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The ultimate guide to migraines

23/11/20225 min read

Struggling to get your head around migraines? Want to know what they are, what can trigger them and how to avoid them? Our ultimate guide to migraines is here to clue you up on all of that and so much more.

Migraines messing with your head? This neurological condition is definitely not ‘just a bad headache’ and can cause very severe and debilitating pain. Discover more about this sometimes-mysterious condition, including the top 7 causes for a migraine, how long they can last, what food could be triggering them and more.

What is a migraine?

A migraine is a moderate-to-severe headache that usually emerges as a throbbing pain on one side of the head. It’s a common health condition that affects around 1 in every 15 men and 1 in every 5 women in the UK. People will tend to start to have migraines in early adulthood¹ and various studies show that you are much more likely to have migraines if you have family history of the condition.²

What happens during a migraine?

Migraines are different for everybody, but most migraine-sufferers experience some common symptoms.

What are common migraine symptoms?

The most common symptoms people will experience during a migraine attack include³ :

A painful, throbbing headache on one side of the head
Increased sensitivity to sound and light
Feeling sick Being sick

Are there different types of migraines?

Yes, migraine attacks come in a few different forms. Some of the most common types of migraines include⁴ :

Migraine with aura

Auras are sensory disturbances, like⁵ :

Flashes of light
Blind spot
Zig-zag lines
Temporary loss of vision
Other changes to your sight

You can also feel auras as a tingling sensation in your face or hands. If your migraine begins or comes after these disturbances, then you have a migraine with aura on your hands. Roughly one third of people will get these auras and be able to predict their migraine before any pain begins.⁶

Migraine without aura

This type of migraine is thought to be the most common and happens without any warning signs, e.g. flashes of light.

Migraine aura without headache

You may also know this is a ‘silent migraine’. It is where a person experiences aura and other migraine symptoms but never develops a painful headache.

How often do migraines happen?

One person may have several migraines in a week and are said to suffer from chronic migraines. Chronic migraine sufferers have 15 of more headache days in a month, for 3 or more months.⁷ Whereas somebody else can go months or years between their migraine attacks and are said to suffer from episodic migraines. People who have episodic migraines are characterised by having 0-14 headache days a month.⁸ It’s good to know which ‘migraine bracket’ you fall into as treatment can often differ between the two.

How long can a migraine last?

Everyone will experience migraines differently, and this includes how long they last too. Migraine attacks will typically last from 4 to 72 hours, meaning a 3 day migraine is not out of the norm.9

Are migraines serious?

Yes, any migraine can be considered serious if it is affecting your ability to lead a happy and healthy life. Migraines, especially if they are frequent, can negatively affect our lives in the following ways¹⁰:

Marriages and other romantic relationships
Family relationships
Parenting
Career progress
Financial achievement
Stability Overall health

What causes migraines?

The exact cause or causes of a migraine are still unknown. It is thought that migraines are connected to temporary changes in the brain to its nerves, chemicals and blood vessels.11 With that being said, there are many known factors that occur both inside and outside of our bodies that can cause or trigger a migraine. Trustee of The Migraine Trust, Professor Peter Goadsby sums it up here¹² : "Migraine is an inherited tendency to have headaches with sensory disturbance. It’s an instability in the way the brain deals with incoming sensory information, and that instability can become influenced by physiological changes like sleep, exercise and hunger." Let’s look a little deeper into the 7 most popular migraine causes below.

The top 7 migraine causes

1. Genetics

Roughly half of all people who have migraines also find they have another close relative with the condition, which suggests that genes may play a role. One rare type of migraine called familial hemiplegic migraine (FHM) is passed on via our DNA and has been interesting geneticists for a while now. Three causative genes have been identified¹³:

CACNA1A
ATP1A2
SCNA1A

Evidence suggests that there may be other genes that cause FHM, too, so further research is needed. Common symptoms of this type of FHM are:

Hemiparesis (when half the body becomes weak
Prolonged aura phase
Blind spots
Flashing lights
Zig-zagging lines
Double vision

To be diagnosed with this type of migraine, at least one first- or second-degree relative must also be affected.

