Migraines: Symptoms, Causes, Treatments & Prevention

Katelyn Hagerty FNP

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 12/02/2020

Migraines are a type of moderate to severe headache. They often recur and can cause intense, throbbing, pounding pain that gradually becomes worse over time.  

For many people, migraines are accompanied by other symptoms, such as nausea, feelings of weakness and vomiting. Things like movement, bright lights and loud noises can often make migraine symptoms more severe.

Migraines are common, affecting around 12 percent of all Americans. They can happen at any time and in any setting. Some people only get migraines one or two times per year, while other people experience persistent migraines that occur every month, week or on a daily basis.

There are several different types of migraines, each of which may produce a different range of symptoms.

Migraines can be extremely painful and unpleasant. While there’s no cure for migraines, there are several effective treatments that can help to relieve your symptoms and lower your risk of experiencing migraines in the future.

There are also several lifestyle changes and therapeutic techniques that may help to prevent migraines from occurring or make them less frequent. 

Below, we’ve provided more information about what migraines are, the common symptoms of migraine and the factors that can cause migraines to develop. Finally, we’ve listed treatments and preventative techniques to help you to control migraine attacks and their symptoms.

What Are Migraines?

Migraines are moderate to severe recurring headaches. The pain caused by migraines is often described as being intense, pulsing and focused on one area of the head.

According to the International Headache Society, a migraine is diagnosed based on its pain and the number of attacks that occur at once. Many migraines take place over the course of several hours or days and involve multiple, recurring headaches.

Migraine Symptoms and Phases

There are several different types of migraine, each with slightly different symptoms. Sometimes, migraines will occur with an aura — symptoms that develop before or during a migraine and can often signal that a migraine is about to start.

Migraines typically go through four phases. Some people will go through all four phases during a migraine, while others may only experience some phases. 

Prodrome Phase

Also referred to as “pre-headache,” the prodrome phase of a migraine typically marks the start of a migraine attack. The prodrome phase of a migraine may last for several hours or extend over several days.

In the prodrome phase, you may experience a variety of symptoms that suggest a migraine is about to start. Common symptoms during this phase include:

  • Unexplained changes in your mood, including feelings of depression or irritability

  • Difficulty focusing on specific tasks or activities

  • Muscle stiffness, particularly around the shoulders and neck

  • Higher-than-normal sensitivity to sound and bright light

  • Cravings for certain foods

  • Increased fluid retention

  • Uncontrollable yawning

  • Frequent urination

  • Constipation or diarrhea

  • Nausea

Identifying the symptoms you experience during the prodrome phase of a migraine can help you to take action and treat the migraine before it worsens.

Aura Phase

The aura phase occurs between the prodrome phase and the headache phase. Not all people who get migraines experience aura. According to the American Migraine Foundation, between 25 percent and 30 percent of people prone to migraines experience the aura stage of a migraine.

Similar to the prodrome phase, the aura phase can often serve as a warning that a migraine is about to start. Common symptoms during this phase include:

  • Temporary loss of vision, or blind spots, in one or both of your eyes

  • Visions of flashing, shimmering lights, sparks or geometric patterns

  • Periods of blurry vision

  • Inability to communicate clearly

  • A feeling that you’re being touched or grabbed

  • Tingling on one side of your body

  • Temporary muscle weakness

Aura symptoms can last for anywhere from five to 60 minutes or longer. About 20 percent of people get aura symptoms that persist for longer than an hour. Some people experience aura symptoms at the same time as a headache.

Although aura symptoms usually precede the headache phase of a migraine, some people may experience aura without a headache after.

Headache Phase

The headache phase occurs after the prodrome and/or aura phase. In this phase of a migraine attack, you may experience pain that affects one or both sides of your head over the course of several hours or days. 

Migraine headaches can vary hugely in severity. While some people only experience mild pain during this phase of a migraine, others can experience severe, extremely unpleasant pain that makes everyday tasks difficult and challenging.

Certain things, such as changes in light levels or some types of physical activity, can cause the pain of a migraine headache to worsen.

