For a condition that affects nearly a fifth of women at some point in their lives, migraine still gets treated like an inconvenience rather than a diagnosis. It gets brushed off as stress, or a hectic week, or simply something to push through. It shouldn’t be. Migraine is a neurological condition, and its impact on a person’s life goes well beyond the hours the headache actually lasts. On World Brain Day, this is exactly the kind of thing worth pulling out of the “just live with it” category.

The gender gap here isn’t subtle. Migraines are two to three times more common in women than in men, and that gap widens sharply after puberty, largely because of hormones. Fluctuating hormone levels affect brain chemistry directly enough to trigger an attack, which is why so many women notice their worst episodes lining up with their menstrual cycle. These are what we call menstrual migraines, and they tend to hit harder and last longer than migraines at other points in the month.

Hormones keep shaping this through different stages of a woman’s life. Some women find pregnancy actually brings relief, since hormone levels settle into a steadier pattern for a while. Menopause tends to do the opposite; the hormonal shifts there often make migraines less predictable- sometimes better, sometimes considerably worse, depending on the person.

What I see most often isn’t the migraine itself; it’s how long women wait before treating it as something worth treating. Many manage it entirely on their own for years, quietly working around the pain rather than getting it looked at. That delay has a real cost; it shows up in missed work, strained relationships, disrupted sleep, and a general shrinking of daily life around the next expected attack.

Not every headache needs urgent attention, but a few signs mean it’s time to stop waiting and see a doctor:

A sudden, severe headache that feels different from your usual pattern

Headache along with weakness, confusion, or vision changes

A seizure, fever, or loss of consciousness alongside the headache

Outside of those red flags, the everyday reality is more manageable than most women assume. Between lifestyle changes, identifying personal triggers, preventive treatment, and newer medication options, migraines can be brought under real control. The first step is simply treating it as what it is: a neurological condition with actual treatment options, not a monthly inconvenience to push through alone.

About the author: Dr. Bijendra Mohanty, Consultant, Neurology, Narayana Hospital, Howrah