Migraine is a neurological condition that typically causes severe, recurring headaches. These headaches occur in episodes that can last anywhere from 4 to 72 hours. In addition to intense head pain, migraines often come with other symptoms such as nausea and heightened sensitivity to light.
Migraine vs. Headache
The term "migraine" is often used to refer to the headache alone, but migraines involve much more than just head pain. While headaches can result from various causes, migraines are a specific neurological condition with distinct features. Common traits of migraine-related head pain include:
- A pulsing or throbbing sensation that intensifies with physical activity.
- Pain that typically affects one side of the head.
- Accompanying symptoms such as sensitivity to light or sound, nausea, and sometimes vomiting.
Migraine Symptoms
For many individuals, a migraine episode unfolds in several phases. During the early stage—known as the prodrome—symptoms may appear hours or even days before the headache begins. Around 60% of people with migraines experience signs such as:
- Increased sensitivity to light, sound, or smells. Normal levels of brightness or noise might suddenly feel overwhelming or painful. Scents like cigarette smoke, exhaust fumes, strong perfumes, or cleaning chemicals may become especially unpleasant.
- Unexplained fatigue or frequent yawning. You may feel unusually tired without a clear reason.
- Changes in appetite. You might crave specific foods (like sweets) or feel hungrier than usual—or you may lose your appetite entirely.
- Emotional shifts. You could become irritable, anxious, or feel down without any obvious cause.
- Increased thirst and more frequent urination.
- Digestive issues. These can include bloating, constipation, or diarrhea.
Experts note that prodrome symptoms are sometimes mistaken for migraine triggers. For instance, craving sweets might prompt you to eat chocolate, which then gets blamed for causing the migraine—when in fact, the craving was an early warning sign.
Migraine Aura
Around 25% of people who experience migraines also have what's known as an aura, which can occur shortly before, during, or just after the headache phase begins. These symptoms are caused by temporary changes in the nervous system, often affecting vision. Auras typically develop gradually over 5 to 20 minutes and usually last less than an hour. Common signs include:
- Visual disturbances, such as seeing flickering lights, zigzag patterns, blind spots, or a narrowing of your field of vision (tunnel vision)
- Tingling sensations or numbness, often affecting the face, hands, or limbs
- Speech difficulties, such as slurred words or trouble finding the right words
- Ringing in the ears, also known as tinnitus
- Muscle weakness, typically on one side of the face or body
Migraine Attack (Headache Phase)
Also known as the headache stage, this is when the actual head pain sets in. The discomfort often:
- Starts off as a mild, dull ache and builds into a throbbing or pounding pain
- Worsens with physical movement or activity
- May affect one side of the head, shift from one side to the other, center in the forehead, or spread across the entire head
In addition to the head pain, you might also experience:
- Nausea, which affects about 80% of migraine sufferers—roughly half may also vomit
- Pale, clammy skin
- Dizziness or feeling lightheaded
- Stiffness or discomfort in the neck
- Feelings of anxiety, restlessness, or sadness
- Congestion or a runny nose
- Heightened sensitivity to light, and sometimes sound or smell
- Trouble sleeping and extreme tiredness
How long does a migraine last?
A typical migraine lasts around 4 hours, but more severe attacks can persist for over 72 hours. Some people experience migraines frequently—even daily—while others may only have them once or twice a year.
Migraine Postdrome (Recovery Phase)
This final phase can last up to 24 hours after the headache subsides. Around 80% of people who have migraines go through this stage, which may include:
- Feeling exhausted, irritable, or emotionally drained
- A sense of being unusually refreshed or euphoric
- Muscle soreness or a feeling of weakness
- Cravings for specific foods or loss of appetite
- Difficulty focusing or thinking clearly
Causes of Migraine
The exact cause of migraines is still not fully understood, but researchers believe they are linked to a combination of genetic and neurological factors. Your inherited genes may determine how sensitive you are to common migraine triggers like stress, bright lights, lack of sleep, or even changes in the weather.
For a long time, experts thought migraines were mainly caused by shifts in blood flow within the brain. While blood vessel changes may play a role in the pain, most scientists now believe they’re not the initial cause.
Many researchers think migraine attacks begin with chemical changes in the brain. Overstimulated nerve cells release signals that alter levels of certain brain chemicals—particularly serotonin and calcitonin gene-related peptide (CGRP). CGRP can cause blood vessels around the brain to expand, while serotonin has the opposite effect. When these chemicals become unbalanced, inflammation and pain can occur.
Risk Factors for Migraine
According to the American Migraine Foundation, over 38 million people in the U.S. experience migraines. Several factors may increase your likelihood of developing them:
- Biological sex: Migraines are up to three times more common in women (or people assigned female at birth) than in men.
- Age: Migraines often begin between ages 10 and 40. For people who menstruate, migraines may become less frequent or even stop after menopause.
- Family history: About 80% of people with migraines have a close relative who also gets them. If one parent has migraines, your chances are around 50%; if both parents do, your risk rises to 75%.
- Other health conditions: Certain conditions, such as depression, anxiety, bipolar disorder, epilepsy, and sleep disturbances, can increase your risk.
Common Migraine Triggers
Certain situations or environmental changes can spark a migraine episode. These include:
- Hormonal fluctuations: Many people notice migraines around menstruation, ovulation, pregnancy, or menopause. Hormonal birth control and hormone replacement therapy may also play a role.
- Stress: Stress can prompt the release of brain chemicals that affect blood vessels, potentially leading to a migraine.
- Missing meals: Skipping food can lead to drops in blood sugar, which may trigger symptoms.
- Weather changes: Shifts in barometric pressure, storm systems, high winds, or altitude changes are known to set off attacks in some people.