What causes a migraine is still a mystery, but doctors are aware of a variety of factors that have been shown to initiate migraines. These factors are called triggers, and for people with migraines, avoiding them may be the only way to avoid a migraine. Each person’s triggers will be different. For some migraine sufferers, only one trigger sets off a headache. For others, the trigger responsible for the headache may change from migraine to migraine. Here, the many factors that are known to make migraines more likely to occur.

The Most Common Triggers

The most common triggers for migraines include:

  • Sleep changes: Getting too much or too little sleep may trigger a migraine.
  • Stress and anxiety: Emotional or mental stress and anxiety can trigger migraines.
  • Medications: Certain medications may increase your chance for a migraine. These include oral contraceptives and vasodilators.
  • Bright lights/photophobia
  • Loud noises/phonophobia
  • Strong odors: Such as perfumes or secondhand cigarette smoke
  • Foods: The most common food offenders include aspartame, an artificial sugar substitute; foods that contain tyramine (a substance that forms as foods age), such as aged cheeses, hard sausages, and Chianti wine; foods that contain monosodium glutamate or MSG, a key ingredient in many broths, Asian foods, and processed foods; caffeinated or alcohol drinks, particularly beer and red wine; and foods that contain nitrates, such as hot dogs, bacon, and salami. Skipping a meal or fasting may also increase your likelihood for a migraine.
  • Changes in the weather and barometric pressure
  • Hormonal changes: This is a particularly troublesome trigger for many women—fluctuations in estrogen, caused by menstruation, pregnancy, or menopause, may cause a migraine. Hormone medications, including oral contraceptives and hormone replacement therapy, can trigger or even worsen migraines, too.
  • Physical activity: Physically exerting yourself—whether through exercise, sexual activity, or physical labor—may cause a migraine.

Other Risk Factors

  • Genes: Research suggests your genetics may play a role in who is likely to suffer from migraines. After all, 90 percent of people with migraines have a family history of the severe headaches. If your parents, siblings, or children have migraines, you’re more likely to have them.
  • Gender: Seventy percent of migraine sufferers are women. However, in childhood, boys are more often affected than girls. The gender switch begins around the time of puberty.
  • Age: Most people will experience their first migraine in adolescence, but they can occur at any age.
  • Weight: Women who are mildly obese or obese have a greater risk for migraine headaches than women with a lower BMI.

How You Can Find Your Triggers

Pinpoint your migraine triggers by keeping a headache diary. Each time you have a migraine headache, record it. Also, be sure to record the time of day your headache started; what you ate or drank in the 24 hours preceding the migraine; where you were and what you were doing when the symptoms of the migraine began; and finally, if you had any other conditions that might have triggered the migraine. For example, if you’re a woman, write down if you have your period. If you take any medications to ease symptoms, record what and how much you took. Also note if that medication helped and how quickly. If your doctor has prescribed a medication to treat your migraines, having a record of its effect on your headache will be especially helpful for him or her to determine if you’re taking the right medicine for your condition.

Take this journal with you to your next doctor’s appointment. Having your doctor review your headache journal may help him or her pinpoint possible triggers. Start by avoiding those triggers as best you can to avoid another migraine. If one occurs anyway, record that information and share it with your doctor. If you find that avoiding the triggers helps your headache, it is possible you’ve found the triggers for your headaches, and avoiding them from now on will help you avoid migraines.

Avoiding Triggers

You can’t always avoid what causes your migraines, but for those risk factors where you do have control, avoiding them may help you prevent migraines and live a pain-free life. Keep away from any food or drinks that make headaches worse. If you know a particular perfume or scent brings on a migraine, avoid that. If possible, establish a daily routine and environments (at home and at work) that are less likely to initiate a migraine headache for you.

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Break It Down: Migraine and Severe Migraine

Migraines are intense headaches that affect more than one in 10 people. Women are three times more likely to experience migraines than are men, and migraines have been shown to run in families.

These painful headaches can last up to 3 days if not treated, causing throbbing pain, sensitivity to light or sound, nausea and vomiting, and difficulty doing normal physical activities, such as standing or walking. Severe migraines can also cause symptoms like uncomfortable tingling or weakness in your arms and legs, or even vision changes such as seeing flashing lights or blurring. Vision changes, odd sensations of smell, or feeling unwell may precede a migraine in what is known as the aura. Auras typically begin slowly over five to 20 minutes and usually cease within 60 minutes.

While rare, other types of migraines can cause partial blindness, double vision, paralysis on one side of the body, vertigo, or symptoms that may mimic a stroke. Migraines can become so severe and disruptive that they require treatment in the emergency department. If you experience speech, vision, or balance problems you haven’t experienced before, you should be seen by a qualified medical professional. Persons over the age of 50 should seek medical attention if what appears to be a migraine starts suddenly, like a clap of thunder, because this presentation could be a sign of something more serious.

You should know that certain factors can trigger migraines. These include physical or emotional stress, bright lights and sounds, strong odors, changes in the weather, cigarette smoking, drinking alcohol, not getting enough sleep or food, and certain foods and food additives. Women experiencing hormone changes during menopause may also begin to experience migraines for the first time.

If you begin to experience a severe migraine, resting in a quiet, dark room might help. Several over-the-counter medicines, such as ibuprofen or naproxen, may help relieve the symptoms and severity of migraines.

Your doctor may prescribe special medications to treat migraines. Triptans comprise the class of drugs most commonly prescribed for severe migraines. Other types of medications, including antidepressants, cardiovascular drugs, and anti-seizure medications, have been approved to help treat and prevent migraine headaches.

Avoiding known triggers is a logical way to avoid migraines. Other ways to help prevent them include getting adequate sleep, relaxing to relieve stress, and using acupuncture or massage therapy.

Keeping a diary of your headaches, noting events that lead up to them and their severity, and bringing it to your doctor’s appointment can offer clues about how best to treat your migraines.