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What is causing your migraines?
It's not clear exactly what causes migraines, but we do know that certain types of things can trigger attacks.1
Triggers can vary a lot from person to person, but usually fall into one of the categories shown.1 Keeping track of things like what you've eaten or how you were feeling when a migraine hits can help you identify your particular triggers.
Click on a category to find out more.
Some women experience migraines around the time of their period, possibly because of changes in the levels of hormones, such as oestrogen, around this time.2
These types of migraines usually occur between two days before the start of your period to three days after.3 Some women only experience migraines around this time, which is known as a pure menstrual migraine.2 However, the majority of women who experience migraines at certain points in their menstrual cycle also have migraines at other times, a version referred to as a menstrual-related migraine.2
Many women find that their migraines improve after the menopause, although this itself can be a trigger for some women or worsen existing migraines.2
Emotional triggers, such as stress, tend to be one of the more prevalent causes of migraines.Changes in emotion ranging from stress at work, stress of a relationship or even the stress of juggling everyday responsibilities can trigger migraines. Emotional triggers may also include:1
Small changes, such as ensuring a good night’s sleep or improving your posture, may help prevent the onset of migraines. Listed below is a sample of physical triggers which may be associated with migraines:1
- Poor quality sleep
- Shift work
- Poor posture
- Neck or shoulder tension
- Jet lag
- Low blood sugar (hypoglycaemia)
- Strenuous exercise, if you're not used to it
Maintaining a healthy and balanced diet may not only help keep migraines at bay, but also supports a healthier lifestyle. Keeping a food diary may help with recognising which foods are triggers. Other dietary triggers may include:1
- Missed, delayed or irregular meals
- Food containing tyramine
- Caffeinated products
- Specific foods such as chocolate, citrus fruit and cheese
Changes in the environment are often linked with migraines. Being aware of strong smells or changes in brightness may be the difference between having a migraine or not. It’s worth noting some of the most common environmental triggers:1
- Bright lights
- Flickering screens
- Smoking or smoky rooms
- Loud noises
- Changes in climate
- Strong smells
- Stuffy atmosphere
In some circumstances, both prescribed and over the counter medication may be triggering the migraine.Below are the three most common medications that have been linked with migraines:1,2,4
- Sleeping tablets
- The combined contraceptive pill
- Hormone replacement therapy (HRT)
Are you missing out on
the right treatment for you?If you feel that you are not responding to your current migraine treatment,or your attacks are worsening, it's worth speaking to your doctor if:8
You are suffering with regular migraines despite trying to avoid triggersIf you know what triggers your migraines and are still experiencing regular migraines despite avoiding them, it may be worth talking to your doctor about alternative treatments. It’s a good idea to still keep a track of your emotional state, any foods you’ve eaten, or any possible environmental triggers that occur around your migraines, so that you have them to hand for discussion in case there may be something you’ve missed.9
Your migraines often occur when out and about or busy at workIf you often suffer from migraines when away from home or the at office you might benefit from formulations such as orodispersible tablets or nasal sprays, which can be taken quickly without the need for a glass of water or any additional means of administration.2 Such formulations may offer a convenient alternative option to tablets when you need something you can take quickly and easily.2
Your migraines cause you to feel sick or vomitNausea and vomiting are common symptoms of migraines and can make it difficult for you to take tablets or for swallowed tablets to take full effect.7 If this is the case you may need an alternative treatment or formulation option to ensure you still get effective symptom relief.
Your current treatment takes a long time to take effectTriptans and other migraine treatments are available in a number of formulations, and some of these take effect quicker than others.4 If you find that your current treatment does not act quickly enough to control your migraine symptoms, or if you find that your symptoms are harder to manage with tablets, you may want to speak to your doctor about alternatives.
You struggle with taking tablets when suffering with a migraineIf you struggle with taking tablets, whether that’s because of side effects or simply difficulties swallowing them, you might benefit from alternatives such as nasal sprays or orodispersible tablets which dissolve on the tongue. Triptans, the most commonly prescribed migraine treatments, are available in a number of different formulations so you should be able to find one which works for you.4
I had never had a migraine in my life until 8 years ago—I got a headache that just wouldn't shift. There seemed no rhyme or reason as to why this started—but I haven't had a single day since where, to a greater or lesser degree, I haven't had a headache, or chronic migraine as I now have the official diagnosis. It's hard not to feel sad. There's sadness when I stop coping for a minute and just consider my chronic migraine.
I feel sad for the days, weeks, months of my life that I've lost just being on a sofa in excruciating pain; unable to ease it no matter what drug I took, and I've taken the lot!
Sad that every time I try a new treatment, whether it's occipital nerve blocks, muscle paralysing injections, or even alternative and holistic therapies, they don't work, and my desperate hopes are dashed again.
