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.

Per- and polyfluoroalkyl substances (PFAS), commonly known as forever chemicals, have sparked interests of epidemiologists who are investigating their links to chronic diseases like high blood pressure, cardiovascular conditions and certain cancers.

PFAS are a large group of chemicals made by humans that have been used in industrial processes and everyday consumer products. They are found in cosmetics, kitchen supplies, clothing, carpets, upholstery, food packaging and other household materials.

They are called forever chemicals because their strong chemical bonds make them resistant to breaking down in the environment. Some PFAS can also exist in the human body, allowing exposure to accumulate over time.

At the American Public Health Association's (APHA) 2026 Annual Meeting, researchers presented findings on how people are exposed to these chemicals everyday through food and drinking water, and what long-term health consequences may be related to that exposure.

Health Problems Linked To Forever Chemicals

Some studies have identified that PFAS exposure could lead to colon and liver cancers, low birth weight, development problems in children, complications during pregnancy and other metabolic disorders. Research has also identified its exposure to cholesterol, changes in liver enzymes, reduced antibody responses to some vaccines and hypertension during pregnancy.

However, this does not establish that PFAS exposure directly causes every condition reported in epidemiological studies. Health effects may depend on the chemical type, exposure levels, duration of exposure and individual factors.

The US Agency for Toxic Substances and Disease Registry (ATSDR) states that research into PFAS health effects is in progress.

Also read: Paper Straws Have 6.33 Times Higher Carcinogenic Risk Than Plastic Straws, Study Finds

Food Is A Significant Source Of PFAS

Besides drinking water, food can also contribute to exposure, prompting researchers to investigate whether dietary habits influence the relationship between PFAS and chronic health conditions.

One study conducted in Massachusetts examined the relationship between dietary patterns, PFAS exposure and blood pressure. Researchers found stronger associations between a specific PFAS compound and high blood pressure among people who regularly consumed fish.

Yuting Wang, a postdoctoral research fellow at Silent Spring Institute and one of the researchers involved in the study, said animal-based foods appeared to contain more PFAS than plant-based foods.

One possible explanation, she suggested, was that meat consumption could increase inflammation, which may influence the relationship between PFAS exposure and blood pressure.

"Better understanding interactions among diet, PFAS and blood pressure may improve clinical recommendations to prevent hypertension," Wang said. "Future studies should account for exposure to environmental pollutants in addition to nutrient benefits of certain food," she added.

Also read: Lancet Study Finds Air Pollution & Chemical Exposures Could Add To South Asia's Diabetes & Heart Disease Burden

PFAS Found In US Drinking Water Supplies

According to the US Geological Survey, approximately 45% of drinking water samples collected across the country showed traces of PFAS. Researchers have also investigated PFAS contamination in 11 townships in southeastern Pennsylvania. Their testing found that several drinking water supplies had PFAS concentrations exceeding the US Environmental Protection Agency's 2021 regulatory limits.

The team also examined two decades of mortality data from the townships to investigate whether areas with higher PFAS levels in public drinking water has different patterns of disease and death.

Erin Kulick, an assistant professor of epidemiology and biostatistics at Temple University College of Public Health who worked on the Pennsylvania study, said, "Southeastern Pennsylvania experiences overlapping burdens of PFAS exposure and cardiovascular disease."

Scientists Are Concerned About Long-Term Exposure

PFAS contamination is a public health concern because these chemicals can remain in the environment for long periods and reach people. Some PFAS accumulate in the body, and repeated exposure may increase the amount present over time.

The National Institutes of Health identifies several health concerns linked with exposure to certain PFAS, including immune system effects, increased cholesterol, liver changes, pregnancy-related complications and some cancers.

The US Environmental Protection Agency has established legally enforceable drinking water limits for six PFAS compounds, including perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS).

Researchers say more comprehensive monitoring, better assessment and long-term epidemiological studies are needed to understand how PFAS contamination affects communities.

A simple five-factor risk score may help identify people at high risk of dementia, particularly in low- and middle-income countries (LMICs), where around 60% of the world's dementia cases now occur.

