In the past, migraines were considered vascular — or blood vessel-related — headaches. They were thought to occur when shifts in blood flow suddenly dilated (expanded) the blood vessels in and around the head causing pain. However, the most current and respected findings suggest that migraines and other primary headaches arise from disturbances within the central nervous system. These disturbances trigger a cascade of chemical changes that cause inflamed blood vessels and neurological symptoms, including pain. There are two major types of migraines — migraine with aura, which includes specific neurological symptoms such as vision disturbances (formerly called “classic” migraine), and migraine without aura (formerly known as “common” migraine).
Considered an inherited disorder, migraines affect women three times more often than men. The female hormone estrogen is believed to play a role in why more women than men are afflicted by this painful condition.
As with all headaches, migraines affect people in different ways. If you are a female migraine sufferer, your headaches may have started with your first menstrual period or upon menopause (your last menstrual period). Some women find that their migraines go away during pregnancy or after menopause. Regardless of when your headaches first began, identifying your migraine triggers is an important first step in determining effective treatment options.
The symptoms of migraine headaches can occur in various combinations and include:
- Moderate to severe pain (often described as pounding, throbbing pain) that can affect whole head, or can shift from one side of the head to the other
- Sensitivity to light, noise or odors
- Blurred vision
- Nausea or vomiting, stomach upset, abdominal pain
- Loss of appetite
- Sensations of being very warm or cold
- Paleness
- Fatigue
- Dizziness
- Fever (rare)
- Bright flashing dots or lights, blind spots, wavy or jagged lines (aura)
The following recognized migraine symptom phases might occur alone or in combination with other phases:
- Prodrome. This consists of events that occur hours to days before the actual headache. Prodrome symptoms include:
- Mood changes.
- Stiff neck.
- Chilled feeling.
- Sluggishness and fatigue.
- Increased frequency of urination.
- Constipation or diarrhea.
- Loss of appetite or food cravings.
- Increased sensitivity to light, sound and smells.
- Fluid retention.
- Aura (present in migraine with aura). These neurologic symptoms typically occur five to 20 minutes before the headache and last up to 60 minutes. Occasionally, the aura symptoms occur during the headache phase. The most common aura symptoms are visual, such as bright zigzag lines, sparkling moving figures, blind spots and distorted objects.
- Headache Phase. Sixty percent of migraine headaches occur on one side of the head (unilateral), while 40 percent occur on both sides (bilateral). For some people, migraine headaches consistently occur on a particular side of the head, while others experience pain on different sides of the head at different times. Migraine headaches typically last hours to days, but rarely last less than four hours. Other common headache phase symptoms include:
- Throbbing and pulsating pain that may vary in intensity.
- Nausea or vomiting.
- Loss of appetite.
- Diarrhea.
- Blurred or restricted vision and sensitivity to light.
- Other sense changes, such as sensitivity to sound, smells, or touch.
- Fatigue, depression, irritability and anger.
- Mental dullness, confusion, hyperactivity.
- Lack of coordination, vertigo (spinning sensation), double vision.
- High or low blood pressure.
- Skipped heart beats.
- Nasal congestion.
- Postrome. After a severe migraine attack, people often feel tired or “washed out,” irritable, and listless. Other symptoms may include:
- Impaired concentration.
- Muscle weakness and aching.
- Food cravings or loss of appetite.
- Feelings of euphoria or hyperactive behavior.