What Causes Migraine Headaches (Part-1)

What Causes Migraine Headaches
What Causes Migraine Headaches

Part- 1

I can’t tell you how many times I’ve touched my fingers to my head, felt the pounding, and tried to figure out what was happening under the surface to cause such agony.  

We are migraineurs – those of us who have migraines. We know they hurt, but we don’t understand exactly what causes migraine headaches.  Migraines are recurring, disabling neurological disorders which lead to head pain and a variety of other symptoms. 

You’d think we’d know what causes them, especially considering that over 1 billion of the nearly 8 billion people on the planet will suffer from a migraine this year. That’s about 15 percent of the population!

Even worse, nearly 250 million of us live with chronic migraines, meaning they rarely go away. One study reported that of the 185 patients examined at a Polish headache clinic, 91, or 49 percent, suffered from chronic migraines.

Migraines afflict women nearly twice as often as they do men. Some estimates put the number at 19 percent of women compared to 10 percent of men.  And neither children nor the elderly are immune to migraines. 

As someone who’s suffered from migraines from childhood until I figured out a solution at the age of 40, I’ve often wondered what causes migraine headaches. 

Before looking at what might be going on inside the skull of a  migraineur, there’s another question I need to address.

Are “Triggers” What Causes Migraine Headaches?

Googling the question, “What causes migraine headaches?” provides a list of possible triggers:

  • bright lights
  • the sun’s glare
  • loud noises
  • strong odors

But these are merely triggers. What I want to understand are the physical mechanisms underlying the problem. 

However, even though we don’t know what causes migraine headaches, we definitely have some clues! Extensive research has identified how the nervous system changes through each of a migraine headache’s five phases.


What Causes Migraine Headaches - The four primary migraine phases.
The four primary migraine phases. JoanDragonfly CC BY-SA 2.0

Phase One: The Prodrome

Also known as the pre-headache or premonitory phase, the prodrome may continue anywhere from hours to days. Its widely variable symptoms include: 

  • Excessive yawning 
  • Frequent urination 
  • Sudden onset of fatigue
  • Thirst 
  • Cognitive difficulties 
  • Mood changes
  • Irritability 
  • Food cravings and hunger
  • Neck stiffness 
  • Sensitivity to light and sound 

Phase Two: the Aura

Not every migraineur experiences an aura, but those who do report 

  • Slurred or jumbled speech
  • Difficulty processing what others are saying
  • Problems thinking clearly
  • Visual disturbances like flashes of light or blind spots
  • Numbness and tingling 
  • Weakness on one side of the body

The auras last from a few minutes to an hour.

Phase Three: the Headache

During this phase, the headache’s severity reaches a crescendo and continues from four hours to three days, during which the migraineur may suffer from:

  • Throbbing or steady pain, usually on one side of the head
  • Nausea and vomiting
  • Loss of appetite 
  • Nasal congestion 
  • Increased sensitivity to movement, light, sound, and odors
  • Dizziness or blurred vision 
  • Feeling warm or cold 
  • Fatigue

Phase Four: the Postdrome

Otherwise known as the “migraine hangover,” this phase lingers for one to two days with: 

  • Fatigue or exhaustion 
  • Muscle weakness 
  • Difficulty concentrating 
  • A feeling of euphoria 

Phase Five: the Interictal Phase

This hiatus from migraines isn’t categorized as a primary phase. During it, migraineurs are susceptible to new attacks because of various triggers and their genetic predisposition. 

Researchers’ Thoughts on What Causes Migraine Headaches

Researchers have learned that distinct parts of the brain have increased blood flow and heightened activity during each migraine phase.

Recently, we’ve also been looking at cerebral blood flow. However, our focus has been on the parts of the brain where increased activity improves cognitive performance. 

During Phase One of the migraine, increased blood flow occurs in the hypothalamus. It’s responsible for maintaining the body’s internal balance, or homeostasis.

The tiny hypothalamus plays a gigantic role in maintaining the body's hormonal balance.What Causes Migraine Headaches
The tiny hypothalamus plays a gigantic role in maintaining the body’s hormonal balance.

As the primary link between the endocrine and nervous systems, it also regulates the hormone production controlling our:

  • Stress response 
  • Sleep cycles
  • Body temperature
  • Heart rate
  • Blood pressure
  • Thirst, fluid, and electrolyte balance 
  • Appetite and body weight 

The correlation between migraine triggers and hypothalamic functions deserves closer attention. For example, the Headache Center of Atlanta neurologist Leslie Kelman, M.D., evaluated over 1,200 migraineurs for triggers.

Three of every four reported having migraine triggers. And of them, nearly 80 percent identified stress as a major trigger. 

Nearly two-thirds of the women mentioned hormonal fluctuations. Over half reported not eating, weather, or sleep disturbances as triggers.  All told, five of their most common triggers were hypothalamus-related. 

The hypothalamus of a migraineur loves balance!

Speaking of balance, my wife just called me for my plant-based dinner, which will help protect me from migraines. No stress here! 

Part 2 of our look at what causes migraine headaches will follow tomorrow.

 ”What Causes Migraine Headaches Part 2”

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