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 found how a cell’s energy source could affect depression and anxiety. The new study published in JNeurosci, led by Southern Medical University, was done on male mice. Researchers discovered that the adenosine triphosphate (ATP), which is the cell’s main energy source and a vital chemical messenger that helps communication between neurons, plays a part in depression and anxiety.

Because good brain cell communication is vital for controlling feelings, the study focused on the hippocampus, a brain area linked to memory, stress, and feeling depressed.

For years, scientists have looked for reasons behind mental health issues like depression and anxiety. While we may know that mental health disorders are caused due to different reasons, researchers have looked into how depression and anxiety stressors are communicated to the brain.

Mental health disorders do not have a single cause. According to the UK Mind organization, there are many different factors that can cause depression or trigger it. Things like childhood depression, life events, physical health problems, family history. So, understanding how this changes in mood and heightened emotions are communicated to the brain, could help us learn more about the root causes of depression as well.

How Does Stress Affect Depression And Anxiety?

Researchers studied what happened to ATP in the hippocampus when mice were under stress. They found that male mice who became more anxious or depressed after long-term stress also had lower levels of ATP.

These mice also had less of a key protein called connexin 43 (Cx43). Think of Cx43 as a tiny door that lets ATP out of cells so it can be used for communication. When Cx43 is low, ATP can't be released properly.

To prove that low ATP release was the problem, researchers did two things:

They lowered Cx43 (the "door") in healthy mice that hadn't been stressed. Even without stress, lowering Cx43 caused the mice to act depressed and anxious, and their ATP levels dropped. This showed that just blocking the ATP release was enough to cause mood problems.

They put Cx43 back (fixed the "door") in the stressed, depressed mice. When they did this, the ATP levels went back up, and the mice's anxious and depressed behaviors got much better.

What Causes Depression and Anxiety?

The lead researcher, Gao, explained that this is the first time scientists have shown that low ATP release in the hippocampus drives both depression and anxiety—suggesting they share one single biological cause.

This is important because depression and anxiety often happen together and are hard to treat at the same time. The study suggests that future treatments could focus on improving ATP signaling by fixing or opening the Cx43 "door," potentially helping people with both conditions at once. The team plans to study female mice next to see if the same process happens in both sexes. Researchers mentioned how these finding can lead to better treatment options for people who have depression and anxiety. More focused studies will also help reveal how mental health issues are different in men and women, as they expand the research across sexes.

Women who skip their first breast cancer screening may face a 40% greater risk of dying from the disease over the long term, according to a new study. The research, published in September in The BMJ, followed more than 400,000 women in Sweden over a span of up to 25 years.

When Should Women Begin Breast Cancer Screening?

The study raises important questions: at what age should women start screening, why does missing the first appointment increase long-term risk, and what other tests or self-checks might help? Dr. Leana Wen, an emergency physician and adjunct associate professor at George Washington University, weighed in on these points.

As per CNN, Wen explained that in the United States, breast cancer is the second most common cancer among women and the second leading cause of cancer death. In 2022, over 279,000 new cases were reported in women, and more than 42,000 women died from the disease in 2023.

Globally, a report from February, as per CNN, indicated that 1 in 20 women will develop breast cancer in their lifetime. Researchers estimate that by 2050, annual diagnoses could reach 3.2 million, with 1.1 million deaths worldwide.

When breast cancer is found and treated in its earliest stage, the five-year survival rate exceeds 99%, according to the American Cancer Society. Once cancer spreads to other organs, the survival rate drops to around 32%.

When Should Women Start Screening For Breast Cancer?

Last year, the U.S. Preventive Services Task Force recommended that most women begin mammograms at age 40 and continue every two years until age 74. Women over 75 should decide in consultation with their primary care provider.

For women at higher risk, screening may need to start earlier or occur more frequently. High-risk factors include prior chest radiation, certain genetic mutations, and having a first-degree relative, such as a mother or sister, with breast cancer.

The Swedish study tracked 432,775 women over up to 25 years. Nearly one-third of women invited for their first mammogram did not participate. Those who skipped the first screening were also less likely to attend future screenings and more likely to be diagnosed at advanced stages.

The study found that women who missed the initial mammogram were 1.5 times more likely to be diagnosed with stage 3 cancer and 3.6 times more likely for stage 4, compared to those who attended. After 25 years, death rates from breast cancer were significantly higher among the initial nonparticipants.

Researchers noted that while the findings reflect Sweden’s healthcare system, the principle that missing initial screenings increases long-term risk likely applies worldwide. An editorial in the same journal emphasized that attending the first mammogram is a long-term health investment, not just a routine check.

Why Does Delaying First Breast Cancer Screening Increase Long-Term Risk?

Wen highlighted that women who skip the first screening often continue to miss subsequent exams. Factors such as lack of awareness, access challenges, fear, and cultural influences may contribute. Late-stage diagnosis leads to lower survival rates and higher mortality.

Mammograms remain the standard screening tool for women at average risk. Higher-risk women may benefit from additional tests, such as genetic testing, breast MRI, or ultrasound. Women with dense breast tissue should discuss supplemental tests with their healthcare provider, as mammograms are less effective for detecting cancer in dense tissue.

What About Breast Self-Exams?

Self-exams are not a replacement for mammograms but can help women notice changes in their breasts. If a lump or other unusual symptoms appear—such as nipple discharge, pain, swelling, color changes, inward-turning nipple, enlarged lymph nodes, or skin changes—women should consult a healthcare provider immediately.

How Can Women Reduce Their Risk Of Breast Cancer?

Lifestyle factors play a major role. Smoking, excessive alcohol consumption, and obesity increase risk. Maintaining a healthy weight, staying physically active, eating a nutritious diet, quitting smoking, and moderating alcohol intake can all lower the risk and improve overall health.

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.

Heavy Meals Can Trigger Heart Risk

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.

Big Meals Stress The Heart

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.

Who Is Most At Risk?

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.

Heart Attack Warning Signs

• Chest pain or pressure in the center or left side of the chest that persists for several minutes or comes back.
• Pain or discomfort in one or both arms, jaw, neck, back, or above the stomach.
• Shortness of breath without physical activity.
• Weakness, dizziness, lightheadedness, or sudden cold sweats.
• Nausea or vomiting.
• Fast or irregular heartbeat.

Tips For Safer Indulgence

• Enjoy indulgent foods, but balance your plate with healthy options. Aim for half your plate to be fruits and vegetables, a quarter protein, and a quarter starch, Kulkarni said. Start with a salad, then add whole foods like turkey with a modest portion of stuffing, beans, or sweet potatoes.
• Eat slowly. It can take up to 20 minutes for your brain to register fullness, so eating quickly can lead to overeating. Treat meals as a social event and savor the time with family and friends.
• Limit alcohol. Drinking can increase appetite and reduce self-control, leading to eating more.
• Stop when you feel full. Skip that second helping once you’ve had enough.
• Take a walk after meals. Walking can help reduce triglycerides, regulate blood pressure, and lower blood sugar, Kopecky said.

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.