Prodrome
One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine, including:
- Constipation
- Mood changes, from depression to euphoria
- Food cravings
- Neck stiffness
- Increased urination
- Fluid retention
- Frequent yawning
Migraine triggers
Many possible migraine triggers have been suggested, including hormonal, emotional, physical, dietary, environmental and medicinal factors.
These triggers are very individual, but it may help to keep a diary to see if you can identify a consistent trigger.
It can also sometimes be difficult to tell if something is really a trigger or if what you're experiencing is an early symptom of a migraine attack.
Hormonal changes
Some women experience migraines around the time of their period, possibly because of changes in the levels of hormones such as oestrogen around this time.
These type of migraines usually occur between 2 days before the start of your period to 3 days after.
Some women only experience migraines around this time, which is known as pure menstrual migraine.
But most women experience them at other times, too, and this is called menstrual-related migraine.
Many women find their migraines improve after the menopause, although the menopause can trigger migraines or make them worse in some women.
Emotional triggers:
- stress
- anxiety
- tension
- shock
- depression
- excitement
- Physical triggers:
- tiredness
- poor-quality sleep
- shift work
- poor posture
- neck or shoulder tension
- jet lag
- low blood sugar (hypoglycaemia)
- strenuous exercise, if you're not used to it
Dietary triggers:
- missed, delayed or irregular meals
- dehydration
- alcohol
- caffeine products, such as tea and coffee chocolate, aged cheese, red wine, citrus fruit, yeast, msg , processed meat , cured meat, nuts and seeds
- specific foods, such as chocolate and citrus fruit
- foods containing the substance tyramine, which include cured meats, yeast extracts, pickled herrings, smoked fish (like smoked salmon), and certain cheeses (such as cheddar, stilton and camembert)
- Also, foods that have been stored at room temperature, rather than being refrigerated or frozen, can have rising levels of tyramine.
- avocados
- chicken livers and other organ meats
- dairy products like buttermilk, sour cream, and yogurt
- dried fruits like dates, figs, and raisins
- garlic
- most beans including lima, fava, navy, pinto, garbanzo, lentils, and snow peas
- onions
- pickled foods like olives, sauerkraut, and, of course, pickles
- potato chips
- some fresh fruits like ripe bananas, papaya, red plums, raspberries, kiwi, and pineapple
- smoked or dried fish
- tomato-based products (including pizza!)
Environmental triggers:
- 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:
- some types of sleeping tablets
- the combined contraceptive pill
- hormone replacement therapy (HRT), which is sometimes used to relieve symptoms associated with the menopause
Many prescription and non-prescription medicines and supplements can cause headaches. A few examples are:
Medicines that contain hormones, such as birth control pills and hormone therapy for menopause.
Medicines for erection problems.
Caffeine (because of caffeine withdrawal).
Some heart and blood pressure medicines.
Vitamins.
