Everything You Need to Know About Migraines

by Jessica Ailani MD
September 12, 2018

Migraines are quite common, affecting 18 percent of women and 6 percent of men in the United States, according to the Migraine Research Foundation. It is a more severe type of headache with moderate to severe pain on one or both sides of the head and usually is accompanied by an upset stomach, sensitivity to light and sound, and in some cases, vomiting. Thankfully, there is a plethora of over-the-counter (OTC) and prescription medications available for treating it. But, what if you could lessen the pain ahead of time or at least prevent your migraine from interrupting your day and sending you to the nearest emergency room? Here’s everything you need to know about migraines and how to treat them.

Migraines with aura vs. migraines without aura

Migraines can be broken down into two broad categories, migraine with aura and migraine without aura. A migraine with aura is a migraine that comes after a brain symptom, and often, that symptom is a change in vision. For example, you may see a bright flashing spot that turns dark. The spot might move for a few minutes or grow to the point where it’s difficult to see through that spot, and the aura will resolve within sixty minutes from when it started. Usually, a migraine follows immediately after or within an hour after the aura resolves itself.

While visual aura is the most common, there are other types of aura. Some examples include a sensation of numbness, tingling, or weakness on one side of the body, dizziness or a sense that the room is moving, or difficulty speaking. The initial episode of migraine with aura can be especially frightening because the symptoms are similar to that of a stroke. Symptoms lasting longer than one hour should be evaluated by a medical professional, and you should see your health care provider to discuss your symptoms if you have experienced what may be migraine with aura.

Migraine without aura, is more common, and occurs when there is no associated aura prior to the migraine. People experience head pain with nausea or vomiting and light and sound sensitivity. The pain is often one-sided, throbbing or pulsing in nature, and can worsen with physical activity. That said, people who have migraines without aura may also experience migraines with aura on occasion.

Can certain things trigger a migraine?

Migraine is a genetic disease that can be impacted by the environment. Often, migraine is the result of having a certain genetic makeup, through which you inherit a brain that is more sensitive, and changes in your behavior, habits, or the environment around you can cause a migraine cycle to occur.

There are several environmental changes that can trigger migraines. Most often, these factors include:

  • Changes in the weather (i.e. before or after it rains or snows)
  • Dehydration
  • Hormonal changes, for women (before or during menstrual period, during early phase of menopause)
  • Lack of sleep
  • Overuse of OTC medications
  • Stress

In addition, many people consider food as a trigger for migraines, but currently, there is no substantial evidence to support this. It’s hard to say that particular foods always correlate with migraine attacks because symptoms and triggers can vary from person to person. It’s actually rare that migraines are caused by one particular thing. Usually, certain factors layer and feed off of each other, and when combined, they can trigger a migraine. For example, if you’re working long hours and under a lot of stress, have irregular sleep patterns, don’t exercise regularly, and don’t eat nutritious meals, then together these factors could trigger a migraine.

What do you recommend for pain relief?

Depending on the severity of your migraine and how fast it starts, some relief methods will be more effective than others. Since migraine headaches can last for up to three days, it’s important to treat them as soon as they begin and get your symptoms under control. If your migraine starts with moderate pain that builds gradually, consider taking an OTC medicine that includes one of the following ingredients:

  • Acetaminophen
  • Aspirin
  • Ibuprofen
  • Naproxen
  • Salicylic acid

Before taking a medication, it is important to always consult with your primary care provider about treatment options, especially if you’re already using prescription drugs for a different condition. When using any type of medicine, you should follow the directions stated on its label. You can also treat your symptoms using holistic and topical methods like taking deep breaths, sleeping, or applying an ice pack, heat pack, or mentholated cream to your head.

For those who are still unable to relieve the migraine using these methods, I recommend speaking with your provider about prescription options or a more targeted treatment with a neurologist. Ask your doctor or neurologist about a preventive method to decrease the frequency of the headaches so they don’t negatively impact your life.

Does gender play a role in causing migraines?

Due to hormonal changes, migraines tend to be more common in women in comparison to men. What’s interesting, though, is that during childhood, migraines occur more frequently in boys than in girls, but as they reach puberty, the reverse happens. As boys age, their frequency of migraines tends to decrease over time, and when girls begin their menstrual cycle, the possibility and frequency of migraines can increase as they get older. It’s possible that the frequency may be affected by the increase of testosterone in young men and the lack thereof in young women during puberty. While more research needs to be done on the effects of testosterone, some medical experts say it could reduce inflammation, and as a result, reduce the pain and other side effects of migraine attacks. However, at this time, there is no substantial proof to support that theory.

Is it possible that migraines can be a sign of something more serious?

If you’re concerned that you may have a more severe, underlying condition, a neurological exam can determine if anything else is going on in addition to your migraine. For adults over age 50 who have new onset headaches, unlike anything they’ve experienced before, that could be a sign of something more serious. If you already have a history of migraines, but there’s a change in the pattern or frequency or they’re accompanied with fever, weight loss, or confusion, that’s also a concerning sign. If you have a preexisting condition, that can compromise your immune system, your doctor may further investigate if anything else is causing the acute headaches. In any of these scenarios, I recommend that you get a neurological exam and seek specialized care from a physician.

Now that you have a better understanding of migraines, their unique characteristics, and treatment options, I hope you feel empowered to take control of your symptoms and tackle your migraines head on. For those with acute cases of migraine attacks, pain relief is attainable with the help of your primary care doctor or neurologist. With more knowledge and resources in tow, you have the advantage over your headaches and can maintain a great quality of life.

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Category: Living Well     Tags: Wellness