But most of all I'm sad about the person my chronic migraine has made me. I'm still me, of course, but a half-light version of myself. When I am blessed with the rare day of a low-level headache, I start to feel like the old me, like my real self, and my joy starts to bubble to the top. Then, when the pain inevitably returns again, I go back to coping, not living once more. My temper is shorter, my humour less, all the room in my brain for creativity and inspiration is taken up by me fighting the drills I can feel boring into my temples.
I still believe that one day the right treatment will come along to lift this from me, or maybe it'll just go away as mysteriously as it started. I just hope I don't have to wait another eight years.
I started having migraines 15 years ago when I hit puberty – as if it wasn’t rough enough. I get them once or twice a month, lasting anywhere between four hours to two days.
In the last year, I’ve worked out that my migraines are related to my menstrual cycle. Realising this has been a huge help in managing my migraines. I’ve also come to realise that specific things can relieve my symptoms, such as getting fresh air, exercising to release tension in my shoulders and limiting caffeine intake. Even though I can’t stop migraines from coming, it’s good to know there are things I can do that help alleviate my symptoms.
Having migraines affects me most at work as, like most of us, I spend the majority of the day looking at a screen. I often find talking to people on the phone can be much harder when I’m having a migraine. I do my best to plough through until half past five, taking regular breaks from the screen, and then I go straight home to sit in a dark room and do absolutely nothing until it has passed.
Even though my colleagues are sympathetic, they can’t really empathise. I actually find that telling people about my migraines weighs me down, so I often tend to keep it to myself when I’m suffering with one at work. When I think back to my life before migraines, I remember being unable to understand what migraines were like – and now I know all too well. This is probably the most frustrating thing about having migraines: people don’t really understand just how bad they can be, and that they’re more than ‘just’ a headache.
My migraines first started at uni, though they’ve become noticeably worse since I started working full time. I think this is probably down to concentrating on one thing all day, whether it’s a computer or a piece of work. If I catch it early, I’m usually okay, but being busy at work means its not always possible; as a result, they usually last around 24 hours, plus another day to recuperate.
I tend to manage my migraines with painkillers from the supermarket. The only trouble is how nauseous they can leave me feeling – this is a tell-tale sign that I’m experiencing a migraine. When I get one, the only thing that makes it better is getting into a dark, quiet room and sleeping…unfortunately, this isn’t something I can do in the office when I have deadlines. I also find it difficult to talk to people when I’m having a migraine, which is annoying.
The thing I find most frustrating about having migraines is the time I have to take off work. Because people don’t tend to understand the severity of migraine symptoms, I often feel a bit pathetic for needing time off. The flipside of this is that people who also suffer from migraines are incredibly understanding, which is invaluable. The worst time was having to miss a free three course dinner, with drinks, because of a migraine. Thanks a lot!
Generally, I manage with my migraines fairly well. I’m planning on speaking to my doctor about alternative treatments that can get around the nausea caused by migraines – fingers crossed I find something that works for me.
When l was growing up with a family with a rather more English outlook we had tea frequently, l'd say 4-5 times a day.
When l missed one of these tea sessions l would get an excruciating headache, start vomiting and sweating up until l had that cup of tea. The relief wasn't instant, l had to sleep it off.
As l grew older and kicked the tea habit, l think it has just become worse. I can feel it coming with a slight headache. l always pray nothing comes of it but l am always wrong. So l avoid eating during such times as l know throwing up is next. I only seem to get some relief after throwing up, it takes hours though. In a week, l have headaches at least 6 days and my social life has gone to the garter as my temper is very high most of the time. I can never enjoy a simple beer as l know what it comes with.
I begin to feel very thirsty with short breath. By the way, l work long hours at home. Being alone seems to help a lot. I am very irritable around people, so my relationships are non-existent. I tend to lose focus on important matters as l focus on this headache situation.
moments that matter
We believe that you are the migraine experts and we want to hear about how you manage your migraines and the amazing things you manage to do despite them. If your story is published, it could help others feel less alone.
Tell us about the moments that matter to you, share your story.
- Silberstein SD. Headache 1995; 35(7): 387-96.
- Gladstone JP and Dodick DW. Practical Neurology 2004; 4: 6-19.
- NHS UK. Migraine causes. Available from: https://www.nhs.uk/conditions/migraine/causes. Last accessed July 2019.
- Kelman L. Cephalagia 2007; 27(5): 394-402
- Sacco S, et al. J Headache Pain 2018; 19: 76.
- NHS UK. Hormone headaches. Available from: https://www.nhs.uk/conditions/hormone-headaches. Last accessed September 2018.
- Steiner T et al. J Headache Pain 2007; 8: 53.
- The Migraine Trust. Visiting your GP. Available from: https://www.migrainetrust.org/living-with-migraine/seeking-medical-advice/visiting-your-gp. Last accessed September 2018.
- The Migraine Trust. Keeping a migraine diary. Available from: https://www.migrainetrust.org/living-with-migraine/coping-managing/keeping-a-migraine-diary. Last accessed September 2018.