A migraine is a headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It’s often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities.
Migraines, which affect children and teenagers as well as adults, can progress through four stages: prodrome, aura, attack and post-drome. Not everyone who has migraines goes through all stages.
One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine, including:
- Mood changes, from depression to euphoria
- Food cravings
- Neck stiffness
- Increased urination
- Fluid retention
- Frequent yawning
There are a number of migraine triggers, including:
- Hormonal changes in women.Fluctuations in estrogen, such as before or during menstrual periods, pregnancy and menopause, seem to trigger headaches in many women.Hormonal medications, such as oral contraceptives, also can worsen migraines. Some women, however, find that their migraines occur less often when taking these medications.
- Drinks. These include alcohol, especially wine, and too much caffeine, such as coffee.
- Stress. Stress at work or home can cause migraines.
- Sensory stimuli. Bright or flashing lights can induce migraines, as can loud sounds. Strong smells — such as perfume, paint thinner, secondhand smoke and others — trigger migraines in some people.
- Sleep changes. Missing sleep or getting too much sleep can trigger migraines in some people.
- Physical factors. Intense physical exertion, including sexual activity, might provoke migraines.
- Weather changes. A change of weather or barometric pressure can prompt a migraine.
- Medications. Oral contraceptives and vasodilators, such as nitroglycerin, can aggravate migraines.
- Foods. Aged cheeses and salty and processed foods might trigger migraines. So might skipping meals.
- Food additives. These include the sweetener aspartame and the preservative monosodium glutamate (MSG), found in many foods.
Several factors make you more prone to having migraines, including:
- Family history. If you have a family member with migraines, then you have a good chance of developing them too.
- Age. Migraines can begin at any age, though the first often occurs during adolescence. Migraines tend to peak during your 30s, and gradually become less severe and less frequent in the following decades.
- Sex. Women are three times more likely than men to have migraines.
- Hormonal changes. For women who have migraines, headaches might begin just before or shortly after onset of menstruation. They might also change during pregnancy or menopause. Migraines generally improve after menopause.
Migraine treatment is aimed at stopping symptoms and preventing future attacks.
Many medications have been designed to treat migraines. Medications used to combat migraines fall into two broad categories:
- Pain-relieving medications. Also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms.
- Preventive medications. These types of drugs are taken regularly, often daily, to reduce the severity or frequency of the migraines.