Migraine FAQs

A migraine is a condition involving multiple moderate to severe headaches that are often characterized by nausea, vomiting, sensitivity to light, smells and sound, mood changes, and lethargy. While symptoms of migraine differ from person to person, the most common symptom of a “migraine attack” is an intense throbbing pain typically on one side of the head. 

Migraines encompass a range of symptoms, with headaches being just one aspect. This neurological disorder is characterized by changes in brain activity, which may lead to nausea, visual disturbances, fatigue, dizziness, confusion, and heightened sensitivity to light, smell, and sound. If you suffer from severe headaches accompanied by other concerning symptoms, it’s advisable to talk to your primary care provider about diagnosis and appropriate treatment.  

A migraine attack can last anywhere from four hours to several days. There are four phases of a migraine attack: the prodrome, aura, headache attack, and postdrome. Prodrome can begin anywhere within 24 hours before your headache starts and is often characterized by mood changes, trouble sleeping, and difficulty focusing. Next, the aura occurs 5-60 minutes before your headache and can involve vision changes (a visual “aura” over your eyes), muscle weakness, trouble speaking, confusion, feeling touched or grabbed, tinnitus (ringing in your ears) and increased sensitivity. The prodrome and aura phases are especially important to identify because many migraine medications must be administered before the headache attack begins to be as effective as possible. The next phase is one most people are familiar with: the headache. Whether it occurs gradually or without warning, pain is typically felt on one side of the head but can move to other areas throughout the headache. You may also experience nausea, vomiting, confusion, sensitivity to light, smell, and sound, and more. The last phase of a migraine attack is Postdrome, characterized by exhaustion and difficulty concentrating, this phase is often compared to feeling hungover or much worse. 

No one is quite sure as to the exact cause of migraines, although there appears to be a genetic component involved. Put simply, our nerves send signals to our brain that trigger an inflammatory response. Regrettably, the reasons behind this nerve behavior are still not fully understood. Additionally, it is evident that migraines disproportionately affect women more often than men, potentially due to triggers associated with the menstrual cycle and pregnancy.  

Migraine attacks are often triggered by external or internal factors, many of which can be anticipated or avoided to aid your treatment. Many different things can trigger a migraine and specific migraine triggers often differ from person to person. Some common migraine triggers include: 

• Stress 

• Hormonal changes 

• Medications 

• Sleep changes 

• Weather 

• Physical Overexertion 

• Caffeine or tobacco 

• Bright lights 

• Strong odors 

• Loud noises 

• Certain foods or additives 

• Head trauma 

• Motion sickness 

• Alcohol 

• Skipped meals/low blood sugar 

To more effectively identify possible triggers that may affect you more than others, experts recommend maintaining a headache journal. This journal should include information like when migraine attacks occur, their intensity, anything you did/ate/experienced before the attack, and your specific symptoms. Documenting this information can help you pinpoint your triggers, but it can also provide valuable insight for your doctor in terms of diagnosis and further treatment options. 

According to the National Institute of Neurological Disorders and Stroke, Migraine is considered a genetic disorder. In fact, more than half of all individuals who suffer from migraine have at least one family member who also has the disorder.  

Yes, researchers noticed an increase in reported headaches from those in arctic zones, where the sun stays high in the sky much longer than regions nearer to the equator. In Hampton Roads, high temperatures and increased humidity are two common triggers for migraineurs. Other strong weather systems can trigger a migraine attack as well. For those with weather-related migraine triggers, try using a weather app to anticipate fluctuations in barometric pressure or other major weather events. 

Yes, drops or changes in estrogen levels can cause migraine attacks. Menstrual migraine, also known as menstrually related migraine, refers to a classification of migraine affecting those who menstruate. Migraine attacks for these individuals often occur during the beginning of the menstrual cycle. 

Making lifestyle changes can prevent or reduce some migraine attacks. Oftentimes migraineurs will supplement treatment with additional changes to routine, diet, and other aspects of their lives. Some common changes include: 

• Special diets or supplementation (with a doctor’s recommendation) 

• Exercise 

• Drinking water 

• Cognitive Behavioral Therapies 

• Quitting smoking or reducing alcohol intake 

• Acupuncture 

• Relaxation techniques to reduce stress 

• Adjustment of your sleep schedule 

• Massage therapy 

• Dry needling 

Treatment for migraines differs from medications to procedures based on the individual and their medical history. There are oral medications, nasal sprays, IV medications, and intramuscular / subcutaneous abortive (rescue) medications that are helpful for the treatment of recent onset pain. If more conservative approaches are unsuccessful, Nerve Blocks is a minimally invasive, in-office procedure which aims to relieve pain and inflammation in the back of the head.  

Preventative medications including beta blockers, antidepressants, and Botox, among others can also prevent migraine before it occurs.  

Unfortunately, there is no cure for migraines, but you can receive treatment to manage your symptoms. 

Most who experience migraine have used over-the-counter (OTC) medication at one time or another. In fact, many who remain undiagnosed self-medicate using OTC treatments such as Excedrin Migraine or other drugs including acetaminophen, aspirin, and ibuprofen. When using OTC medications, make sure you read drug labels carefully, follow recommended dosage and instructions, and refrain from overuse. If you are consistently taking OTC medication without prescription, consider talking to a doctor about your pain and how you can tailor treatment to better suit your needs. Overuse of OTC medications can lead to liver, kidney damage and rebound headaches which is why it is important to follow recommendations from your doctor and pharmacist. 

At TPMG, we can offer pre-medication like anti-anxiety and pain medication depending on your needs. If you’re experiencing fears regarding pain during IUD insertion, make sure to address them with a trusted provider during your consultation appointment. 

A commonly prescribed medication to reduce discomfort associated with device placement is cytotec which is used to help dilate the cervix, making it easier for insertion. This can be discussed with your provider.  

Find relief from migraines and don’t leave your migraine symptoms unaddressed. If you are experiencing new or worsening symptoms, side effects from your migraine treatments, or have questions regarding your condition, contact a qualified TPMG health professional today for next steps.