For many people, a migraine is a very unpleasant experience with negative mental and physical impacts. Migraines are similar to headaches, but they cause more severe pain and can be accompanied by other symptoms, such as visual disturbances. Migraines are a common health condition that you can experience at any stage in your life, with some people facing frequent migraines. It may be hard for others to understand how much migraines can affect a person’s day-to-day life, especially if you experience them regularly.
A big problem faced by migraine sufferers is understanding what the root cause of their migraine is and what triggers them in the first place. This is because migraines have a wide range of trigger factors, so it is difficult to pin down exactly what might initiate a migraine.
This article will take a closer look at the causes and triggers of migraines, how to identify a migraine attack through the signs and symptoms, and what management and treatment options are available.
Causes of migraines
Sadly, scientists haven’t figured out the exact cause of migraines, but it may be linked with abnormal changes in brain activity. However, there are risk factors that may make you more susceptible to migraines, which are:
- Genetics: There is a strong genetic link between family history and migraines. If one parent suffers from migraines, then their child’s risk of developing migraines is 40%. This increases to 75% if both parents suffer from the condition1
- Gender: Women are three times more likely to experience migraines than men.1 This may be to do with oestrogen levels changing during the menstrual cycle
- Age: Migraines are more likely to start during late childhood or early adolescence, and tend to be less common after the age of 501
Aside from risk factors that can increase your likelihood of migraines, there may be certain trigger factors that play a role in initiating a migraine. Below are some common triggers and tips to help overcome them:
Change in sleep pattern
Going to bed at different times each day, sleeping too little or too much, or even the time zone change when on holiday abroad can be a trigger for migraines. It is important to get into a routine and go to bed at the same time at night.
Strong emotions such as stress or anxiety can trigger a migraine attack. Activities such as breathing exercises, meditation, or physical exercise can help to minimise stress.
Caffeine or alcohol
Sometimes changes in weather, bright lights, or loud sounds/music can lead to a migraine attack. It may be best to avoid or minimise conditions that trigger your migraines.
Women may experience migraines during their period or at other times of their menstrual cycle due to hormone fluctuations. Contraceptive pills can help alleviate migraines linked to your menstrual cycle, but it is important to discuss these with your doctor.
Certain foods such as cheese, other dairy products, and processed meats could influence the chance of a migraine attack. Keeping a food diary can help you keep track of your triggers, and it may be worth eliminating certain food items to see if doing so reduces your migraines. Skipping meals can also cause migraines due to low blood sugar levels, so try to eat regular meals.
Not drinking enough fluids can play a role in migraines, so it is important to keep yourself hydrated throughout the day.
Signs and symptoms of migraines
If you have migraines, you may experience different signs and symptoms during a migraine attack. These may also vary depending on the type of migraine you are experiencing. They can be classed into 2 main categories - migraine with aura and migraine without aura. People who experience an aura usually encounter visual disturbances before the migraine attack, but if you have a migraine without aura, this doesn’t happen.
It can be hard to tell when you will experience a migraine, but knowing the stages that a migraine attack goes through could help you identify it early on. You might not go through all the stages or experience the same stages every time you have a migraine.
A migraine attack can be divided into these stages:
This is known as the beginning phase of a migraine attack. It can occur up to three days before you experience a migraine attack. During this stage you may feel tired or irritable, crave certain foods, yawn more frequently, and be more sensitive to bright light.2
This occurs in people who suffer from migraines with aura. It is thought that around a third of migraine sufferers experience a migraine aura.2 You may see zigzag lines or coloured spots, and you can also experience pins and needles, feelings of dizziness, and weakness.3 The aura is short in duration and usually doesn’t last longer than 60 minutes.
- Main attack
This is where pain is experienced on one or both sides of your head. The pain can be described as a throbbing sensation, and it may be more severe for some individuals. This migraine stage can last from a few hours to a few days. During the migraine attack, you could experience nausea, vomiting, become more sensitive to light, and worsening symptoms with physical activity.
This happens after the migraine attack, and people usually describe feeling tired, weak, or having trouble concentrating. The postdrome phase can last for around 1 or 2 days.
