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.

A new retrospective cohort study claims that men with low testosterone levels may face a greater risk of developing higher-grade disease; the data came from undergoing active surveillance (AS) for localised prostate cancer.

The study evaluated 924 men who participated in AS between 2005 and 2024 to find out if lower serum testosterone levels are connected with Grade Group (GG) progression.

The participants in this study had an average age of 63.6 years, with a mean baseline testosterone level of 394 ng/dL. About 29% of the patients at the AS had testosterone levels at ≤300 ng/dL, which was a benchmark to define low testosterone.

The study finds that having lower testosterone may lead to progression to GG2 disease and faster progression to GG3 or higher. The researchers found at the AS that men with testosterone levels ≤300 ng/dL had a 61% higher risk of higher progression than men with high testosterone levels.

What Is Prostate Cancer?

The gland in the male reproductive system that makes seminal fluid is the prostate. This is the most common type of slow-growing cancer in men, which sees the abnormal growth of cells in the gland; if detected early, it is very much curable. Some early-stage symptoms of the disease are blood in the urine or semen, trouble urinating, and erectile dysfunction, and if you’re asking yourself, why you?

You could probably blame age, family history, or lifestyle choices. While we cannot change the ‘why’, we can master the ‘how’ of finding the right treatment in time. Step 1: Rule out the possibility of cancer with a simple Prostate-Specific Antigen (PSA) blood test.

In the last 10 years, technology and innovation have revolutionized the diagnostics and treatments of the disease. Scientists from across the world are working around the clock, making marked improvements in treating prostate cancer.

Multiple Sclerosis is a chronic and progressive neurological condition affecting an estimated 1.5–2 lakh people in India, and remains one of the country's most overlooked invisible disabilities.

Many of its symptoms, including fatigue, cognitive impairment, chronic pain, visual disturbances, and bladder dysfunction, are often not outwardly visible, contributing to delayed diagnosis, barriers to disability recognition, insurance challenges, and difficulties in accessing long-term care and support.

Declaration at National Policy Dialogue

In a significant step towards strengthening disability-inclusive healthcare and social protection in India, policymakers, neurologists, disability rights advocates, insurance stakeholders, and persons living with Multiple Sclerosis (MS) today endorsed a landmark 10-point Declaration on Invisible Disabilities and Gender at the National Policy Dialogue organized on the occasion of World Multiple Sclerosis Day 2026.

The National Policy Dialogue was held under the theme, "Shaping Policy. Advancing Access. Improving Lives."

"India has made significant progress in recognizing the rights of persons with disabilities, and conversations such as these are essential to ensuring that our laws, policies, and institutions continue to evolve in ways that better reflect the lived experiences of people affected by conditions such as MS," said Menaka Guruswamy, Member of Parliament, Rajya Sabha.

Also read: President Donald Trump Remains In Excellent Health, Says White House

Barriers to Care and Support

Experts from the Multiple Sclerosis Society of India (MSSI) stated that for people living with Multiple Sclerosis, the challenges often extend far beyond the disease itself.

Delayed access to insurance, high out-of-pocket costs, limited awareness of available entitlements, and the absence of comprehensive patient data continue to create barriers to timely care.

Thus, they expect the Declaration to catalyze stronger insurance inclusion, better access to support systems, and a more robust national understanding of the true burden of MS in India.

The 10-Point Declaration

The Declaration on Invisible Disabilities and Gender outlines a roadmap to strengthen implementation of the Rights of Persons with Disabilities (RPwD) Act, 2016, and improve the inclusion of invisible neurological conditions within India's healthcare, disability, and welfare systems.

Key recommendations include:

• Recognition guidelines for invisible and episodic disabilities under the RPwD Act.
• Flexible disability certification for people with fluctuating conditions.
• Inclusion of MS and other chronic neurological conditions within National Health Mission care pathways.
• Expansion of the Indian MS Registry Network (IMSRN) into a broader national invisible disability registry.
• Affordable access to disease-modifying therapies and long-term neurological care.
• Expanded tele-neurology services across India.
• Gender-sensitive diagnosis and treatment pathways.
• Stronger digital monitoring of disability rights implementation.
• Inclusive workplace policies for invisible disabilities.
• A National Mission on Invisible Disabilities.

Call for Stronger Policy and Healthcare Support

The declaration reflects a growing consensus among stakeholders that India's healthcare and social protection systems must evolve to better address invisible conditions that significantly affect an individual's functional ability, quality of life, and socioeconomic participation.

"Multiple Sclerosis is a complex, unpredictable, and lifelong neurological condition that requires early diagnosis, timely intervention, and sustained access to advanced therapies. While often simplified for patient understanding, the clinical reality is far more challenging and demands a nuanced approach to treatment and long-term care," said Dr. R.K. Dhamija, Distinguished Neurologist, Director, IHBAS, and Chair, National Task Force, NITI Aayog Brain Health Initiative.

"Investing in neurological care is not merely a healthcare expenditure; it is an economic imperative that helps prevent irreversible disability, reduces long-term care costs, and enables people to remain active and productive," Dr. Dhamija added.

For many people, tobacco does not begin as an addiction; it starts as a habit woven into ordinary moments of daily life. A cigarette shared with friends, a smoke break during a stressful day, or chewing tobacco after meals can soon become a routine that feels difficult to avoid.

While these habits may seem harmless in the beginning, tobacco slowly affects nearly every organ in the body, often giving subtle warning signs long before a serious disease is diagnosed.

When The Body Starts Giving Signals

These effects rarely manifest suddenly and usually come after years of prolonged use. It is this slow progress that leads most tobacco users to believe that "I am fine." But there are unmistakable signs of some diseases brought about by the use of tobacco that ought not to be dismissed:

• The Persistent Cough: A cough that has lasted for more than two to three weeks, becomes progressively worse each day, and is associated with a wheeze.

• Unexplained Fatigue: A person feeling breathless or unnaturally tired after having climbed a couple of stairs or walking a short distance can easily attribute this to general fatigue.

• Weight Fluctuations: The unexplained drop in weight can also be caused by some diseases that tobacco is likely to inflict upon the body.

Changes Inside the Mouth

Oral cancer caused by tobacco often appears initially in the form of persistent mouth ulcers, white or red patches inside the mouth, and jaw stiffness. These painful and irritating conditions can be so subtle that a person is not concerned by them.

Persistent changes like the change in your voice pitch or constant throat irritation are not to be taken lightly, either; they could be signs of deeper problems arising. Seeking medical help when it is still in the superficial stages will not only decrease your chances of being treated with aggressive measures but may actually result in an easier way to fight the condition.

Beyond Lungs: Other Effects of the Illness

Tobacco affects much more than just the lungs, and many symptoms associated with chronic conditions often go unnoticed.

• Cardiovascular Strain: Dizziness and chest heaviness are indications of heart problems caused by the presence of toxins in the body.

• Physical Discomfort: Headaches or leg edema may sometimes be seen as manifestations of blood vessel disorders.

The Untapped Power of Prevention

The most important remedy at our disposal is not a complicated surgery but an accurate identification of such conditions at their superficial stage, allowing for minimal and non-invasive treatments.

The human body is an incredibly powerful machine at healing, and the instant the consumption of tobacco ceases, a chain of events kicks off that increases circulation and improves lung function.

If you ever find yourself dealing with a persistent cough, mouth ulcer, or undue fatigue, it is advisable to visit a specialist at the earliest to prevent future complications.

(By Dr Yash Mathur, Senior Head, Neck, Oral, and Robotic Onco-Surgeon at HCG Cancer Hospital, Borivali, Mumbai)