutide in lowering A1C levels. The 5 mg, 10 mg, and 15 mg doses of tirzepatide reduced A1C by 2.01, 2.24, and 2.30 percentage points respectively, compared to a 1.86-point reduction with the 1 mg dose of semaglutide.

Read: WHO Issues First Guidance On Obesity Drugs — GLP-1 Drugs Get the Green Light

How Do Mounjaro and Ozempic Side Effects Compare?

Both medications share similar side effects, most commonly gastrointestinal issues such as nausea and vomiting. However, some data suggest that side effects with Mounjaro may be slightly more frequent or severe.

The SURPASS-2 trial found that the most common side effects were generally comparable between tirzepatide and semaglutide. However, tirzepatide was associated with a slightly higher rate of serious adverse events.

Mounjaro’s prescribing information includes a warning about severe gastrointestinal disease, a caution not listed in Ozempic’s label. Clinical trials also showed that more patients discontinued Mounjaro due to gastrointestinal side effects. For both drugs, higher doses were linked to an increased likelihood of side effects.

Ultimately, how a person responds to either medication can vary. Each drug works differently in the body, and individual tolerance, medical history, and treatment goals all play a role in determining which option may be more suitable.

Difference Between GLP-1 Drug and GIP Drug

GLP-1 Drugs

GLP-1 drugs mimic the action of the natural hormone GLP-1 to regulate blood sugar and promote weight loss. They work by increasing insulin release in a glucose-dependent manner, decreasing the liver's production of glucagon, and slowing down the emptying of the stomach, which helps lower blood sugar levels after a meal. They also act on the brain to suppress appetite and increase feelings of fullness, leading to reduced calorie intake.

In people with type 2 diabetes, notes Harvard Health, the body's cells are resistant to the effects of insulin and body does not produce enough insulin, or both. This is when GLP-1 agonists stimulate pancreas to release insulin and suppress the release of another hormone called glucagon.

These drugs also act in the brain to reduce hunger and act on the stomach to delay emptying, so you feel full for a longer time. These effects can lead to weight loss, which can be an important part of managing diabetes.

GIP Drugs

As per the American Diabetes Association's published study, Gastric inhibitory peptide (GIP) is best known for its role as an incretin hormone in control of blood glucose concentrations.

GIP is produced from a larger 153–amino acid precursor protein encoded by the GIP gene. In the bloodstream, it circulates as an active 42–amino acid peptide. It is synthesised by K cells located in the lining of the duodenum and jejunum in the small intestine.

Like other endocrine hormones, GIP is released into the bloodstream and travels to target organs through circulation. Its receptors are seven-transmembrane G protein–coupled receptors (GPCRs) found primarily on the beta cells of the pancreas.

In a major push towards eliminating cervical cancer from India, Prime Minister Narendra Modi today launched the nationwide Human Papillomavirus (HPV) vaccination program for girls aged 14 years.

The new vaccination drive comes as cervical cancer remains the second most common cancer among women in India, with nearly 80,000 new cases and over 42,000 deaths reported annually. As per data from the ICMR-National Cancer Registry Program (NCRP), an estimated 78,499 new cases and 42,392 deaths were reported in 2024.

Calling it a "decisive step”, the government noted that it is aimed at “strengthening the vision of ‘swasth nari’ (healthy women) while being rooted in scientific evidence, strict regulatory oversight and global best practices”.

“India's vaccination drive reflects safety, responsibility, and long-term commitment to women’s health,” it added.

The national program will use Gardasil, a quadrivalent HPV vaccine that protects against HPV types 16 and 18, which cause cervical cancer, as well as types 6 and 11.

However, social media has been rife with concerns around the safety of the vaccine, its impact on women’s reproductive health, among others.

HPV Vaccine: The Myths And Facts

Myth: HPV vaccines can cause severe side effects and even death.

Fact: The HPV vaccines come with a “confirmed strong safety record”.

“Extensive global monitoring shows a strong safety profile supported by scientific reviews. Independent evaluations have found no causal link between vaccination and chronic harm, strengthening confidence in its continued use worldwide,” the government said.

The vaccine has been licensed in India since 2008, and the new rollout follows recommendations by the World Health Organization (WHO) and approvals from the National Technical Advisory Group on Immunization (NTAGI).

“HPV vaccines have been given to hundreds of millions globally. Extensive post-marketing surveillance shows an excellent safety profile, with no causal link to serious adverse outcomes. The evidence is robust, transparent, and reassuring,” Dr. CS Pramesh, Director of the Tata Memorial Hospital, Mumbai, shared in a post on the social media platform X.

Myth: The HPV vaccine has never been used in India

Fact: The vaccine has been in use in India. It has been administered for years since 2008 with successful implementation in states like Punjab, Sikkim, and Tamil Nadu.

Myth: HPV vaccination does not prevent cervical cancer

Fact: The HPV vaccine has been proven to prevent cervical cancer

Studies show a 65 percent drop in cervical cancer cases among US women between 2012 and 2019 and an 88-89 percent reduction in precancerous lesions among Scottish women over a decade.

Countries with early HPV vaccine adoption have also shown large declines in HPV infection, high-grade cervical lesions, and cervical cancer incidence.

"Even when considering the rarest side effects, HPV vaccines are overwhelmingly safe. The protection they offer against cervical cancer far outweighs the minimal risks. Parents are encouraged to vaccinate their daughters on time," said Dr. Neena Malhotra, Professor and Head of Department, Department of Obstetrics and Gynecology, AIIMS New Delhi on X.

Myths: Are Multiple Doses Needed?

Fact: A single dose of the quadrivalent HPV vaccine is effective. It provides strong protection against HPV infection. It helps prevent cervical cancer.

“Strong global and Indian scientific evidence confirms that a single dose provides robust and durable protection when administered to girls in the recommended age group," the government said.