2. Food

Some people tend to find that there is a connection between what they eat and their migraines. Commonly mentioned potential migraine trigger foods include:

Coffee, tea, energy drinks and other caffeinated beverages
Beer, wine, cider, spirits and other alcoholic drinks
Tyramine, which naturally occurs in some foods like soy sauce, aged cheeses, sauerkraut, etc.
Nitrates, which are commonly used to preserved cured meats like bacon, ham, etc
Aspartame – an artificial sweetener you can find in sugar-free soft drinks, squash, and other foods and drinks (often low-cal, low-sugar, etc.)
Monosodium glutamate (MSG) – a flavour enhancer commonly added to Chinese food

Multiple studies have found that when a patient can identify which food or foods trigger their migraines and cut them out for a prolonged period of time, things can start to improve. Patients often found that the frequency of their migraine attacks went down when they discovered which foods were a trigger, as well as experiencing a reduction in migraine symptoms.¹⁴Keeping a migraine / food diary could be useful in figuring out if you have any migraine food triggers.

3. Stress

Feeling stressed is often a migraine trigger, especially for those suffering from chronic migraines.¹⁵ Having a stress migraine may be caused by the following¹⁶ :

Internal stress in the body, e.g. hormonal activity
Physical stressors, e.g. bright lights
Psychological stressors, e.g. anxiety
Emotional / physical trauma, e.g. past abuse
Socioeconomic stress, e.g. poverty

One theory on why migraines may be caused by stress is that over time these stressors may cause ‘wear and tear’ to the brain, which may alter brain networks. This may cause the brain to respond abnormally to stressors and cause a migraine.¹⁷

4. Menstruation (aka your period)

Hormonal changes in the body happen all the time, and some have been found to trigger migraines, like menstruation. More than half or women who suffer from migraines observe a link with their periods. These ‘menstrual migraines’ tend to be particularly severe and often start in the few days leading up to a period or the first few days of menstruation. This is thought to be due to a natural drop in the hormone oestrogen. Try keeping a migraine / period diary for at least 4 menstrual cycles to help you determine if your migraines are affected by your period.¹⁸

5. Birth control

Some women find that the combined oral contraceptive pill can either improve their headaches or cause more frequent migraines – especially in the week they take a break from the pill and oestrogen levels in the body drop.¹⁹

6. Menopause

Another potential cause for migraines concerning hormones is the menopause. Women often report that their headaches get worse as they approach the menopause, as periods become irregular and the natural hormone cycle is often disturbed and disrupted.²⁰ Multiple clinical studies suggest that migraines get worse during the transition into menopause and then tend to improve post-menopause.²¹ It’s also worth noting that the conditions that sometimes come with menopause like stress, anxiety and sleep disturbances may also contribute to migraines getting worse.²²

7. Sleep

Although not understood fully at present, there has always been a link between sleep and having headaches and migraines. Interestingly, migraine attacks are more likely to occur between 4am and 9am in the morning, which suggests that it may be related to our natural sleep-wake cycle. Both a lack of sleep and too much sleep have been seen to trigger a migraine in some individuals, as well as shift work and jet lag. All of which point back to a link between migraines and our circadian rhythm.²³ On study in South Korea on sleep disorders and migraines found that there is a positive correlation with patients diagnosed with sleeping disorders and diagnosis of migraines. Insomnia has the greatest associations with migraines.²⁴

8. Low blood sugar

Experiencing abnormally low blood sugars (glucose) has been seen to trigger or aggravate migraines. Our brains are one of the first organs to be impacted by low blood sugar, as glucose is its main source of energy. Eating high-sugar foods, following restrictive diets, skipping meals, fasting or even having an irregular meal pattern can trigger migraines as they can cause blood sugar levels to drop too low.²⁵

What is the best thing to do for a migraine?

There is no known cure for migraines, but you can try the following treatments to help reduce migraine symptoms or make them more manageable:

Painkillers like paracetamol and ibuprofen can help provide pain relief
Visiting your GP to see if they recommend certain medicines like triptans and anti-emetics

Migraine home remedies

There are also things you can do at home and lifestyle changes you can make to help relieve migraine symptoms, like:

Keeping a migraine diary to determine if factors like your period, certain foods, your sleeping pattern, etc. could be triggering your migraines
Maintain a healthy lifestyle by exercising regularly, sleeping well and eating regular healthy meals
Stay hydrated by drinking lots of water and avoiding alcohol and caffeine

If you do suffer with migraines and want extra help and support, please contact your GP.