Developed and validated by researchers at Northumbria University, the risk score uses five everyday factors to identify older adults at higher risk of dementia. It aims to address a gap in dementia research, as existing prediction tools have largely been developed using data from high-income countries and may not work as well in lower-income settings.

The research team developed the model using data from more than 11,000 older adults across seven countries and three continents.

“We know the burden of dementia is shifting towards lower-income parts of the world, yet the prediction models clinicians and researchers rely on were designed with wealthier populations in mind. This model is a step towards changing that. It is simple, it is built for the settings where it is needed most, and it gives researchers a practical way to find the people who should be the focus of future studies and trials,” said Dr Eduwin Pakpahan, from Northumbria University's Applied Statistics and Data Science Research Group. The study is published in the American Journal of Epidemiology.

What Are The Five Factors Used To Predict Dementia Risk?

Also read: WHO's New Dementia Guidelines Prioritize Healthy Habits, Warn Against Supplements

The model can be applied using information gathered through a straightforward conversation with an older adult and, where relevant, a family member or carer. It does not require blood tests, brain scans or specialist equipment.

The five factors included in the risk score are:

• Age: The strongest single predictor. Dementia risk rises meaningfully from age 70 and more steeply from 80 onwards.
• Social engagement: This includes whether a person is married or living with others, how often they meet friends or family, and whether they participate in community or religious groups.
• Physical activity: The model considers how active a person is in daily life, across both work and leisure. Everyday movement, such as farming, walking to the market or doing household tasks, also counts.
• High blood pressure: Uncontrolled hypertension can damage the blood vessels supplying the brain over time. It is common, often undiagnosed in lower-income settings, and inexpensive to manage.
• Difficulty managing money: A family member or carer is asked whether the person has experienced a noticeable change in their ability to handle finances. This can be one of the early everyday signs of cognitive change.

How Does The Dementia Risk Score Work?

Each factor contributes points towards a total score ranging from 0 to 9. A person scoring 0 has around a 1% chance of developing dementia within three years, while someone scoring 9 has a nearly 19% chance.

The researchers built and tested the model across seven sites in China, Cuba, the Dominican Republic, Puerto Rico, Venezuela, Mexico and Peru. It achieved a performance score of 0.75, above the 0.70 threshold generally regarded as clinically useful.

However, the researchers emphasise that the tool is primarily intended for research rather than routine screening of the general population. It could give researchers and clinical trial teams a practical, low-cost way to identify and recruit people at higher risk of dementia.

The team has also called for the model to be validated in regions not covered by the study, particularly South Asia, the Middle East and North Africa, and Sub-Saharan Africa.

Read More: Dementia Is More Than Forgotten Birthdays, Lost Keys: Doctors Explain Early Signs Before Memory Loss

Why Is A Dementia Risk Prediction Tool Important?

Dementia affects more than 57 million people worldwide, with around 60% of cases occurring in LMICs across Latin America, the Caribbean, Asia and Africa.

Identifying people at higher risk could help researchers in these regions plan studies and clinical trials that better reflect their populations. A simple tool based on everyday information may also make risk assessment more accessible in settings where specialised diagnostic resources are limited.

From Independence Day and Janmashtami to Ganesh Chaturthi, Onam, Eid, Navratri, Dussehra, Diwali, Christmas and New Year, the period from August to January means celebrations across the country. However, some can also suffer from stress, loneliness and worsening of pre-existing mental health symptoms.

In India, festivals can provide connection, cultural continuity and family bonding. However, celebration is not positive for everyone. For some, the period can lead to issues such as social pressure, loneliness, grief, financial concerns and even interpersonal conflict. Festive periods can be challenging for the general population, while people with pre-existing mental health conditions may be vulnerable to worsening symptoms, increased sensitivities or relapse.

Festivals carry an expectation that everyone should be happy. People are expected to participate, dress up, attend gatherings and appear enthusiastic. Though some may experience anxiety, burnout, depression or emotional exhaustion, maintaining this expected level of participation can become another source of stress. Emotional wellbeing does not automatically change because it is a festival. Recognising this can reduce guilt and self-criticism.

Family Gatherings And Emotional Sensitivities

Festivals frequently bring extended families together. While this can strengthen relationships, it can also reactivate longstanding interpersonal dynamics. Questions about marriage, children, career, finances, appearance or personal choices can become uncomfortable, particularly when they touch existing vulnerabilities.

