Causes of migraine - Migraine

We do not know the exact causes of migraine, but they may include:

• temporary changes in the chemicals, nerves and blood vessels in the brain
• your genes - around half of people who have migraine have a close relative with the condition

Some people with migraine find certain things can trigger a migraine attack. For example, stress.

Migraine triggers

Triggers do not cause migraine attacks. But if you have migraine, certain things may make a migraine attack more likely to happen.

There are many possible triggers, such as:

• periods and hormone levels
• stress or strong emotions
• sleep or changes in routine
• tension in your body
• food and diet
• your environment
• medicines

It can be difficult to tell if something is a trigger or a warning sign of a migraine attack. For example, being sensitive to light.

It may help to keep a diary to see if you can identify a consistent trigger.

Periods and hormone levels

Lower oestrogen levels may make migraine attacks more likely to happen. Oestrogen is a sex hormone. It affects processes in your body such as puberty, periods and pregnancy.

Oestrogen levels are lower around your period. Migraine attacks may happen between 2 days before the start of your period to 3 days after.

You may have:

• pure menstrual migraine - migraine attacks only around your period
• menstrual-related migraine - migraine attacks around your period and at other times

Oestrogen levels also change around perimenopause and menopause. This is when your periods stop.

Many women find their migraines improve after menopause. But menopause can trigger migraines or make them worse in some women.

Stress or strong emotions

Migraine attacks can happen during or after times of strong emotions.

Triggers can include:

• stress
• anxiety
• tension
• shock
• depression
• excitement

Migraine and mental health difficulties

Sleep or changes in routine

Migraine attacks can happen if something affects your sleep or routine, such as:

• sleep problems
• shift work
• jet lag

Tension in your body

Different types of tension in your body can trigger a migraine attack, such as:

• tiredness
• poor posture
• neck or shoulder tension
• high-intensity exercise, if you are not used to it

Food and diet

Certain foods or how you eat can trigger a migraine attack, such as:

• missed, delayed or irregular meals
• dehydration
• alcohol
• caffeine products, such as tea and coffee
• specific foods, such as chocolate and citrus fruit
• foods high in tyramine - such as cured meats, yeast extracts, smoked fish and aged cheeses
• low blood sugar (hypoglycaemia)

Environmental triggers

If you have migraine, you may be more sensitive to light, sound or smells.

Things that may trigger a migraine attack or make symptoms worse include:

• bright lights
• flickering screens, such as a television or computer screen
• smoking or smoky rooms
• loud noises
• changes in climate, such as changes in humidity or very cold temperatures
• strong smells
• a stuffy atmosphere

Medicines

Medicines that may trigger a migraine attack include:

• some types of sleeping tablets
• the combined contraceptive pill
• any oestrogen-containing contraceptive, for example the contraceptive ring or patch
• hormone replacement therapy (HRT)

Combined contraceptive pill - sexualwellbeing.ie