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.

The discrepancy between Pennsylvania’s reported measles-associated deaths and the US Centers for Disease Control and Prevention’s national tally sparked a political and public-health controversy.

In an exclusive interview with HealthandMe, Dr Paul Offit, paediatrician and director of the Vaccine Education Center at Children’s Hospital of Philadelphia and former member of the CDC’s Advisory Committee on Immunization Practices, accused US Health Secretary Robert F. Kennedy Jr. of adopting a “see-no-evil approach” to the outbreak.

He criticised the Trump administration’s handling of measles deaths, the proposal to split the measles, mumps and rubella (MMR) vaccine, and a new federal initiative to expand vaccine-injury reporting.

Pennsylvania reported six measles-associated deaths, according to its Department of Health. The CDC, meanwhile, had confirmed two deaths.

The figures have become the focus of a dispute over how deaths among measles patients should be classified and included in government data.

‘These Are Measles-Related Deaths’: Dr Paul Offit On CDC’s Death Toll

Also read: US Shelved Poultry Vaccination Due To RFK Jr’s Vaccine Skepticism: Can Vaccine Help Control Bird Flu?

During the interview, Offit spoke about the discrepancy between Pennsylvania’s report of six deaths and CDC’s count of two. “These are measles-related deaths,” he said, arguing that measles had contributed to the deaths reported by the state.

“Had these children or adults not had measles, in the case of the one-day-old and few-month-old, they would have never died,” Offit said.

He accused Kennedy of refusing to acknowledge the state’s report and said the federal government’s approach risked obscuring the seriousness of the outbreak.

“This is just Robert F. Kennedy Jr. refusing to acknowledge the fact that he is an excellent anti-vaccine activist,” Offit said.

The disagreement involves more than a difference in numbers. Pennsylvania health officials count deaths that meet the state’s epidemiological definition of measles-associated fatalities.

The federal government has moved towards requiring confirmation through the National Center for Health Statistics. It now considers the fact that measles is listed as the underlying cause of death before including a fatality in its tally. This process can take longer than state reporting.

A death occurring in someone with measles does not automatically establish that the infection caused the death. However, measles can lead to serious complications, including pneumonia and brain inflammation, which can be fatal.

US Measles Outbreak Is ‘The Tip Of A Much, Much Bigger Iceberg’

Also read: Sixth Measles-Associated Death Reported In Pennsylvania As Cases Cross 1,100

Offit said the reported number of measles cases in Pennsylvania could substantially underestimate the actual scale of transmission. “You can assume that's off by a factor of at least five. I think there's between 5,000 and 10,000 cases of measles in our state,” he said during the interview.

Pennsylvania’s Department of Health reported 1,260 confirmed cases across 42 counties as of October 16, alongside 225 hospitalisations. “So this is the tip of a much, much bigger iceberg,” Offit said.

He also highlighted the risk among adults who may neither have acquired immunity through previous infection nor received vaccination.

“The thing that strikes me about measles right now is it's an adult disease,” he said, pointing to people in their 20s, 30s and 40s who may remain susceptible.

Offit argued that the resurgence should be attributed to failure to vaccinate rather than a failure of the vaccine itself. “Certainly not a vaccine failure. The vaccine doesn't work if you don't get it,” he said.

On MMR Split Proposal

Also read: Trump Signs Order To Change Childhood Vaccine Schedule Amid Measles Outbreak, Split MMR Into Three Shots

While addressing the measles crisis in the United States, Offit also addressed President Donald Trump’s proposal to separate the combined MMR vaccine into three individual shots.

The MMR vaccine has been used for decades. Trump’s executive order to split the vaccine had revived a debate that the combined vaccine causes autism, which has been discredited.

He referred to research conducted over several decades that has not established a causal link between MMR vaccination and autism. “There was the MMR vaccine in 1971. So we've had 50 plus years of the MMR vaccine,” he said.

Offit argued that separating the vaccines would increase the number of injections children receive without providing an established benefit.

“There's no reason to do it. Just makes it more expensive, less available, and has a longer period of time when children aren't getting vaccines,” he said. “And they get six shots instead of two for no benefit.”

He also said the proposal had made parents more skeptical about vaccination.

The debate sparked concerns as delaying vaccination can leave children susceptible to measles during the period before they receive protection. Any changes to vaccine schedules or formulations need to be assessed against evidence of safety, effectiveness and practical consequences for vaccine access.

