Migraines can cause significant disruption to a person’s daily life due to the severity and frequency of symptoms. This type of headache is characterized by throbbing pain or a pulsing sensation generally on one side of the head. The discomfort can last for hours or even days. The headache is often accompanied by other symptoms like sensitivity to light and/or sound, feeling like throwing up (nausea), fatigue, and vision changes. Migraine attacks can be chronic or come and go over time. They often have identifiable triggers. It is important to note that migraines are unique for everyone. Therefore, symptoms, causes, and treatment options can vary widely.
Understanding Migraines – Symptoms
The symptoms of a migraine can vary quite significantly from person to person. However, for many, the migraine will be experienced in stages. Note that not all persons will share each stage or listed symptoms.
Stages include:
Prodrome – This stage starts hours or even days before the headache. Symptoms during this stage include sensitivity to light, sound, and smell, feeling fatigued, changes in mood, thirst, bloating, food cravings or lack of appetite, constipation, and diarrhea.
Aura - These symptoms typically affect your vision as they stem from the nervous system. You may see dots, have tunnel vision, see double, or lose sight temporarily.
Attack – This is the onset of the throbbing, aching headache. Nausea and vomiting are common during this stage.
Postdrome – The headache has subsided. For the next few hours, you may feel tired, have difficulty concentrating, experience muscle pain or weakness, have food cravings, or lack appetite.
What Causes Them?
There is no direct cause of migraines, but they can result from several factors, which include genetics, environment, and lifestyle. Here are some of the common triggers that can bring on a migraine attack:
- Hormones – Specifically in women, migraines may worsen during pregnancy, ovulation, menstruation, and menopause
- Stress
- Lack of sleep or changes in your sleep
- Skipping meals or not eating enough
- Certain foods
- Excess caffeine or caffeine withdrawal
- Changes in the weather
- Bright or flashing lights
- Prolonged exposure to screens (phone, computer, TV, etc.)
- Loud noises
- Strong smells
- Physical activity like exercise and sex
- Tobacco
- Alcohol
Who Gets Migraines
As mentioned above, there is no direct cause of migraines, but women generally experience migraines three times more often than men. Women often have their migraines get better or disappear by the age of 50.
Additionally, it is far more common for migraine sufferers to have family members who also get migraines. WebMD states, “If one parent has a history of these headaches, their child has a 50% chance of getting them. If both parents have them, the risk jumps to 75%.”
Other medical conditions may also raise your risk of getting migraines. These include but are not limited to depression, anxiety, bipolar disorder, sleep disorders, and epilepsy.
Treating & Preventing Migraines
Depending on the severity of your migraine attacks, your doctor may prescribe you medications or treatments to help prevent or stop a severe migraine.
Medications to treat migraines include:
- Over the counter NSAIDs like ibuprofen or naproxen or aspirin
- Acetaminophen/Tylenol
- Caffeine
- Triptans (like sumatriptan/Imitrex)
- Anti-nausea medications like metoclopramide, prochlorperazine, ondansetron, or diphenhydramine/Benadryl
- Ergotamines like dihydroergotamine/D.H.E. 45
Other at-home remedies you can try include:
- Going into a dark, quiet room to lay down and close your eyes
- A cold compress on the forehead
- Hydrating
- Sleep
Medications for migraine prevention include:
- Beta blockers – such as propranolol or metoprolol
- Antidepressants – such as venlafaxine or amitriptyline
- Anticonvulsants – such as valproate or topiramate
- CGRP monoclonal antibodies – such as Erenumab/Aimovig or fremanezumab/Ajovy
- Blood pressure medication such as verapamil
- Birth control pills
- Gabapentin
- Botulinum toxin type A (Botox®) – effective for prevention of chronic migraines when other treatments have failed (ie. > 15 headaches per month with at least 8 of the 15 headaches characterized as migraines).
What’s the doc say?
“When nothing else works, Botox® can really be a game-changer. I have seen patients’ lives transformed after getting Botox® for their chronic migraines. They can finally get back to doing the activities they love, without the constant headache.”
Click here for a patient testimonial.
Dr. Jennifer Purifoy, DO, MPH
Northwest Family Clinics
Rogers, MN
Other ways to help prevent migraines:
- Aerobic exercise
- Keeping a journal to best determine triggers and avoid them
- Stress management & relaxation
- Make sleep a priority
- Avoid alcohol and tobacco
- Drink plenty of water
- Eat a healthy diet
- Biofeedback
- Acupuncture
When to See your Doctor
It is always a good idea to consult your doctor when experiencing any health issues feeling abnormal. Migraines are no exception, especially if severe symptoms occur frequently. Talk to your doctor today.