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Migraine

Migraines are a type of recurring severe headache that can have a major impact on your quality of life. They are often accompanied by feeling sick, vomiting and increased sensitivity to light.

Migraines affect one in seven adults in the UK. Women are three times more likely to get them than men. You can get migraines at any age but they are most common from your late teens up to the age of 50.

There are a number of different types of migraine. The most common types of migraine are migraine with aura (classic migraine) and migraine without aura (common migraine). Aura is a term used to describe the symptoms that come on just before your migraine. Less common types of migraine are retinal, abdominal and menstrual migraines.

Severe migraine can be very distressing and disabling. It can affect your daily life and can mean taking time off work or school.

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Details

  • Symptoms Symptoms of migraine

    The main symptom of migraine is a severe headache, which can last for anything between four hours and 72 hours. The headache usually occurs on one side of your head and is a throbbing or pulsating pain. Activity usually makes the pain worse, for example climbing stairs. You may also feel sick or vomit during a migraine, and you may find you’re more sensitive to bright lights and noise.

    You can get a migraine at any time, though it’s more common to have a migraine during the day than to be woken by one at night. Some people have migraines once a year, whereas other people may have them as often as several times a week. Most people have one or two migraines a month.

    One of the things that make a migraine different from other types of headache is that it has clear stages. Most people will have one or more of the following stages.

    • Premonitory Stage. This is a sense that a migraine is about to start and includes symptoms like tiredness, craving sweet foods, feeling thirsty and mood changes. These feelings can last up to 24 hours.
    • Aura Stage. About one in three people have this stage, which may last up to an hour. Symptoms include visual disturbances, such as flashing lights or sensory symptoms, such as pins and needles.
    • Main Attack Stage. This is when the headache develops.
    • Resolution and Recovery Stage. This is when the migraine fades. This usually happens slowly although a migraine can sometimes stop suddenly, if you vomit for example.

    Most people don’t need to see their GP when they get a migraine. However, you should see your GP if:

    • your migraines become more frequent or get worse over time
    • you have a sudden very severe headache
    • you’re over 50 and you have never had a migraine before
    • you get aura symptoms lasting more than an hour
    • you have symptoms such as a fever or weight loss with the headache
    • you have a child under the age of 10 that develops a migraine
    • you get migraines with aura and are taking the combined oral contraceptive pill (COCP)
  • Diagnosis Diagnosis of migraine

    Your GP will ask you about your symptoms and examine you. He or she may also ask you about your medical history.

    There isn’t a specific test that can diagnose migraines. Try to keep a diary of when you get migraines and possible triggers. This will help your GP to see if there is a pattern to your symptoms.

  • Treatment Treatment of migraine

    Although migraine can’t be cured, there are treatments that can help you to control your symptoms and minimise the effect of migraine on your daily life. Some treatments can help to prevent a migraine, whereas others work to stop a migraine once it has started. You may need to try a number of different treatments, such as medicines, before you find the ones that work for you. It can help to keep a record of your symptoms and how treatments affect your migraines.

    Self-help

    If you know what triggers your migraines, do your best to avoid these triggers. For example, it may help to change your sleeping patterns or eating habits. If you find that stress can trigger your migraine you may find yoga and relaxation techniques helpful.

    When you get a migraine it’s best to rest in a quiet, darkened room and sleep if you can. You may want to try using a cold compress, such as an ice pack or ice wrapped in a towel to ease your headache. Don’t apply ice directly to your skin as it can damage your skin. A hot compress may also help. You can also try applying pressure to the pulse points on the side of your forehead or neck.

    Medicines

    Different types of medicine are used to treat migraines, depending on your symptoms and how severe your migraines get. You doctor will usually suggest you take an over-the-counter painkiller, such as ibuprofen, with an anti-sickness tablet. Because you need the painkillers to work quickly once a migraine has started you can take soluble painkillers which dissolve in water, or fast acting tablets. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

    If this doesn’t work, your doctor may suggest taking medicines called triptans. Triptans stop the effects of serotonin, which is thought to cause migraines. They are more effective if you take them as soon as your migraine starts. Triptans are available as tablets, dissolvable wafers, nasal sprays or injections. Up to half of all people who take triptans medicines find that their migraine symptoms come back within the next 48 hours.

