on the moments that matter?
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
- The food additive 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 don’t think your migraine treatment is doing as much as it should,it’s worth speaking to your doctor about other alternatives.For instance, you should speak to your doctor if:
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.5
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. Such formulations may offer a convenient alternative option to tablets when you need something you can take quickly and easily.
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. If this is the case you may need an alternative treatment or formulation option to ensure you still get effective symptom relief.4
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.
- Migraine Action. Migraine Triggers. Available from: http://www.migraine.org.uk/information/triggers. Last accessed September 2018.
- 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: S3.
- 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.
- 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.
- Uemura N, et al. Cephalalgia 2003; 23(7):707. Gawel M, et al. Cephalalgia 2003; 23 P5N73:711. (Abstract); Uemura N, et al. Headache 2003; 43(5):584. (Abstract); Charlesworth CNS Drugs; 2003; 17(9):653-667