Migraines: causes, symptoms, and treatments

What is a migraine?

Migraine is a severe and painful illness that can have a long-term effect on a person’s mental and physical wellbeing. Migraines are moderate to severe headaches that tend to present as a throbbing pain felt on one side of the head, alongside a series of other symptoms. Some people may have migraines several times a week, while others don’t have them very often.

What are the symptoms of a migraine?

The symptoms of migraines are wide-ranging. Different people suffer from different symptoms, and severity can vary from person to person. When people do have an attack, it can prevent them from functioning normally in their day-to-day lives.

The most common symptoms of an attack include, but are not restricted to:

• Intense headaches that are often one sided

• Problems with vision, such as seeing flashing lights

• Heightened sensitivity to light, sounds, and smells

• Nausea and sickness

• Exhaustion and lethargy

Often, you’ll hear the phrase “aura” when people are talking about migraines. These are temporary symptoms that will “warn” people of an impending migraine and can take the form of sensory disturbances, such as blind spots, flashing lights, numbness, and feeling dizzy. These will affect 1 in 3 people who have migraines and can last anywhere from 5 minutes to up to an hour.

There are different types of migraines, but the most experienced migraine is one without an aura. Other migraines include migraines with aura, and migraine aura without headaches. A migraine aura without headache is also known as a silent migraine, where patients will experience symptoms of an aura without a headache.

How long do migraines last?

It differs from person to person, but migraines can last anywhere between four hours and three days. Symptoms can start earlier than you may realise ­– in some cases they will begin to present 24 hours before you get the typical head pain and will end around 24 hours after you stop having head pain. It’s common to not get any symptoms at all.

What are the causes of migraines?

There is no definitive answer to this question. In fact, there are many different schools of thought, but many scientists and doctors believe migraines stem from abnormal brain activity that, in turn, affects your brain’s nerve signals, chemicals, and blood vessels. There’s no certainty on what causes this brain activity, but there is a link to a person’s genetics for up to 60% of people who live with migraines.

What triggers migraines?

There are certain triggers that have been found to have an impact on people who are susceptible to migraines. These include:

• Stress

• Missing meals

• Low blood sugar

• Alcohol

• Hormonal changes related to periods or menopause

• Lack of sleep

• Environmental factors such as lighting or temperature

Taking care to understand which triggers affect you most can help you to manage the impact or onset of migraines, although this is not always possible.

Who gets migraines?

Migraines can affect anyone and can start at any age. They’re most common between the ages of 25 and 55, but children can get migraines, too. In girls, it often starts in puberty. Both men and women can get migraines, but they’re two to three times more common in women than men.

So, why are migraines more prevalent in women? There’s clinical evidence to suggest that hormonal factors and genetic differences have a role to play. During women’s menstrual cycles, for instance, one report found that there were a higher number of attacks when oestrogen was falling, and a lower number of attacks when it was returning to normal levels.

What is the best treatment for migraines?

Migraines can’t be cured, but steps can be taken to manage the symptoms. There are treatment options available that may help. Treatment will depend on the type of migraine, your symptoms, how often you have the attacks, and how bad they are.

Many sufferers find lying in a darkened room or sleeping is effective during a migraine. Sunglasses, eye masks, and ear plugs may help with light and noise sensitivity. It’s important that you stay hydrated as dehydration can worsen migraine attacks.

Migraine treatment usually involves acute medicines such as painkillers and anti-sickness medicines. Over the counter painkillers such as paracetamol, aspirin, or ibuprofen can be taken at the first signs of a migraine, and soluble painkillers can be very efficient as they are quickly absorbed by the body.

Triptans are a medicine class available on prescription for acute treatment of migraines. They work by narrowing the brain’s blood vessels and reducing substances that trigger headaches and aura symptoms. If you already have a migraine diagnosis from your GP, you can buy sumatriptan from pharmacies without needing a prescription.

The recommended dose for those aged 18-65 is one 50mg tablet, but we encourage you to speak to your doctor if you feel you need a higher dose.

1. As soon as the pain starts, take the tablet with water

2. After 2 hours, if the migraine has returned, take the second tablet

3. Do not take more than 100mg of sumatriptan in a 24-hour period

If you have frequent or severe migraines, your doctor may prescribe preventive treatments aimed at reducing the number or severity of attacks over time.

It’s likely that you will still need to continue acute medication alongside preventative treatment as it’s unlikely to stop all your migraine attacks. Other therapies for migraines include acupuncture, migraine devices, and behavioural therapies.

However, it’s worth bearing in mind that repeated use of painkillers may make migraines worse, so we recommend speaking to your doctor about the best options for you. If you suspect you might be experiencing migraines but have not yet had a diagnosis, we recommend making an appointment with your GP.