    If you use any type of painkiller for your migraine too frequently, it may become less effective and cause further headaches. You may get medication-overuse headaches if you regularly use painkillers for 10 to 15 days a month, for more than three months to relieve your migraines. If you’re worried you may have this type of headache, speak to your GP.

    Complementary therapies

    There is some research which shows that acupuncture and biofeedback may help to ease the symptoms of migraine. If you decide to try either of these therapies, check that your therapist belongs to a recognised professional body.

  • Private GP appointments

    With our GP services, we aim to give you an appointment the next day or sooner if it’s urgent. Find out more today.

  • Causes Causes of migraine

    It’s not fully understood what causes migraines, but it’s thought they may be caused by a chemical called serotonin. Serotonin affects the blood vessels in your brain. It’s not known exactly what causes the serotonin levels to change.

    Migraine is also linked to your genes. About half of all people who get migraines have a close family member who also has them.

    Some things can cause a migraine to start and these are called triggers. You may find it useful to keep a diary to spot the triggers that cause your migraines or make them worse.

    Common triggers include:

    • stress
    • change in sleep patterns and tiredness
    • poor posture or tension in your neck and shoulders
    • certain food or drink – commonly chocolate, cheese, alcohol, caffeine
    • loud noises
    • bright or flickering lights
    • strong smells
    • strenuous exercise if you’re not used to it
    • skipping meals
    • not drinking enough fluid

    Women may get migraines around the time of their periods, during the menopause, or as a result of taking oral contraceptives or hormone replacement therapy (HRT).

    Other less common triggers may include high blood pressure, smoking, toothache, eye strain or taking certain sleeping tablets.

  • Complications Complications of migraine

    Occasionally, a migraine can last for more than 72 hours and doesn’t go away by itself. This type of migraine is known as status migrainosus. It’s important to see your GP if your migraine lasts longer than 72 hours.

    If you get frequent migraines on more than 15 days a month for an average of three months out of the year, this is called chronic migraine. When describing an illness, the term chronic refers to how long a person has it, not to how serious a condition is. If you have chronic migraine, you may need to take increasing amounts of medication to help control your symptoms. Over time, this can lead to further headaches, called medication-overuse headaches.

    If you get migraines, you may be more likely to develop depression, anxiety, and panic disorders. You may also be more likely to have a stroke. If you’re taking the COCP and have frequent migraines or migraines with aura, your risk of stroke will be increased. Speak to your GP for more advice.

  • Prevention Prevention of migraine

    It’s important to learn to spot the signs and triggers of your migraine to help prevent them. The easiest way of doing this is by keeping a diary about your migraines.

    Keeping active may also prevent migraines. The recommended healthy level of physical activity is 150 minutes (two and a half hours) of moderate exercise over a week in bouts of 10 minutes or more. You can do this by carrying out 30 minutes on at least five days each week.

    Some medicines such as antidepressants, antihistamines and beta-blockers can help to reduce the number of migraines you have. Your GP may suggest these if your migraines are severe or happen often, and if they are affecting your daily life.

    If you have chronic migraine (headaches on at least 15 days per month, of which at least eight days are with migraine), and other medicines haven’t worked, your GP may refer you to a neurologist (a doctor who specialises in investigating, diagnosing and treating conditions of the nervous system).

  • FAQs FAQs

    Are the symptoms of migraine different in children?

    Answer

    Migraine symptoms in children are usually similar to those in adults. However, children’s migraines don’t tend to last as long, usually for one to two hours. Speak to your GP if your child has any migraine symptoms.

    Explanation

    About one in 10 school-aged children get migraines and they can occur at any age. The symptoms of migraines in children are similar to symptoms in adults, however, there are some differences.

    In children, migraines last for a shorter time than in adults, usually for no longer than four hours. They are usually less painful than in adults and develop over the whole head. Children are less likely to have aura before a migraine and also generally have fewer symptoms.

    Your child may feel sick or vomit. He or she may have abdominal pain rather than a headache. In some children, travel sickness is also a symptom of migraine.