On RFK Jr.’s Vaccine-Injury Reporting Proposal

Offit also criticised Kennedy’s initiative to expand research into vaccine injuries and improve reporting through the Vaccine Adverse Event Reporting System (VAERS).

Announced by the US Department of Health and Human Services in October, the initiative includes a new National Institutes of Health clinic, plans to record vaccine-related adverse events in electronic health records, modernisation of VAERS and a proposal to reimburse doctors for reporting suspected vaccine injuries.

When asked if the initiative was a useful step towards vaccine safety monitoring, Offit replied: “Not in his hands.”

He alleged that the information collected under the programme could be misrepresented to support claims linking vaccines to chronic diseases, including autism, diabetes and multiple sclerosis.

Offit also questioned whether the existing reporting system was being misunderstood. He said that "we did a pretty good job" establishing the existing vaccine injury reporting system.

He further described VAERS as a “noisy warning system”, explaining that reports can help identify adverse events but cannot establish that a vaccine caused a reported health problem.

The CDC says VAERS accepts reports of health problems after vaccination even when the person reporting them is unsure whether the vaccine caused the event.

Offit cited the example of the RotaShield rotavirus vaccine to illustrate how safety signals should be investigated. Reports of a possible serious adverse event prompted further study, which helped establish a link and led to the vaccine’s withdrawal.

His did not say that vaccine safety should go unexamined, but that reports must be investigated using reliable scientific methods.

When Andrea de Armas was diagnosed with breast cancer at 26, she was preparing for a future that looked very different from the one she was suddenly handed.

Along with surgery and chemotherapy, she had to make decisions about her fertility and adjust to the of long-term consequences from treatment.

Now 30 and cancer-free, the US woman is still taking hormone therapy. The treatment has put her into temporary menopause.

“I’m really lucky. I feel like I’m doing OK,” de Armas told CBS News. “It took me a little bit to kind of adjust. It wasn’t immediate; it took time. It took understanding the kind of changes my body was going through. But I’m able to live a pretty normal life for a 30-year-old.”

Andrea’s experience highlights a revealing challenge of breast cancer in younger women. Young women who survive breast cancer face a series of emotionally heavy decisions about menstrual cycles, fertility, sexual health and emotional well-being, and menopause that comes decades earlier than expected.

Effects Of Breast Cancer Treatment On Young Women

Also read: Why Peak Incidence For Breast Cancer In India Occurs Between Ages 40–50, Compared To 60–70 In The US & Europe

De Armas initially struggled to get her concerns taken seriously. She was eventually diagnosed with breast cancer in 2023 and discovered that she carried a genetic mutation associated with an increased risk of the disease.

She underwent a lumpectomy in June, followed by chemotherapy. She later had a bilateral mastectomy and reconstruction, scheduling treatment around her studies so she could continue her physician assistant programme.

“We worked together as a team,” said Dr. Cristina Lopez-Penalver, the surgical oncologist at Baptist Health's Herbert Wertheim Cancer Institute who treated her. “She was really not about ready to let this breast cancer get in her way.”

De Armas graduated as a physician assistant in 2025 and began working a month later. However, despite completing surgery and chemotherapy, she continues to take hormone therapy because of the characteristics of her cancer.

That medication has placed her in temporary menopause, a treatment-related effect that can be particularly difficult for younger women to navigate.

Early Menopause Due To Hormone Therapy

Also read: Breast Cancer: Know the Risks, Recognise the Signs & Get Checked

Menopause occurs when the ovaries stop releasing eggs and producing lower levels of hormones, particularly oestrogen.

Although natural menopause usually occurs in the late 40s or early 50s, some cancer treatments can bring on menopause much earlier.

According to the American College of Obstetricians and Gynecologists (ACOG), chemotherapy can damage the ovaries, causing periods to become irregular or stop altogether.

Hormone therapy can also block oestrogen's effects to help prevent hormone-sensitive breast cancer from returning.

Some women experience temporary ovarian suppression, in which medication switches off ovarian function during treatment.

Others may develop permanent ovarian damage and early menopause. The outcome depends on the treatment, the woman's age and her ovarian function before treatment. In de Armas' case, hormone therapy has brought on temporary menopause.

