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Patient Education: Migraines

What are migraine headaches?

 Migraine headaches or “migraines” are a kind of headache that can happen in adults and children. They are more common in women than in men. Migraines often start off mild and then get worse. 

What are the symptoms of migraines in adults?

 Symptoms can include: 

  • Headache – The headache gets worse over several hours and is usually throbbing. It often affects 1 side of the head. 
  • Nausea and sometimes vomiting 
  • Feeling sensitive to light and noise – Lying down in a quiet, dark room often helps. 
  • Aura – Some people have something called a migraine “aura.” An aura is a symptom or feeling that happens before or during the migraine headache. Each person’s aura is different, but in most cases the aura affects the vision. You might see flashing lights, bright spots, or zig-zag lines, or lose part of your vision. Or you might have numbness and tingling of the lips, lower face, and fingers of 1 hand. Some people hear sounds or have ringing in their ears as part of their aura. The aura usually lasts a few minutes to an hour and then goes away, but most often lasts 15 to 30 minutes.

 Women who get migraines with aura usually cannot take birth control pills. That’s because they might increase the risk of stroke.

Many people get other symptoms that happen several hours or even a day before the migraine headache. Doctors call these “premonitory” or “prodromal” symptoms. They might include yawning, feeling depressed, irritability, food cravings, constipation, or a stiff neck. 

Is there a test for migraines?

 No. There is no test. But your doctor should be able to tell if you have migraines by doing an exam and learning about your symptoms. 

Should I see a doctor or nurse?

 Yes. If you think you are having migraines, you should talk to your doctor or nurse. You should also see a doctor or nurse if your migraines get worse or more frequent, or if you have new symptoms. 

Is there anything I can do to prevent migraines?

 Yes. Some people find that their migraines are triggered by certain things. If you can avoid some of these things, you can lower your chances of getting migraines. 

You can also keep a “headache calendar.” In the calendar, write down every time you have a migraine and what you ate and did before it started. That way you can find out if there is anything you should avoid eating or doing. You can also write down what medicine you took and whether or not it helped. 

Common migraine triggers include:

  • Stress 
  • Hormonal changes 
  • Skipping meals or not eating enough 
  • Changes in the weather 
  • Sleeping too much or too little 
  • Bright or flashing lights 
  • Drinking alcohol 
  • Certain drinks or foods, such as red wine, aged cheese, and hot dogs 

If your migraines are frequent or severe, your doctor can suggest others ways to help prevent them. For example, it might help to learn relaxation techniques and ways to manage stress. There are also medicines that can help. 

Some women get migraines just before or during their period. Medicine can help with this, too. 

How are migraines treated?

 There are many different medicines that can help with migraines. Your doctor can help you find the best treatment for your situation.

For mild migraines, your doctor might suggest an over-the-counter medicine such as acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), or naproxen (sample brand name: Aleve). There is also a medicine that combines acetaminophen, aspirin, and caffeine (sample brand name: Excedrin). For more severe migraines, there are prescription medicines that can help. If you have severe nausea or vomiting with your migraines, there are medicines that can help with that, too. 

Do not try to treat frequent migraines on your own with non-prescription pain medicines. Taking non-prescription pain medicines too often can actually cause more headaches later. 

What if I want to get pregnant?

 If you want to get pregnant, talk to your doctor or nurse about it before you start trying. Some medicines used to treat and prevent migraines are not safe during pregnancy, so you might need to switch medicines before you get pregnant. 

Some women notice that their migraines actually get better during pregnancy and breastfeeding. This is related to hormonal changes in the body.