If you’re a sufferer of migraine headaches you can probably spot one coming. You might experience changes in vision, pins-and-needles sensations in your body or even difficulty speaking.
And then, the pain: A severe headache, often on one side of your head, sometimes pulsing, sometimes with other symptoms such as nausea and sensitivity to light or sound.
For migraine sufferers, these headaches can be debilitating. Nationwide, 39 million people experience migraines — and three out of four of them are women.
“Women are more likely to suffer from migraine headaches, which can be strongly tied to fluctuations in estrogen,” says Dr. Katherine Nonweiler, family medicine physician with ThedaCare Physicians-Kimberly. “Knowing the symptoms, triggers and how to care for yourself can help alleviate the frequency and impact these headaches can have.”
The onset of migraines
Not everyone experiences symptoms prior to a migraine. However, if you do, they often signal an episode’s arrival — even a day or two before the pain comes — with a “prodrome” stage.
“Symptoms can include mood changes, food cravings, constipation or fluid retention, increased urination, yawning or a stiff neck,” Dr. Nonweiler says.
You might experience an aura immediately prior to the onset of head pain. It can include visual phenomena like spots or moving lights. You might also have tingling in your face, arms or legs, or you may have trouble speaking.
The attack phase — the pain — can manifest differently, usually with a headache occurring on one side of the head but sometimes both. During this phase, you might experience throbbing or pulsing pain, sensitivity to light, sound and touch, and nausea and vomiting. Left untreated, the headaches can last up to three days.
The postdrome phase, or the day or so after a migraine headache, may leave you feeling drained and confused, with pain returning briefly with sudden head movement.
The hormone connection
People with a family history of migraines are at greater risk of developing the headaches. Age plays a role, with younger people usually experiencing them more intensely, and the first often manifesting in the teen or preteen years.
This is especially true for women, who are three times likelier than men to have migraines. The first headache might happen around the onset of menstruation. Menstrual periods, pregnancy and the onset of menopause also can impact migraine occurrence.
Oral contraceptives and other hormonal medication can make migraines worse for many women — though some women say these medications help diminish the frequency of the headaches.
“Many other external factors also can trigger migraines or intensify them,” Dr. Nonweiler says. “Patients who experience migraines may be able to alleviate the frequency or severity by making some lifestyle changes.”
- Avoiding alcohol, particularly wine
- Switching to decaf, as caffeine can be a trigger
- Reducing stress
- Avoiding loud noises, bright or flashing lights, and strong smells
- Getting enough sleep and keeping a regular sleep schedule
- Avoiding excessive physical exertion
- Avoiding salty and processed foods, as well as aged cheeses; certain additives including aspartame and monosodium glutamate (MSG) also can trigger migraines
- Avoiding fasting, which can trigger migraines
- Avoiding overuse of painkillers, particularly aspirin, acetaminophen and medicines that contain caffeine
You might notice your migraines are triggered by changes in weather, such as fluctuations in barometric pressure, bright sunlight, extremely hot or cold weather, dry air, or storms.
“It may help to keep a migraine diary to record the factors that may be triggering the onset of your headaches,” Dr. Nonweiler says. “This can include keeping track of your food and what’s happening with the weather.”
Staying in on days that are likely to trigger your migraines, along with making other healthy lifestyle changes, can help reduce the frequency of the headaches, she says.
Taking care of a migraine
When a migraine is unavoidable, there are ways you can help diminish its impact.
“Relaxing in a dark and quiet room can help alleviate some pain from a migraine, as light and sound can intensify the headaches,” Dr. Nonweiler says. “Hot or cold compresses also can provide relief, with heat helping to relax stiff neck muscles and cold helping to numb the pain.”
Sipping a small amount of a caffeinated drink can help as well. However, remember that too much caffeine can trigger a migraine, and it can interfere with needed sleep and cause a withdrawal headache later.
“If you have frequent migraines, see your provider to talk about prescription medications and other therapies that may help,” Dr. Nonweiler says.
While migraines can feel distressing, they don’t require a visit to the emergency room. Instead, if you have concerns about migraines or headaches, you can visit an urgent or walk-in care site or make an appointment with your primary care provider.
Seek emergency care for headaches when they are:
- Sudden, severe and seem to come out of nowhere
- Following a head injury
- Accompanied by fever, stiff neck, numbness or weakness in the body
- Accompanied by confusion or double vision
- Chronic and get worse with exertion or coughing
“These symptoms may indicate a more serious medical condition such as a stroke or other concerns that need immediate attention,” Dr. Nonweiler says. “Don’t hesitate to seek assistance if you have any question about the nature of your headache.”
Have concerns about migraines or headaches?
Visit your primary care provider or a walk-in or urgent care clinic.