There are many causes of migraines. Sometimes they run in families, and in many cases migraines can go back several generations. Migraines may be caused by changes in the trigeminal nerve, a major pain pathway. Imbalances in brain chemicals, including serotonin — which helps regulate pain in your nervous system — may also be involved. Serotonin levels sometimes drop during some migraines. This may trigger your trigeminal system to release substances called neuropathies which travel to your brain's outer covering (meninges). The result is headache pain.
The most common types of headaches are migraine, tension headache, sinus headache, and mixed headaches. Cluster headaches are another type in which headaches cluster in bunches during certain times.
Triggers are things that can bring on a headache or migraine such as certain foods, changes in a woman’s menstrual cycle, certain sensory stimuli like flashing lights or motion, changes in weather, or sensitivity to the cold in winter or hot weather in summer. There are many possible triggers and oftentimes a person knows what their triggers are. A common part of treatment is to reduce the possibility of triggers.
Hormonal changes in women often contribute to migraines. Fluctuations in estrogen seem to trigger headaches in many women who have migraines. Women with a history of migraines often report headaches immediately before or during their periods, when they have a major drop in estrogen. Others have an increased tendency to develop migraines during pregnancy or menopause. Hormonal medications — such as oral contraceptives and hormone replacement therapy — may also worsen migraines, though some women may find them beneficial.
Foods. Some migraines appear to be triggered by certain foods. Common offenders include alcohol, especially beer and red wine; aged cheeses; chocolate; aspartame; overuse of caffeine; monosodium glutamate — a key ingredient in some Asian foods; salty foods; and processed foods. Skipping meals or fasting can also trigger migraines.
Stress. Stress at work or home can instigate migraines. The reduction in stress that occurs upon completion of a big project or at the end of the work week can also trigger migraines.
Sensory stimuli. Bright lights and sun glare can produce migraines, as can loud sounds. Unusual smells — including pleasant scents, such as perfume, and unpleasant odors, such as paint thinner and secondhand smoke, can also trigger migraines. Patients with chemical sensitivity can have a headache after exposure to chemicals most others can tolerate.
Changes in wake-sleep pattern. Either missing sleep or getting too much sleep may serve as a trigger for migraine attacks in some individuals, as can jet lag.
Physical factors. Intense physical exertion, including sexual activity, may provoke migraines.
Changes in the environment. A change of weather or barometric pressure can prompt a migraine.
Medications. Certain medications can aggravate migraines.
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