Migraines are a type of severe headache that can have a major impact on quality of life. They are often accompanied by feeling sick, vomiting or increased sensitivity to light.
Migraines are one of the most common types of headache in adults, affecting about two million Australians. Women are three times more susceptible than men. You can get migraines at any age but they’re most common before the age of 40. About half of all people who get migraines have a family history of them.
A classic migraine follows a set of warning symptoms called aura. These symptoms usually come on before the general symptoms of a migraine and last for about an hour. Around one in three people will experience aura symptoms. A common migraine strikes without aura.
Less frequent types of migraine include abdominal, hormonal and hemiplegic.
Common aura symptoms include:
You may get a migraine at any time. Sometimes you may be able to sense when a migraine attack is about to start. This is different from aura, and includes signs such as irritability, lack of concentration, food cravings and tiredness.
The general symptoms of migraines include:
Most people don’t need to see their GP when they get a migraine. However, it’s a good idea if:
People who get migraines generally don’t get any symptoms between attacks.
Occasionally, a migraine may last for more than 72 hours and doesn’t go away by itself. This type of migraine is known as status migrainosus. It’s important to see your GP if your migraine lasts longer than 72 hours.
If you get frequent migraines on more than 15 days a month for an average of three months out of the year, this is known as a chronic migraine. When describing an illness, the term chronic refers to how long a person has it, not to how serious it is. About one percent of people have chronic migraine and may require increasing amounts of medication to help control the attacks. Over time, this may lead to further headaches, known as medication-overuse headaches.
If you get frequent migraines, you may be at an increased risk of depression, anxiety, panic disorders and stroke.
It’s not fully understood what causes migraines, but they may be caused by a chemical called serotonin. Low levels of serotonin cause changes to the blood vessels in your brain. It’s not known exactly what causes the serotonin levels to change.
You may find it useful to keep a diary to track what might be triggering your migraines or making them worse.
Common triggers include:
Women may get migraines around the time of their periods, during pregnancy and menopause, or as a result of taking oral contraceptives or hormone replacement therapy (HRT). It’s possible that these hormonal changes may affect the frequency and severity of migraines.
Other less common triggers may include high blood pressure, smoking, toothache, eye strain or taking certain sleeping tablets.
There isn’t a specific test that can diagnose migraines. Your GP will ask about your symptoms and look for a pattern with possible triggers. This is where your diary can be useful. They will also examine you and may ask about your medical history.
Keep a diary of your migraines. Record your symptoms, how bad they get, how long they last and what medication you use, if any. This can help you to spot things that may trigger or make your migraines worse.
It’s best to rest in a quiet, darkened room and sleep if you can. You may want to try using a cold compress, such as an ice pack or ice wrapped in a towel to ease your headache. Don’t apply ice directly as it can damage your skin. A hot compress may also help. You may want to try applying pressure to the pulse points on the side of your forehead or neck.
Different types of medicine are used to treat migraines, depending on your symptoms and the severity of your migraines.
If you use any type of painkiller too frequently, it may become less effective and cause further headaches called ‘medication overuse headaches’. This can happen if you regularly use painkillers for 10 to 15 days a month, for more than three months.Over-the-counter medicines
You may find that over-the-counter painkillers (such as aspirin, paracetamol and ibuprofen) help to relieve the symptoms of your migraines. Your body absorbs soluble painkillers that you dissolve in water quicker than non-soluble ones so they may be more effective.
You could also try a combination painkiller (paracetamol) and anti-nausea medicine (metoclopramide). This can help relieve pain and may stop you vomiting and feeling sick. Make sure you don’t take additional paracetamol with this combination product because too much paracetamol can harm your liver.
Always read the accompanying consumer medicines information leaflet and if you have any questions, ask your pharmacist or GP for advice.
If over-the-counter painkillers don’t help to ease your migraines, your GP may prescribe other medicines called triptans (also known as 5HT agonists). These work well in about two thirds of people and you may need to try more than one before you find which medicine works best for you.
Triptans stop the effects of serotonin, which is thought to cause migraines. They are more effective if you take them when the headache is beginning to develop. Triptans are available as tablets, dissolvable wafers, nasal sprays or injections.
Triptans are not recommended in people who:
Check with your GP if you are pregnant or breastfeeding.
Common side effects of using triptans may include dizziness, feeling sick, vomiting, tiredness or sensations of tingling, heat, heaviness or pressure in any part of the body.Other prescription medicines
Although the cause of migraines is unclear, stress and anxiety are thought to make migraines worse. Relaxation techniques such as yoga, meditation, muscle stretches and controlled breathing exercises can be useful in the management of stress and anxiety.
Another option is a talking treatment called cognitive behavioural therapy (CBT). A trained therapist can help you challenge negative thoughts, feelings and behaviour to help reduce stress and anxiety that may cause or make your migraines worse.
You may wish to try acupuncture to help relieve some of your symptoms, but there is little evidence to show that it’s effective for migraines. Before trying it, speak to your GP and check that your acupuncturist belongs to a recognised professional body.
Many medicines for migraines aren’t suitable if you’re pregnant or breastfeeding. Speak to your GP before taking any medicines for your migraines, even if they were prescribed to you previously, as they may be harmful to your baby.
It’s important to learn to spot the signs and triggers of your migraine to help prevent them. The easiest way of doing this is by keeping a diary about your migraines.
Keeping active by doing 30 minutes of exercise of moderate intensity on five or more days a week may also help prevent migraines.
If you get frequent or severe migraines, your GP may prescribe medicines to help prevent them.
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Last published: 30 July 2011
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