It’s common for migraine headaches to begin gradually and grow more severe over time. For some people, a migraine headache can begin on one side of the head and “move” to the other side as it progresses.

In addition to pain, the headache phase of a migraine can also involve other symptoms. During this phase, you may experience:

  • Anxiety

  • Nausea and vomiting

  • Enhanced sensitivity to noise, light and scents

  • Insomnia and/or other sleep difficulties

  • Pain that worsens with movement, sneezing or coughing

Most of the time, the headache phase of a migraine fades away gradually over time. However, in some cases, the headache phase can stop quickly. Some people find that sleeping helps to bring the headache phase to an end faster.

Postdrome Phase

The postdrome phase, or recovery phase, is the final stage of a migraine attack. It occurs after the headache phase and is often referred to as the “migraine hangover” phase, as many of the symptoms of a migraine can persist during this phase.

Approximately 80 percent of people who experience migraines go through the postdrome stage of a migraine attack. The postdrome phase doesn’t always occur — even in people prone to it, some migraines may end without going through this phase.

For some people, the postdrome phase of a migraine can be just as severe and unpleasant as the headache phase. It can vary in length from just a few hours to several days. Symptoms of the postdrome phase include:

  • Exhaustion

  • Body aches

  • Weakness and confusion

  • Difficulty concentrating

  • Sensitivity to light

  • Dizziness

During the postdrome phase, it’s still important to actively avoid migraine triggers. Things such as bright or flashing light and loud noises can worsen symptoms. You may find that relaxation techniques provide relief during this phase of a migraine.

Virtual Primary Care

Connect with qualified healthcare providers online

What Causes Migraines?

Most people affected by migraines start to note them between the ages of 10 and 45. Women, people with a family history of migraines and people with certain psychiatric disorders, including anxiety and depression, typically have the highest risk of experiencing migraines.

Researchers believe that migraines are caused by abnormal brain activity. The exact process by which a migraine develops isn’t fully known, although certain activities and events can often trigger migraines and cause symptoms to develop. 

Most experts believe that migraines begin in the brain, with sudden changes to brain chemicals and nerve pathways altering the flow of blood to the brain and nearby parts of the body. 

A variety of factors can trigger a migraine, with migraine triggers differing between people. The most common migraine triggers include:

  • Certain medications, or overuse of medications

  • Overexertion, exercise or other forms of physical stress

  • Mental stress, anxiety and other factors that affect mood

  • Sleep-related issues, such as insufficient sleep, excessive sleep or changes in a person’s sleeping patterns

  • Hormonal changes, including (in women) changes related to use of hormonal birth control or the menstrual cycle

  • Loud noises, strong smells (including perfume) and other sensory factors

  • Sudden changes in temperature, weather or environment

  • Bright and/or flashing lights

  • Smoking or exposure to smoke

  • Caffeine use or caffeine withdrawal

  • Drinking alcohol

  • Missed meals

Some people experience migraines after eating certain foods. Common food-related migraine triggers include:

  • Aged cheeses

  • Chocolate

  • Alcohol

  • Certain types of fruit and nuts

  • Cured or processed meats that contain nitrates

  • Monosodium glutamate (MSG)

  • Fermented, pickled or marinated foods

  • Tyramine-rich foods, such as smoked fish, red wine, chicken liver and some beans

Risk Factors for Migraines

Although migraines affect both men and women, they’re significantly more common in women than in men. In fact, women are approximately three times more likely than men to experience migraines.

Other risk factors for migraines include a family history of migraines. Researchers think that migraines have a genetic component, meaning you may have an increased risk if your family members also experience migraines.

Finally, some medical conditions may increase your risk of getting migraines. You may have a higher risk of being affected by migraines if you have:

  • Anxiety

  • Bipolar disorder

  • Depression

  • Epilepsy

  • Sleep disorders, 

Treatments for Migraines

Currently, there’s no cure for migraines. However, a variety of treatment options are available to provide relief from the pain and other symptoms caused by migraines. Some treatments can also reduce your risk of experiencing migraine attacks. 

