Migraine Symptoms and Triggers

Recognizing the signs of a migraine

Migraine symptoms can be different for everyone. The length, frequency and intensity of migraines may vary, but most migraines include more than just a headache. 

You may notice: 

Prodrome: Early signs up to 24 hours before a migraine 

About 60% of people with migraines notice warning signs like: 

• Mood changes 
• Trouble concentrating 
• Yawning 
• Food cravings 
• Constipation 
• Muscle stiffness 
• Bloating 
• Needing to urinate more often 

This early phase is called the prodrome. 

Headache pain 

Migraine pain is usually moderate to severe. It often throbs or pulses on one side of the head. Moving around may make it worse. The headache can last from 4 to 72 hours and may interfere with daily activities. 

Sensitivity to light (photophobia) 

Bright lights - or even normal lighting - can feel uncomfortable and make the pain worse. 

Sensitivity to sound (phonophobia) 

Everyday sounds or loud noise may feel painful or hard to tolerate. 

Other sensory changes 

Some people may have: 

• Heightened sensitivity to smells (osmophobia) 
• Sensitivity to touch 
• Numbness or tingling in the face, arms or legs 

Nausea or vomiting 

Feeling sick to your stomach can happen before, during or after the headache. 

Cognitive symptoms (“brain fog”) 

Migraines can make it hard to think clearly. You may have trouble concentrating, remembering things or feeling mentally sharp. 

Dizziness or vertigo 

You might feel dizzy, lightheaded or like the room is spinning. 

Postdrome: After the migraine ends 

About 80% of people feel tired, weak or out of sorts for up to a day after the headache goes away. This is called the postdrome phase.  

What is an aura?

Some people experience aura before or during a migraine. This includes visual or sensory disturbances like:

• Flashing lights
• Zigzag lines
• Blind spots
• Temporary vision loss
• Numbness or tingling
• Trouble speaking

Auras usually come on gradually and last less than an hour. Only 15% to 20% of people with migraines experience aura.

What causes migraines?

Doctors don’t know exactly what causes migraines, but research suggests that genetics, brain chemistry and environmental factors all play a role.

Migraines may involve:

• Changes in the brainstem
• Overactive pain pathways
• Chemical imbalances in the brain

Most people with migraines have a family history of the condition.

Common migraine triggers

Not everyone has the same triggers, and your symptoms may not follow a clear pattern. Still, some common migraine triggers include:

• Hormonal changes – such as changes in estrogen levels during periods, pregnancy or menopause
• Certain foods and drinks – like aged cheeses, chocolate, caffeine, alcohol (especially red wine), cured meats, nuts, MSG, aspartame or pickled foods
• Skipping meals
• Environmental factors – like bright lights, loud sounds, strong smells, smoke, allergens or changes in weather
• Stress or emotional strain – stress, anxiety or tension may increase migraine frequency or severity
• Sleep issues – getting too little or too much sleep can trigger a migraine
• Medications – such as birth control pills or vasodilators like nitroglycerin
• Physical exertion – sudden, intense exercise or unfamiliar activity may cause a migraine
• Sensory stimuli – flickering lights, strong smells or repeating patterns

Tracking your symptoms and triggers

Keeping a migraine diary can help you find patterns and prevent future migraines. Log details like:

• When your migraine started and how long it lasted
• What symptoms you had
• What you ate, drank or did beforehand
• How you slept
• What medications you took
• How you felt emotionally or physically

Share your notes with your health care provider. This can help guide your treatment and reduce the number of migraines you have.