The transition can be more abrupt than natural menopause, leaving women with symptoms that affect daily life. Common effects include:

• Hot flashes and night sweats: Sudden waves of heat and sweating can disrupt sleep and daily activities.
• Sleep disturbances and mood changes: Hormonal changes may contribute to insomnia, irritability and low mood.
• Vaginal dryness and sexual discomfort: Reduced oestrogen can affect vaginal tissues and sexual health.
• Changes in fertility: Damage to ovarian function can reduce the chances of conceiving naturally, sometimes permanently.
• Bone health concerns: Low oestrogen levels can accelerate bone loss, increasing the risk of osteoporosis over time.

The National Cancer Institute notes that treatment-related ovarian insufficiency can also cause joint pain, reduced libido and difficulty concentrating.

Menopause is often characterised symptoms like by hot flashes and night sweats. But for some women, the transition can also bring changes in mood, memory and concentration that may be harder to identify. These symptoms can affect everyday life and may be misconstrued as stress, ageing or the emotional effects of children leaving home.

On World Menopause Day 2026, Dr. Abha Majumdar, gynaecologist and one of the lead IVF specialists in the country, told HealthandMe that women and their families need to identify the least obvious symptoms of perimenopause, the transition leading up to menopause.

Menopause Symptoms Dismissed For Empty Nest Syndrome

Empty nest syndrome refers to the feelings of grief, loneliness or loss of purpose that some parents experience when their children leave home to study, work or start their own families. The transition can bring changes to family routines and relationships, especially for parents who have spent years raising their children.

Dr Abha points out that mood changes in women during their 40s should not automatically be attributed to empty nest syndrome.

Perimenopause, the transition leading up to menopause, can also involve mood swings, forgetfulness and difficulty managing everyday tasks.

As she puts it, “Suddenly, around 45 or around that time, she starts feeling depressed. Everyone says, "Oh, children have grown up, you know, it is like an empty nest. But it is not just an empty nest.”

Recognising the symptom is key so that women experiencing new or persistent symptoms are not dismissed as simply struggling with their children leaving home, and can seek medical advice when needed.

Also read: World Menopause Day 2026: Perimenopause Can Begin In Your Late 30s. What Changes Should You Watch For?

Symptoms Not Related To Menstrual Cycle

Perimenopause can bring changes that don't relate to menstrual or hormonal cycle. Women may find themselves to be forgetful about routine things, struggle to concentrate or feel overwhelmed by tasks they previously managed with ease.

Dr Abha explains how these changes may appear in everyday life. She said, “She starts forgetting. She starts finding it difficult to cope with the daily chores which she did very easily before that.”

She says women may also face cognitive symptoms like brain fog and mood swings during this phase. She said, “Forgetfulness, cognition difficulties, brain fogging, mood swings.”

These symptoms can be confusing when women do not know that they come with menopausal transition. Changes in mood, for instance, may be misconstrued as reaction to family responsibilities, work stress or other pressures, while difficulties with memory and concentration may completely go unnoticed.

Also read: Menopause Abruptly Shifts Bones, Liver And Blood Fats, Study Finds

Perimenopause Duration

Perimenopause does not begin at the same age for everyone. Also, the transition may continue for several years before menopause sets in.

Dr Abha said that perimenopause may last for five or even 10 years before menopause sets in. She also said that fluctuating oestrogen levels are part of this phase.

“She's probably going through a perimenopause, which is it estrogen deprived and then comes up, goes down and comes up, and goes down and comes up. It may take couple of years for menopause to set in," she said.

Since the transition can be prolonged, understanding its symptoms is important for women as well as their families. Dr Abha explains that husbands and adult children should be attentive to changes in a woman's behaviour, mood or ability to manage familiar routines, rather than dismissing them.

She also stresses that women's health after menopause deserves attention, particularly as life expectancy increases.

She said, “Please support her at that time because she's got 25 years more to live right away. Maybe more.”

Medical Attention

Mood changes, fatigue, sweating and memory difficulties should not automatically be attributed to menopause. Other health issues can produce similar symptoms, which makes medical attention important.

Dr Abha advises women to seek help whenever they notice a change that makes everyday activities more difficult.

She said, “Any point. If she feels something is happening to her, she's not being able to cope with her daily chores. She used to cook so effortlessly, now it takes a lot of effort. She starts getting tired, she sweats. That is the time. May it be 40, may it be 45, may it be 38 also.”

A doctor can assess menstrual cycle and determine whether symptoms are related to perimenopause or another condition. Dr Abha says investigations may also help identify other possible explanations, including vitamin deficiencies or thyroid problems.

“So, they can be sorted out. So don't avoid going to a doctor if you feel something is changing in your body. And what you were coping with earlier, you're not being able to cope with that.”