Medications for Migraines

Several medications are used to treat migraines. Some medications are used to treat migraines when they occur. These are referred to as abortive treatments. Other medications may be used to prevent migraines from occurring. These are referred to as preventative treatments.

Common abortive treatments for migraines include the following medications:

  • Anti-inflammatory medications (NSAIDs and acetaminophen). Some NSAIDS, such as ibuprofen, naproxen sodium, aspirin and others, are used as treatments for migraines when they occur.

  • Acetaminophen (paracetamol). The pain relief medication acetaminophen, either on its own or in combination with aspirin and caffeine, may be used to treat acute migraines.

  • Triptans. Several triptan medications are approved by the FDA as migraine treatments, including eletriptan, zolmitriptan, naratriptan, sumatriptan, frovatriptan, almotriptan and rizatriptan.

    Triptans are often used to treat severe migraines, or as a second treatment option when NSAIDs and acetaminophen aren’t effective.

  • Antiemetics. Antiemetics, such as metoclopramide and prochlorperazine, are used to treat migraines that involve vomiting and nausea. These medications may be used on their own or in combination with NSAIDs or triptans.

  • Ergotamine. Although it’s largely been replaced by triptans, ergotamine is used to treat migraines in certain situations. Ergotamine may be effective for people who experience infrequent or long duration headaches. It’s often used in combination with caffeine.

If you experience migraines, your healthcare provider may recommend that you use one of the medications listed above. You may need to try several different medications before finding one that provides adequate relief from your symptoms. 

Abortive treatments for migraines are generally more effective the earlier you take them, making it important to have medication ready if you’re prone to migraines. 

While abortive treatments can provide relief from migraine symptoms during a migraine attack, they aren’t designed to prevent migraines from occurring. If you get persistent migraines, your healthcare provider may recommend that you use a preventative treatment. 

Common preventative treatments for migraines include the following medications:

  • Antiepileptics. Some antiepileptic and anticonvulsant medications, such as topiramate and valproate, are used to prevent migraines.

  • Antidepressants. Some antidepressants, including the SSRI fluoxetine (Prozac®) and the tricyclic antidepressant amitriptyline (Elavil®) may be used to prevent migraines.

  • Beta-blockers. Several beta-blockers, including atenolol, propranolol and others, may be used as preventative treatments for migraines.

  • Calcium channel blockers. Several calcium channel blockers, such as verapamil, are also used to prevent migraines.

Some of these medications may be prescribed to prevent migraines off-label, meaning they’re not approved for this purpose by the FDA. Like with abortive treatments, you may need to use several preventative treatments in order to find one that works effectively for you.

Techniques for Treating Migraines

If you experience a migraine, using certain techniques may make it easier to deal with the pain and discomfort. Try to:

  • Avoid bright light, whether natural or artificial. Spend your time in a darkened room, as this may be less likely to cause your migraine symptoms to worsen. As well as bright light, try to avoid loud noises.

  • Keep yourself hydrated. Make sure to get plenty of water and other fluids while you’re dealing with migraine symptoms.

  • Use an ice pack to relieve pain. Try placing an ice pack on your forehead to make any pain you experience less intense and uncomfortable.

  • If possible, take notes about your symptoms after you recover. This can help your healthcare provider to prescribe an effective treatment. It’s also useful to write down the factors that may have triggered your migraine for avoidance in the future.

How to Prevent Migraines

In addition to using a preventative treatment, making certain changes to your habits and lifestyle may help to prevent migraines. 

Take Steps to Avoid Migraine Triggers

Migraines are often triggered by certain events or activities, such as changes in the weather or exposure to bright light.

Although migraine triggers can differ from person to person, there are several triggers that seem to cause migraines in a large percentage of people. Taking steps to avoid these may help you to reduce your risk of experiencing migraine headaches. 