For someone who has experienced criticism or comparison within the family, a seemingly casual festive comment may carry considerably more emotional weight because of the history attached to it. The festive setting can therefore bring individuals into closer contact with relationships or unresolved issues that they may otherwise have greater distance from.

Also read: Excessive Screen Time & Mental Health: Expert Urges Parents To Limit Children's Screen Time At Times Health Summit 2026

Why Clinical Populations May Be More Vulnerable

For individuals already living with a mental health condition, the festive season can introduce several stressors simultaneously. Travel, disrupted sleep, irregular meals, increased social stimulation, financial pressure, family conflict and interruptions to established treatment routines can place additional demands on psychological functioning.

People with conditions such as depression, anxiety disorders, bipolar disorder, trauma-related conditions, obsessive-compulsive symptoms, eating disorders or other psychiatric difficulties may be more sensitive to these changes.

In individuals with a history of recurrent episodes, significant disruption may also contribute to relapse. Festivals themselves do not necessarily cause relapse. Rather, the accumulation of environmental, interpersonal and behavioural stressors can increase vulnerability in someone already at risk.

Changes from an individual's usual baseline such as significant alterations in sleep, appetite, mood, anxiety, irritability, impulsivity, social withdrawal or functioning can therefore be important early warning signs.

Grief Can Become More Visible

Many traditions are built around shared experiences: preparing food, decorating homes, travelling to family members, exchanging gifts or gathering for meals. When someone important is no longer present, familiar rituals can make their absence more noticeable.

This can occur during religious festivals as well as occasions such as Independence Day or New Year, when people naturally reflect on their lives and relationships. Participating in a celebration does not mean grief has disappeared, just as sadness during a celebration does not eliminate the capacity for joy.

The festive season can also place pressure on household finances. Clothing, gifts, travel, home decoration and social events can increase expenditure over several months. For those already experiencing financial uncertainty, this can create considerable stress.

People living alone, those estranged from family, individuals experiencing relationship difficulties, older adults and people who have recently relocated may become more conscious of social isolation during this period. New Year can be particularly challenging because social expectations around parties, relationships and celebration become highly visible.

Also read: Can Mental Health Improvement Help Lower High Blood Pressure? Study Points Towards 3 Habits

Indians Living Abroad: Culture, Belonging and Homesickness

Celebrating Diwali, Eid, Navratri, Onam, Christmas or Gurpurab away from India can provide an important connection with cultural identity and family traditions. At the same time, it can highlight physical distance from parents, siblings and extended family.

A person may attend a community celebration abroad while still missing the food, sounds, neighbourhood atmosphere and family rituals associated with celebrations in India. Those unable to travel home may experience increased homesickness, particularly when several major occasions occur within a short period.

Festivals Can Be Difficult For General Population Too

Feeling tired, overwhelmed, irritated, lonely or emotionally sensitive during a demanding period does not automatically indicate a psychiatric disorder.

Even psychologically healthy individuals can experience festive stress because of travel, social obligations, financial commitments or difficult family interactions.

Making The Festive Season Psychologically Sustainable

• Set boundaries around intrusive questions: “I’d rather not discuss that today” or “We’re comfortable with where things are right now” can end conversations about marriage, children or finances without confrontation.
• Decline invitations without over-explaining.
• A smaller number of meaningful gatherings may be preferable to trying to attend every event.
• Decide spending limits for gifts, travel and celebrations in advance rather than responding to social pressure.

For those receiving mental health care, prescribed medication, therapy and established support systems should not be casually disrupted during the festive period.

Curated festive content represents selected moments, not the entirety of another person's life.

Professional support becomes particularly important when festive stress is accompanied by persistent hopelessness, severe anxiety, substantial social withdrawal, changes in sleep or appetite, increased substance use, impaired functioning or other marked behavioural changes.

The goal is not to remove complexity from celebration, but to make space for it. Allowing people to experience the festive season without the pressure to feel festive can itself be an important form of psychological care.

By Ms Dhara Ghuntla, Psychologist/Psychotherapist, Sujay Hospital, 7 Hills Hospital & Criticare Hospital