Migraine

Migraines usually mean you regularly get a severe headache and other symptoms that stop you carrying on as normal. You may feel sick or be extra sensitive to light and noise.

Migraines are very common. Migraines interfere with daily life. You may need to take time off work or studies and rest in bed.

You can get migraines for the first time at any age. They can start during childhood or adolescence. Most people with migraines have had their first one by the time they’re 30. Attacks usually get less severe as you get older.

There are many ways to treat migraine symptoms, reduce the pain and stop them from happening so often.

Types of Migraine

The three main types are:

  • Migraine with aura
  • Migraine without aura
  • Migraine aura without headache

One in three people who get migraines have an aura. This is a warning sign that you’re about to have a migraine attack. It usually happens up to an hour before. Common symptoms are tingling sensations and visual problems like blurred vision.

You may experience more than one type of migraine attack, or change between types. Older people are most likely to have an aura.

Other specific types of migraine may mainly affect children or women, last for a long time, run in families or be linked to particular symptoms. But the treatment is often the same for all forms of migraine.

Symptoms of Migraine

You may notice signs that a migraine is on its way a few hours or even days before you have an attack. This is called the ‘prodrome’ or ‘premonitory phase’. You may yawn a lot, get cravings for certain food and have mood swings.

You may get aura symptoms as well, sometimes just minutes before your headache starts. You may have blurred vision or blind spots or see flickering lights. Your face, lips, tongue, arms or legs may tingle. You may feel dizzy or find it hard to speak clearly. These symptoms are only temporary but can last up to a couple of hours.

Migraine headaches can last for between four hours and three days. You’ll probably have a throbbing, pulsating or banging pain at the front or on one side of your head. Even everyday activity like walking or climbing stairs may make the pain worse.

Other common symptoms are:

  • Feeling or being sick
  • Stomach ache
  • Diarrhoea
  • Needing to urinate more often
  • Pain in your neck, behind your eyes and across your nose and jaw
  • Sweating
  • Feeling hot or cold
  • Sensitivity to light, noise and smells

It can take a while to recover from a migraine. You may feel tired and irritable and find it hard to concentrate.

The number of migraines people get and how long they last varies a lot. Some get attacks once a year or less; others several times a week. If you have headaches for less than 15 days a month, this is called episodic migraine. More frequent attacks are referred to as chronic migraine.

Chronic Migraine

Chronic migraine is when you get headaches on more than 15 days a month over at least three months. And on eight of these days you have a migraine. Chronic migraines can have a big effect on your life. You may take increasing amounts of medicine to help control your symptoms, but this can cause more headaches, called medication-overuse headaches. See a doctor so he or she can provide advice on how to tackle this.

Hormonal Changes in Women

Women are three times more likely to get migraines than men. About 18 in every 100 women get migraines, while only about six in every 100 men do. Women who have migraines on average start when they’re about 18 years old. Men often start younger.

Women’s hormone levels can affect their migraines. Over half of women who have migraines say that their symptoms are linked to their periods (menstrual cycle). This is called menstrually-related migraine. But just one in 10 get migraines only during their period. This is known as menstrual migraine.

If you think you may be experiencing one of these, keeping a diary of your migraines and symptoms, over at least three menstrual cycles, may help identify which type you have. Your doctor needs to know this to prescribe the most suitable treatment.

You may have migraines a couple of days before your period starts or finishes.

Migraines may stop or get better during pregnancy. There are migraine medicines you should avoid while pregnant (or breastfeeding). Your GP or pharmacist can advise on which painkillers and anti-sickness medicines are still safe to use.

You may find your migraines get more frequent and severe when you go through the menopause. Hormone replacement therapy (HRT) helps some women, but makes migraines worse for others.

Oral contraceptives can also have an effect on your migraines. Some women find they make their migraines worse.

Tell your doctor if you use an oral contraceptive and think it may be linked to your migraines.

You shouldn’t take the combined oral contraceptive pill if you get migraines with aura. This is the tingling sensation and visual problems like blurred vision you can get up to an hour before the attack. You should contact your doctor about stopping this type of contraceptive if you have a migraine without aura and get new or more serious symptoms.

Risk of Stroke

A stroke happens when the blood supply to part of your brain is cut off, causing damage to the brain cells.

You have a slightly higher risk of stroke if you have some types of migraine, especially migraines with aura. The risk is increased further if you smoke, have high blood pressure, high cholesterol levels or are overweight.

There’s an added risk of having a certain type of stroke if you’re a woman under 45 who gets migraines with aura. The risk is greater if you also smoke or take the combined oral contraceptive pill.

Some of the symptoms of migraine and stroke are similar, although they appear at different rates. Auras can be confused with a transient ischaemic attack, which causes temporary signs of stroke. Some strokes cause a sudden severe headache, which could be mistaken for migraine. There’s also a rare type of stroke called a migrainous stroke that causes lasting neurological symptoms.

See a doctor if you’re worried that any of your migraine symptoms could be signs of stroke, or if you’re at increased risk of stroke.

Specialist Treatment of Migraine

If your migraines change, don’t improve with treatment, or there’s uncertainty about the diagnosis, see a specialist migraine clinic.

You may need hospital treatment if you have a severe migraine that lasts more than three days. These may include seizures, feeling confused or a lack of coordination, which could indicate another condition.