No one wants to get a migraine, ever. If you suffer from chronic migraines, you probably cringe at the thought of having one but at least have some tools to combat them. But if you get sporadic migraines ― or just experienced one for the first time ― the crippling pain can come with a serious side of confusion about why exactly you got one in the first place.
There’s still a lot that experts don’t understand about migraines, but there are a few things they do know. For starters, migraines can cause severe pain or a pulsing feeling, usually on just one side of the head, according to the Mayo Clinic. And unfortunately, migraines usually come along with nausea, vomiting and sensitivity to light and sound. Some people may even experience something called an “aura,” which can be flashes of light, blind spots or tingling on one side of your face or in your arm or leg.
Doctors think there are several different mechanisms behind why you might get a migraine, although “it’s not completely understood,” said Dr. Katherine S. Carroll, a neurologist and migraine expert at Northwestern Memorial Hospital in Chicago.
It’s believed that there’s a wave of electricity that spread across a person’s cortex (the wrinkly, outer layer that surrounds the brain), leading to the release of inflammatory mediators, Carroll said. These irritate the nerves in the brain, including the trigeminal nerve (the largest of the cranial nerves), creating the migraine’s pain.
It’s also known that levels of serotonin, which helps regulate pain in your nervous system, drop when people have migraines, although the exact role this plays is unclear, according to the Mayo Clinic. This might cause your trigeminal nerve to release molecules called neuropeptides, which then travel to your meninges (the outer covering of your brain) and cause inflammation, said Dr. Amit Sachdev, an assistant professor and director of the Division of Neuromuscular Medicine at Michigan State University.
Whatever the cause, migraines all boil down to one major symptom: crippling pain. That pain can last anywhere from hours to days, which is why it’s completely understandable that you’d want to know what’s causing them and avoid them in the future.
There are a few migraine triggers you’ve probably heard of before, like stress, bright lights and wine, but there are plenty of others that should be on your radar. Keep these in mind the next time you’re grappling with pain:
Hormonal birth control pills
Women tend to start getting migraines when they begin menstruating and those who have chronic migraines tend to get them right before their period starts, said Dr. Brinder Vij, associate director of the University of Cincinnati’s Health Headache & Facial Pain Center.
Changes in estrogen, in particular, seem to trigger migraines in women. “The fall in estrogen before a woman’s period may be a mechanism that triggers the process for some women,” Vij said.
And for some reason, hormonal birth control pills seem to make it worse in some people, Vij added.
Salty foods can affect your blood pressure. Specifically, they increase the amount of sodium in your bloodstream and mess with your kidney’s ability to remove water. Your body responds with higher blood pressure — and that can create an environment that’s ripe for migraines in people predisposed to them, said Dr. Ilan Danan, a neurologist at the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles.
It’s not completely clear why aged cheeses may set off migraine pain, but tyramine, a substance found in them, has been linked to the ailment, Sachdev said.
Still, eating aged cheeses doesn’t mean you’re guaranteed to get a migraine, even if you suffer from them. “Some patients can get a migraine after eating these cheeses; others don’t,” Vij said.
Beware what you’re adding to your coffee. Artificial sweeteners such as aspartame can be migraine-starters. It’s thought that these sweeteners lower serotonin levels in a person’s body, which can then trigger the release of neuropeptides and set off a chain reaction that leads to a migraine, Carroll said.
This is a big one, Carroll said. Any sort of disruption in sleep, like flying between time zones, can be a trigger for migraines. Cabin pressure from flying may even play a role, she said, since it can cause dilation in blood vessels that can be a part of the migraine response.
Changes in weather
When the weather shifts, changes in barometric and atmospheric pressure also occur ― and those are thought to be directly related to migraines, Danan said. As a result, fluctuations in the weather can trigger migraines in sufferers. “I hear this mentioned by my patients quite often,” Carroll said.
A regular eating schedule is crucial for those who experience migraines. Missing a meal or eating long past your usual time can cause a drop in your blood glucose. And that can cause a chemical change in your body that can be a migraine trigger, Carroll said.
If you’re struggling with migraines and you have no idea what’s behind them, it’s important to keep a migraine diary and write down what you did and ate on the days when you have a migraine, as well the weather conditions, she said. For women, writing down menstrual cycle information is important, too. Then, go back and see if there are any common factors.
Consistency is key here, Vij added. If you had a migraine after you had aspartame once, but didn’t the other nine times you had it, it’s pretty unlikely that’s your trigger, he said. And, of course, talk to your doctor about your symptoms and medication that can help prevent migraines, as well as ease your pain when they do happen.