Migraines are thought to be caused by the brainstem’s interaction with the trigeminal nerve, a major pain pathway in the body. Imbalances in the brain—including serotonin, which helps regulate pain in the nervous system—may be involved. Migraine triggers aren’t fully understood, but genetics and environment can play a role. Triggers may include:
Fluctuations in estrogen immediately before or during a woman’s menstrual cycle.
Medications, such as oral contraceptives, estrogen replacement therapy, and vasodilators, including nitroglycerin.
Foods, such as aged cheeses, salty and processed foods.
Food additives, such as the artificial sweetener aspartame, nitrates in processed meats, and the preservative called MSG.
Alcohol, especially wine.
Skipping meals or fasting; also low blood sugar.
Ongoing stress, or the period following a stressful event.
Sensory stimuli, like bright lights, strobes and sun glare; loud sounds; and smells, like perfume, paint thinner, secondhand smoke, etc.
High blood pressure.
Changes in sleep patterns; also jet lag.
Intense physical exertion, including sexual activity.
Changes in the weather, including a rise or fall in barometric pressure.
Medications can help prevent some migraines and make them less painful. Initial treatment suggested by the doctor might include pain medication like ibuprofen and acetaminophen for the headache, medication for the nausea, and the avoidance of triggers.
Webmd.com has information on prescription medications for migraine headaches. Be sure to check your insurance carrier’s “drug formulary” to see if a prescribed migraine medication is on the list. If it’s not, it can be very expensive. Also, beware of opioids prescribed for any pain. Talk to your doctor about alternatives to these highly addictive drugs.