Migraine risk factors: sex, family history, hormones and common triggers

What a migraine is

Migraines are a recurring type of headache. They cause moderate to severe pain that is throbbing or pulsing, often on one side of your head. You may also have other symptoms, such as nausea and weakness, and you may be sensitive to light and sound (MedlinePlus). About 12% of Americans get migraines (MedlinePlus).

Migraine happens in both children and adults (NINDS). The most common type of migraine is migraine without aura (NINDS).

Who is more likely to get migraines

Migraines can affect anyone, but you are more likely to have them if you (MedlinePlus):

• Are a woman. Women are three times more likely than men to get migraines (MedlinePlus).
• Have a family history of migraines. Most people with migraines have family members who have migraines (MedlinePlus).
• Have other medical conditions, such as depression, anxiety, bipolar disorder, sleep disorders, and epilepsy (MedlinePlus).

Researchers believe that migraine has a genetic cause (MedlinePlus).

Hormones and the menstrual cycle

Hormone changes that happen with the menstrual cycle or pregnancy seem to be one important trigger for migraine. NINDS says this is likely why females experience migraine more than males (NINDS).

• Migraine episodes may begin during a person's first menstrual period or during pregnancy (NINDS).
• Most females see improvement in migraine episodes after menopause, but removing the ovaries ("surgical menopause") can make migraine episodes worse (NINDS).
• Using birth control (contraception) can also change how often migraine episodes happen and how severe they are (NINDS).

Health conditions that often occur with migraine

People living with migraine more commonly experience mental health conditions, such as depression and anxiety, and are more likely to have sleep disorders than the general population. Some health conditions, including epilepsy and bipolar disorder, are more common in people with migraine (NINDS).

Common migraine triggers

Several factors can trigger a migraine episode or increase a person's risk of having one. These factors differ from person to person and include (NINDS):

• sudden changes in the weather or a person's environment
• too much or not enough sleep
• strong smells
• emotional stress that affects mental health and wellbeing
• physical strain on the body
• loud or sudden noises
• motion sickness
• low blood sugar or skipped meals
• tobacco
• drinking too much alcohol
• some medicines
• hormonal changes
• bright or flashing lights

MedlinePlus also lists anxiety, caffeine or caffeine withdrawal, overexertion (too much physical activity), and medication overuse (taking medicine for migraines too often) (MedlinePlus). Some people have found that certain foods or ingredients can trigger headaches, especially when combined with other triggers. These include alcohol, chocolate, aged cheeses, monosodium glutamate (MSG), some fruits and nuts, fermented or pickled goods, yeast, and cured or processed meats (MedlinePlus).

A headache journal can help a doctor diagnose the type of headache and find the best treatment. NINDS suggests noting things such as the time of day, how intense the headache was, sleep the night before, stress, the weather, and food and drinks in the previous 24 hours (NINDS).

Symptoms and phases

A migraine episode can have four phases, and you may not go through every phase each time (MedlinePlus):

• Prodrome: a few hours to a few days before an episode, with symptoms such as food cravings, unexplained mood changes, uncontrollable yawning, or needing to urinate more than usual (NINDS).
• Aura: only some people have an aura. Symptoms include vision changes, trouble speaking, tingling in the hands or face, and confusion (NINDS).
• Headache: pain usually starts slowly and gets worse and is usually felt on one side of the head, often with nausea, vomiting, and sensitivity to light, smell, and sound (NINDS).
• Postdrome: people are usually exhausted or confused afterward, and this phase may last up to two days (NINDS).

Chronic migraine is when migraine headaches happen on at least 15 days of the month for more than three months (NINDS). Status migrainosus is a rare but serious complication that lasts longer than 3 days and can cause pain and nausea so intense that a person needs to be hospitalized (NINDS).

Headaches that need medical help right away

Not all headaches require a doctor's attention, but sometimes headaches warn of a more serious disorder. MedlinePlus says to let your health care provider know if you have sudden, severe headaches, and to get medical help right away if you have a headache after a blow to your head, or a headache along with a stiff neck, fever, confusion, loss of consciousness, or pain in the eye or ear (MedlinePlus).

A sudden severe headache with no known cause is one of the warning signs of stroke. NINDS advises calling 9-1-1 at once if stroke signs appear (NINDS). See stroke warning signs for the full list.

Migraine and stroke risk

The National Heart, Lung, and Blood Institute (NHLBI) lists migraine headaches among other conditions that can raise the risk of stroke (NHLBI). See stroke risk factors for the full list.

Common questions

Are migraines more common in women?

Yes. Women are three times more likely than men to get migraines (MedlinePlus).

Do migraines run in families?

Most people with migraines have family members who have migraines, and researchers believe that migraine has a genetic cause (MedlinePlus).

Are imaging scans used to diagnose migraine?

Not usually. A doctor might order an MRI or CT scan if they suspect another condition that causes headaches or other symptoms of migraine (NINDS).