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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.

About migraines

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.

Types of migraine

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.

Aura symptoms

Common aura symptoms include:

  • visual disturbances – such as flashing or flickering lights, zigzag lines, blurred vision, temporary blindness
  • numbness or a tingling sensation – common in the hands, arm or face, similar to ‘pins and needles’
  • slurred speech
  • poor concentration
  • problems with your co-ordination.

Symptoms of migraine

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:

  • a headache that lasts anything from four up to 72 hours
  • pulsating or throbbing pain, often just on one side of your head
  • a headache that gets worse when you’re active or stops you from being active
  • feeling sick or vomiting
  • increased sensitivity to light and noise.

Most people don’t need to see their GP when they get a migraine. However, it’s a good idea if:

  • your migraines become more frequent or get worse over time
  • you’re over 50 and haven’t had a migraine before
  • you get aura symptoms lasting more than an hour.

People who get migraines generally don’t get any symptoms between attacks.

Complications of migraine

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.

Causes of migraine

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:

  • stress
  • changes in sleep patterns
  • poor posture or tension in your neck and shoulders
  • certain food or drink – commonly chocolate, cheese, alcohol, caffeine
  • loud noises
  • bright or flickering lights
  • certain smells
  • strenuous exercise if you’re not used to it
  • skipping meals
  • not drinking enough fluid.

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.

Diagnosis of migraine

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.

Treatment of migraine


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:

  • have uncontrolled high blood pressure
  • have had a stroke
  • have had a heart attack
  • are taking certain medicines – for example ergotamines, lithium or some antidepressant medicines.

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
If you can’t take triptans or over-the-counter painkillers don’t work for you, your GP may prescribe non-steroidal anti-inflammatory drugs or a combination of anti-nausea medicine and painkillers.

Other treatments

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.

If you’re pregnant

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.

Prevention of migraine

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.

Preventive medicines

If you get frequent or severe migraines, your GP may prescribe medicines to help prevent them.

Further information

Headache Australia


British Association for the Study of Headache. Guidelines for all healthcare professionals in the diagnosis and management of migraine, tension-type headache, cluster headache, medication-overuse headache. 3rd ed (1st revision). [online] 2010 [Accessed 7 July 2011] Available from:

Chawla J. Migraine headache. [online] New York, NY: WebMD LLC. [last updated 25 May 2011, accessed 7 Jul 2011] Available from:

Clinical Knowledge Summaries. Migraine. [online] London: National Institutes for Health and Clinical Excellence. 2008 [last updated Mar 2010, accessed 7 Jul 2011] Available from:

Etminan M Takkouche B Isorna F et al. Risk of ischaemic stroke in people with migraine: systematic review and meta-analysis of observational studies. BMJ. 2005; 330(63).

Headache Australia. Migraine -  ‘a common and distressing disorder’. [online] Crows Nest, NSW: Brain Foundation. c2011 [Accessed 7 July 2011] Available from:

Headache Classification Subcommittee of the International Headache Society. The international classification of headache disorders: 2nd edition. Cephalalgia. 2004; 24 Suppl 1: 9-160.

Institute for Clinical Systems Improvement (ICSI). Healthcare guidelines: diagnosis and treatment of headache. [online] Bloomington, MN: ICSI. Jan 2011 [Accessed 7 July 2011] Available from:

Merck Manuals Online Medical Dictionary. Migraine. [online] Whitehouse Station, NJ: Merck, Sharp and Dohme Corp. [Last updated Apr 2008, accessed 7 Jul 2011] Available from:

NSW Therapeutic Assessment Group (TAG). Prescribing guidelines for primary care clinicians: Migraine. [online] Darlinghurst, NSW: NSW TAG. 1998 [Last revised 2002, accessed 7 July 2011] Available from:

Pryse-Phillips W Dodick D Edmeads J et al. Guidelines for the nonpharmacologic management of migraine in clinical practice. CAMJ. 1998; 159: 47–54.

Rossi S (ed). Australian Medicines Handbook. Adelaide: Australian Medicines Handbook. 2011.

Schurks M Rist PM Bigal ME et al. Migraine and cardiovascular disease: systematic review and meta-analysis. BMJ. 2009; 339.

Scottish Intercollegiate Guidelines Network (SIGN). Diagnosis and management of headache in adults. [online] Edinburgh, Scotland: SIGN. Nov 2008 [Accessed 7 July 2011] Available from: (PDF, 686Kb)

Simon C, Everitt H, van Dorp F. Oxford handbook of general practice. 3rd ed. Oxford: Oxford University Press. 2010: 562–63.

World Health Organization (WHO). Headache disorders. [online] Geneva, Switzerland: WHO. c2011 [accessed 7 Jul 2011] Available from:

Last published: 30 July 2011

This information has been developed and reviewed for Bupa by health professionals. To the best of their knowledge it is current and based on reputable sources of medical research. It should be used as a guide only and should not be relied upon as a substitute for professional medical or other health professional advice.

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