    It’s a good idea to keep a diary of your child’s migraines, noting how long they last, what triggers them, if anything, and what relieves them.

    I get migraines – am I at risk of having a stroke?

    Answer

    If you’re a woman under 45 and you get migraines with aura, you’re more at risk of having a stroke. You’re particularly at risk if you smoke or if you take the combined oral contraceptive pill.

    Explanation

    A stroke happens when the blood supply to part of the brain is cut off causing damage to the brain cells. There are two main types of stroke – ischaemic and haemorrhagic. An ischaemic stroke is when the blood supply to the brain is blocked by a blood clot or a fatty plaque. A haemorrhagic stroke is bleeding in the brain caused by a burst blood vessel.

    Research shows that if you’re a woman under 45 and you get migraines with aura, you’re more at risk of having an ischaemic stroke than someone who doesn’t get migraines. If you also smoke or take the combined oral contraceptive pill the risk is even greater. However, the risk of having a stroke is still very small.

    If you’re a woman and get frequent migraines or migraines with aura, it’s important not to take the combined oral contraceptive pill because this can increase your risk of stroke.

    If you get migraines and are worried about an increased risk of stroke, talk to your GP.

    What hormonal changes affect migraines in women?

    Answer

    If you’re a woman, you may find that your hormone levels have an effect on your migraines. Your migraines may be triggered by the change in hormone levels just before your period. Some women also find that pregnancy, menopause and contraception can also affect their migraines.

    Explanation

    Women are three times more likely to get migraines than men, mainly because of hormone changes.

    Migraines usually start around the time of puberty in women and continue until you go through the menopause. If you become pregnant your migraines may stop or get better during your pregnancy.

    About half of women say that their migraines are affected by their menstrual cycle. You may have migraines in the days just before and at the start of your period. Some women only have migraines at or near the first day of their period.

    You may find your migraines get worse, and happen more often, when you go through the menopause. For some women HRT can help, but for others it can make migraines worse. If your migraines are hormone related, your GP may prescribe medicines that can help ease them.

    Some women find that oral contraceptives make their migraines worse, but for other women oral contraceptives can improve migraines. If you think your migraines may be triggered by the oral contraceptive, speak to your GP who may suggest you try a different one. If you’re taking the combined oral contraceptive pill and get aura with your migraine, your GP may suggest you stop taking them. This is because taking the combined oral contraceptive pill if you have migraines with aura can increase your risk of having a stroke.

  • Resources Resources

    Further information

    Sources

    • Guidelines for all healthcare professionals in the diagnosis and management of migraine, tension-type headache, cluster headache, medication-overuse headache. 3rd ed (1st revision) 2010. British Association for the Study of Headache.
    • Migraine. Prodigy. www.prodigy.clarity.co.uk, published October 2010
    • Migraine, what is it? Migraine Trust. www.migrainetrust.org, accessed 27 November 2012
    • Diagnosis and management of headache in adults. Scottish Intercollegiate Guidelines Network (SIGN), November 2008. www.sign.ac.uk
    • Migraine headache. eMedicine. www.eMedicine.medscape.com, published May 2011
    • Simon C, Everitt H, van Dorp F. Oxford Handbook of General Practice. 3rd ed. Oxford: Oxford University Press, 2010: 562
    • Migraine triggers. Migraine Action. www.migraine.org.uk, published September 2011
    • Diagnosing migraine. The Migraine Trust. www.migrainetrust.org, accessed 29 November 2012
    • Treatment. The Migraine Trust. www.migrainetrust.org, accessed 29 November 2012
    • Parents/carers of young sufferers guide. The Migraine Trust. www.migrainetrust.org, accessed 29 November 2012
    • Stroke and migraine. The Migraine Trust. www.migrainetrust.org, accessed 29 November 2012
    • Menstruation and migraine. The Migraine Trust. www.migrainetrust.org, accessed 30 November 2012
    • Menopause, midlife and migraine. The Migraine Trust. www.migrainetrust.org, accessed 30 November 2012
    • Migraine and the contraceptive pill. The Migraine Trust. www.migrainetrust.org, accessed 30 November 2012
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  • Author information Author information

    Produced by Dylan Merkett, Bupa Health Information Team, March 2013.

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