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.

Over one million Americans have contracted chronic hepatitis B and are now forced to go through a lifelong treatment process. Though these treatment only helps in terminating the virus, the risk of liver cancer stays on, and the constant fear and torment remain. Now, a new study of a drug trial for hepatitis B patients has given hope to millions.

The trial saw 1 in 5 patients with chronic hepatitis B infection getting cured. The 24-week test had 1,838 patients from 29 countries in Asia, Europe, and North and South America. The research published in the New England Journal of Medicine concluded that 20% of patients got a functional cure, and no virus was detected in them after 48 hours.

The drug, bepirovirsen, is made by Ionis Pharmaceuticals and GlaxoSmithKline and can stop the virus from replicating itself while giving the immune system a chance to eradicate it. The treatment process will be done by administering an injection once a week. Notably, GlaxoSmithKline has already applied to the Food and Drug Administration for approval to market the drug.

Though there was an option of vaccination to prevent the disease, still, millions are infected. This effective functional cure option will be a great addition to the treatment of hepatitis B.

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What Is Hepatitis B?

Hepatitis B is a viral infection that affects the liver. Many adults can clear the virus after an acute infection. Some, however, go on to develop chronic hepatitis B, which increases the risk of liver cancer, liver failure, and cirrhosis, or permanent scarring of the liver.

Also Read: Study Finds Healthy Lifestyle Reduces Cardiovascular Risk In Childhood Cancer Survivors

How Is Hepatitis B Spread?

The hepatitis B virus is highly contagious. It spreads when blood, semen, or other bodily fluids from a person who carries the virus enter the body of someone who is not infected.

Certain medical conditions, personal habits, and other circumstances can raise the risk, such as injection drug use or sexual contact, but the virus can infect anyone. Hepatitis B can also pass from an infected mother to her baby during childbirth, whether through a vaginal delivery or a C-section.

How Can Hepatitis B Be Prevented?

Vaccination is the most reliable way to prevent hepatitis B. The shots offer strong protection in infancy and continue to shield individuals well into adulthood. Babies usually receive a three-dose series.

A healthy lifestyle is very crucial for any human being, but for cancer survivors, it's a must, as they tend to get various diseases, including cardiovascular ones. A recent study by the University of Gothenburg and St. Jude Children's Research Hospital also doubles down on this aspect. Their research reveals that a healthy lifestyle can significantly lower the risk of diseases like cardiovascular disease in childhood cancer survivors.

The study published in Nature Communications observed over 18,000 childhood cancer survivors for 30 days. The results clearly show that most of the chronic health problems among childhood cancer survivors revolve around lifestyle. Those with a habit of inactivity, obesity, smoking, and high alcohol intake are likely to catch diseases.

Aron Onerup, Pediatrician and Researcher at the University of Gothenburg and former Postdoctoral Fellow at St. Jude Children's Research Hospital in Memphis, said, "This reveals that lifestyle plays a much bigger role than previously thought. Unlike the treatments already given, the lifestyle can actually be changed."

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Another study published in JACC: CardioOncology with 2,300 cancer survivor participants finds that those who do not exercise regularly are 1.4 times more likely to contract a cardiovascular disease. The disease burden in childhood cancer survivors who do not exercise is twelve times more than that of the general population.

Aron Onerup, a Researcher within Pediatrics at Sahlgrenska Academy at the University of Gothenburg and a Specialist Physician at the Pediatric Cancer Center at Queen Silvia Children's Hospital, Sahlgrenska University Hospital, in Gothenburg, said, "This means that physical activity can make a big difference in reducing the extra risk that emerges after cancer treatment and modify the negative effects from cancer treatments. Our results provide strong scientific support for offering survivors structured support for healthy lifestyles."

Also Read: Vitamin B12 And Folate Deficiencies Behind Chronic Fatigue, New Study Finds

Why Women Are More Likely To Develop Cardiovascular Diseases?

Cardiovascular diseases are the number one reason for death among women and men, according to the Centers for Disease Control and Prevention (CDC). Statistics show that about 44% women are living with heart diseases, and it is responsible for the death of 1 in 5 women.

There are many risk factors for heart diseases, like high blood pressure, which often goes undiagnosed in women. While studies have shown that women are more likely to live longer, even with diseases, a recent report shared how women are also more likely to have cardiovascular diseases than men.

According to the study published in the American College of Cardiology, even though women often try to live healthier, if they have issues like bad food habits or high blood pressure, their risk of heart disease goes up much more than it does for men.

Vitamin B12 is vital for red blood cell formation, DNA production, and nerve function. Deficiency is more common in vegans, vegetarians, and pregnant individuals. In such cases, supplementation may be necessary to maintain adequate levels. Vitamin B9, commonly known as folate, is also very important for DNA synthesis, production of red blood cells, and cell growth.

A recent study by Osaka Metropolitan University reveals an important aspect of these two nutrients: their deficiency is directly connected with chronic fatigue. The study published in the journal Nutrient urges for a proper diet and ensuring that all necessary nutrients are present for health and energy levels.

The researchers studied over 600 healthy adults to determine whether vitamin deficiency can cause fatigue. They mainly focused on B12 and B9 because these two nutrients are crucial to maintain a natural amino acid called homocysteine in the human body. The research finds that the deficiency of these two nutrients causes an increase in homocysteine in the body, which may be connected to fatigue and low motivation.

Notably, these deficiencies can impact you differently because of your gender, as the study found that the low level of these nutrients affects men mostly with fatigue, while women feel low motivation.

Professor Hiroaki Kanouchi from Osaka Metropolitan University's Graduate School of Human Life and Ecology said, "This suggested relationship between vitamin B12, folate, and fatigue in healthy individuals may represent the first report of its kind."

Also Read: Feeling Tired And Foggy? It Could Be Vitamin B12 Deficiency

Why Does B12 Deficiency Happen?

Vitamin B12 is mainly found in animal-based foods such as meat, fish, eggs, and dairy products. People who follow vegetarian or vegan diets may need fortified foods or supplements to get enough.

Absorption is also a key factor. Vitamin B12 requires a special protein in the stomach called intrinsic factor to be absorbed properly. Certain medical conditions, medications, or aging can reduce absorption. This means that even if someone eats enough B12, their body may not absorb it efficiently.

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Why Does B9 Deficiency Happen?

Folate is naturally found in foods like leafy green vegetables, citrus fruits, lentils, beans, and whole grains, and a diet low in these can cause deficiency. Though in some cases, certain medical conditions can also be the reason for the problem.

When To See A Doctor?

If you experience ongoing fatigue, tingling sensations, or noticeable changes in memory or mood, consult a healthcare professional. A simple blood test can measure your B12 or B9 levels.

Both deficiencies are usually treatable. Treatment may include dietary changes, oral supplements, or, in more severe cases, injections. When identified early, most people recover well.