Try the following strategies to avoid common migraine triggers and gain better control over your migraine attacks:

  • Maintain healthy, consistent sleep habits. Migraines are closely associated with sleep disturbances. If you typically don’t get enough sleep, or have inconsistent sleep habits, making some positive changes to your sleep schedule may be helpful.

    Try to sleep at the same time every night. Aim for the CDC’s recommendation of seven hours or sleep or more per night. You can also use the tips in our science-based guide to better sleep to improve your sleep duration and quality.

  • Take steps to minimize stress. Stress is a common trigger for migraines that’s present in about 70 percent of people.

    If you often feel stressed, try using stress management techniques. Other things that can help include eating healthier, avoiding tobacco and nicotine, using relaxation techniques, avoiding common stress triggers and setting goals to minimize stress in your life.

  • Avoid migraine-inducing foods. Many foods can trigger migraines, including a variety of cheeses, fruits, nuts and cured meats.

    If you’re prone to migraines after eating, try keeping a food diary to identify the specific foods that are contributing to your symptoms. Take note of foods that are linked to your migraine attacks and make an effort to avoid them in the future.

  • Keep yourself hydrated. Dehydration is a common migraine trigger that’s reported by about one third of people prone to migraines. Beyond migraines, dehydration can also cause potentially severe symptoms such as dizziness, confusion and tiredness.

    To reduce your risk of migraines, keep yourself hydrated. While there’s no exact target for water consumption, drinking four to six cups per day is a helpful target for generally healthy people.

  • Make sure not to overuse migraine medication. Although the pain relief medications used to treat migraines are effective, using them too often can cause you to experience secondary headaches known as medication overuse headaches (MOH).

    If you develop headaches after using your medication, it’s best to talk to your healthcare provider. They may adjust your dosage, prescribe a different medication or suggest that you make certain changes to your use of migraine medication.

  • Understand how caffeine affects your migraines. Some people experience migraines after drinking coffee or other caffeinated drinks. Others report that caffeine makes their migraines less severe.

    If you’re prone to migraines after drinking caffeine, consider reducing your coffee intake or removing caffeine from your diet entirely. If you absolutely can’t go without coffee, try to limit your consumption to just a few days a week to avoid developing a tolerance.

  • Try to limit your alcohol consumption. Research shows that alcohol is a minor trigger for migraines, although its risk is overstated. If you’re prone to migraine attacks from alcohol, try to limit your consumption or avoid drinking alcohol altogether.

  • Avoid strong smells. Strong odors, such as perfumes, gasoline, chemicals and certain types of food, can activate the nerve receptors in your nose and may trigger or worsen a migraine.

    If you’re prone to migraines from strong smells, avoid things like perfume and chemicals that may trigger your symptoms. Let your friends, family members and other people that spend time with you know about this migraine trigger so that they can help you.

  • If light triggers your migraines, wear sunglasses. Migraines are often triggered by a sensitivity to bright natural light — a condition referred to as photophobia.

    While it sounds overly simple, wearing sunglasses can help to make dealing with bright natural light much easier. When you’re inside, try to avoid staying too close to bright or flashing lights, as these can trigger or worsen migraines.

If You’re Overweight or Obese, Try to Lose Weight

Migraines are closely associated with obesity, with the risk of migraine higher in people who are overweight or obese compared to those who are a normal weight.

If you’re overweight or obese, losing weight may reduce your risk of experiencing migraines. Try to eat healthier, exercise and gradually reduce your weight until you’re in the normal body mass index (BMI) range.

In Conclusion

Migraines can be debilitating and extremely unpleasant, especially when they cause severe pain and other symptoms. 

Although there’s no cure for migraines, numerous treatments can manage the pain and other symptoms you may experience during a migraine attack. Certain treatments and changes to your lifestyle may also prevent migraines from occurring or make them less frequent. 

If you get migraines, talk to your healthcare provider or consult with a US-licensed healthcare provider online. They’ll work with you to identify your migraine triggers and recommend a safe, effective treatment that you can use to get your migraines under control. 

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

📫 Get updates from hims

Insider tips, early access and more.