While the causes of migraine are not yet clear, researchers have found genetics, environment, serotonin levels, and electrical activity in the brain to be significant contributing factors.

Migraine is a chronic neurological condition that affects 39 million people in the United States.

It has a variety of symptoms, most notably severe headache pain. But a migraine episode is much more than just a bad headache. The symptoms vary from person to person but can include:

  • intense headache pain
  • nausea
  • vomiting
  • neck pain
  • general aching
  • irritability or sadness
  • sensitivity to sounds
  • sensitivity to smells
  • sensitivity to light
  • changes in vision

Migraine can be episodic or chronic. If you experience migraine pain 14 days per month or fewer, doctors classify the condition as episodic.

If you experience the pain 15 days per month or more and have other migraine symptoms on most of these days, doctors consider it chronic migraine.

Migraine is a bit of a mystery. While the exact cause is unclear, researchers have identified a few contributing factors, including:

  • genetics
  • environmental factors
  • levels of serotonin in the body
  • slight blood vessel changes
  • electrical activity in the brain

Researchers continue to look into the potential causes of migraine.

Three out of 4 people who experience migraine are women. Most migraine episodes occur in women ages 20 to 45. Often, they occur during a menstrual period, though the link between migraine and menstruation is still unclear.

Women often tend to report more varied symptoms than men, including nausea or vomiting.

While migraine in women is often triggered by hormonal changes, migraine episodes in men are more often triggered by physical exertion.

The assumption that migraine is a “woman’s disease” may cause men to underreport their migraine symptoms or to think it is something else.

Experts believe that certain factors can trigger a migraine episode. The best way to prevent migraine episodes is to avoid their triggers. These can vary from person to person, and most people with migraine have several triggers.

Often, foods and drinks are involved, including:

  • alcohol, especially red wine
  • cheese and other dairy products
  • chocolate
  • coffee
  • cured meats
  • foods that have a strong smell
  • preservatives and sweeteners, such as aspartame, monosodium glutamate (MSG), and nitrates, which are often in processed meats

Other common triggers include:

  • Skipping meals: Missing meals altogether or not eating proper meals can lead to a migraine attack.
  • Exercise: Excessive neck movements may trigger a migraine episode, especially if you haven’t been active in a while.
  • Dehydration: For some, even the slightest dehydration can bring on a migraine attack.
  • Sensory stimulation: For some people, certain smells or other sensory stimulation can be a migraine trigger even if they’re mild. Unusually bright lights, loud noises, or strong smells may set off a migraine episode. Flashlights, bright sun, perfume, paint, and cigarette smoke are all common triggers.
  • Hormonal changes: Up to 75% of women with migraine report that attacks develop around the time of their periods. Others report migraine episodes during pregnancy or menopause. Experts believe that fluctuations in estrogen and progesterone levels during these times can trigger migraine episodes.
  • Hormone medications: Birth control and hormone replacement therapy, for example, can also trigger or worsen migraine attacks. But sometimes, these treatments may actually reduce migraine headaches.
  • Other medications: Vasodilators, such as nitroglycerin, which are used to treat conditions like high blood pressure or heart failure, can trigger migraine episodes.
  • Stress: Stress may be a trigger for almost 70% of people with migraine. Emotional stress may stem from demands at work or at home, and physical stress, from overexertion or sexual activity, for example, can also trigger migraine attacks.
  • Irregular sleep: Sleeping too much or too little can be triggers. If you don’t have a routine sleep schedule, you may experience more migraine episodes.
  • Weather changes: Storms, intense heat waves, shifts in barometric pressure, or high altitudes can trigger a migraine episode for some people.
  • Screen time: Many people find that spending a lot of time in front of a computer can bring on migraine attacks.

Not everyone exposed to triggers develops migraine. The following factors can influence your risk of developing the condition:

  • Age: A first migraine episode can happen at any age, but most people with migraine have their first episode during adolescence.
  • Family history: If a close family member has migraine, this increases your risk. In fact, 90% of people with the condition have a family history of it.
  • Sex: During childhood, migraine is more common in males. After puberty, females become three times more likely to have it. The risk of migraine continues to rise in women until age 40 then starts to decrease.

What is the main cause of migraine?

The causes of migraine are not fully known. Current theories suggest they are a result of changes in neurotransmitter action or slight blood vessel changes in the brain, but research is still ongoing.

Migraine has been found to be genetic, and most people affected have a family history.

What usually triggers a migraine?

Migraine triggers vary greatly among individuals. Common triggers for a migraine episode include hormonal changes, certain physical positions, stress, and certain smells, lights, or sounds.

How do you make a migraine go away?

Triptans are a class of drugs that have effects on blood vessels and nerves in the brain that may ease symptoms during a migraine attack. Triptans are the drug of choice for treating migraine.

Once you’re experiencing a migraine episode, pain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce inflammation and relieve pain.

What are the 4 stages of migraine?

A typical migraine episode has four stages:

  • Prodromal: The initial phase, which may last 1–2 days, includes symptoms like irritability, sadness, or food cravings.
  • Aura: This may occur before or during the headache and involves visual effects like flickering or jagged light or other effects, including numbness or tingling. More rarely, some may experience language or motor impairment.
  • Headache: A throbbing headache that may occur on one side of the head or both with moderate or severe pain.
  • Postdromal: You may experience muscle aches or a sense of relief, often accompanied by exhaustion.

There are two main types of treatment for migraine: acute and preventive treatment.

A person takes acute treatment during a migraine episode to relieve the symptoms and stop them from getting worse. Options include over-the-counter pain relievers, prescription medications, and devices. Many of these devices provide stimulation that affects the brain’s electrical signaling.

Preventive treatment aims to reduce the frequency, severity, and duration of migraine episodes before they start. Options include medications and procedures, as well as lifestyle changes and behavioral therapy.

Preventive treatment only works for about 40% of the people who take it. When it does work, it helps reduce the frequency of migraine episodes by at least 50%.

If you experience migraine symptoms, make an appointment with a doctor. After they confirm the diagnosis, you can work together to determine which triggers to avoid and which treatment options to try.