By keeping a migraine diary, it will be easier to identify any symptoms that you experience before your migraine attack, so that you can recognise the warning signs earlier on. This can be documented along with any factors that you think may trigger your migraines.
Management and treatment for migraines
Migraines can be treated in different ways depending on how frequently and severely you experience them. People usually experience episodic migraines, which are defined as less than 15 migraine episodes a month.1 If you suffer more than 15 migraine days a month, with features of a migraine on 8 occasions a month, for at least 3 months, this is known as chronic migraines.1 Even though doctors and scientists haven’t developed a cure for migraines, there is a range of medications that can help relieve your symptoms:
- Painkillers:Over-the-counter medication such as aspirin or ibuprofen can ease migraine pain. They should be taken as early on as possible to fully alleviate the pain. Paracetamol can also be used if you cannot take aspirin or ibuprofen.3 You can talk to your healthcare provider for advice on selecting the most appropriate medication for you, or what to do if painkillers do not relieve your symptoms
- Anti-nausea medication: These include domperidone and metoclopramide and are prescribed by doctors if you experience nausea or vomiting during a migraine3
- Triptans: If painkillers do not ease your migraine pain, then a doctor may prescribe triptans such as sumatriptan or zolmitriptan. They should be taken as early as possible when you start experiencing a migraine attack3
How common are migraines?
Migraines are widely experienced by the population; according to the Migraine Trust, about 1 in 7 people experience them. Women experience migraines more frequently than men.
What are the types of migraines?
The two most common types of migraine are migraine without aura and migraine with aura. There are other types of migraine such as chronic migraine, migraine with brainstem aura, vestibular migraine, abdominal migraine, hemiplegic migraine, retinal migraine, and menstrual migraine.
What are the risks factors of migraines?
The three main risk factors that could increase your likelihood of experiencing migraines are age, gender, and genetics.1
Are migraines hereditary?
There is a link between family history and migraine susceptibility.1 This means that a person is more likely to suffer from migraines if a close family member also suffers from them.
How are migraines diagnosed?
Migraines are usually diagnosed by a doctor. They will carry out a medical history interview, which involves questions about your symptoms, their frequency and severity, how they may affect your daily life, and if there is any family history of migraines.
How can I prevent migraines?
It may be useful to keep a migraine diary to track when you have migraines and identify the trigger factors. There are many triggers that could play a role, so it is important to try to minimise them.
When to see a doctor
You should see a doctor if you experience migraines frequently, if over-the-counter medication such as ibuprofen doesn’t seem to help, or if it affects your day-to-day life.
Migraines are experienced by around 1 in 7 people. Even though there is no clear cause, various triggers can play a role. These include environmental, emotional, physical, and dietary factors. Aside from your triggers, it is useful to know your typical signs and symptoms of migraines to help you identify them faster and intervene early with medication. Symptoms can include yawning, tiredness, or aura in certain individuals. It may be helpful to keep a migraine diary to spot patterns earlier and prevent the migraine attack. There are many over-the-counter medications to choose from, but if these don’t help or you have migraines frequently, speak to your doctor.
- Golden L, Peters P. Migraine overview and summary of current and emerging treatment options. Am J Manag Care [Internet]. 2019 Jan 25 [cited 2023 Jan 19];25. Available from: https://www.ajmc.com/view/migraine-overview-and-summary--of-current-and-emerging-treatment-options
- Dodick DW. A phase-by-phase review of migraine pathophysiology: supplement article. Headache: The Journal of Head and Face Pain [Internet]. 2018 May [cited 2023 Jan 19];58:4-16. Available from: https://onlinelibrary.wiley.com/doi/10.1111/head.13300
- Eigenbrodt AK, Ashina H, Khan S, Diener HC, Mitsikostas DD, Sinclair AJ, et al. Diagnosis and management of migraine in ten steps. Nat Rev Neurol [Internet]. 2021 Aug [cited 2023 Jan 20];17(8):501-14. Available from: https://www.nature.com/articles/s41582-021-00509-5