Are migraines hereditary?

Although science has yet to fully uncover the reasons why some people develop migraines and others don’t, genetics seems to play a role. However, there are other risk factors that you should be aware of in order to fully understand the condition.

Migraines do seem to run in families. While we don’t yet fully understand the role that certain patterns of genetics play in migraines, we do know that both genes and the environment impact how likely a person is to develop them. As many as 80% of people who experience migraines have a parent, sibling or child who also gets them. If one parent has migraines, their child has a 50% chance of developing them. If both parents have migraines, there’s a 75% chance the child will experience them.

Typically, a single genetic variation or defect doesn’t cause migraines. Most migraines appear to have an association with a number of specific genes. This means that if you have a certain set of variations across multiple genes, you’re more likely to develop migraines.

Specifically, certain mutations in the CACNA1A, ATP1A2 and SCN1A genes are believed to be responsible for certain types of migraines. These genes determine how proteins that control the electrical activity across the outer layer of cells function. Variations in one of these genes cause abnormalities in nerve function, causing hemiplegic migraines. People who have variant genes can pass them on to their children.

The majority of genes involved in migraine headaches impact the muscles that surround blood vessels in the brain. Variations in these genes can disrupt blood flow to the brain, potentially causing migraines. However, you can have these genetic variations and never get a migraine.

One form of migraine, the hemiplegic migraine, seems to be directly caused by genetic variations. Hemiplegic migraines cause temporary paralysis or sensory changes on one side of the body and can occur with or without headaches. 

Genetic variations are only one of the risk factors for migraines. Some others include:

• Gender: Migraines are more common in women than in men.
• Depression/mood disorders: There is a higher risk of migraines in people with mood disorders.
• Obesity: Weight gain can increase the number of migraines a person may experience.
• Stress: If you experience chronic stress, you’re more likely to develop migraines.
• Smoking: People who smoke experience migraines more frequently than those who don’t.
• Age: Although you can develop migraines at any age, they typically begin in adolescence and early adulthood and grow more severe through your 30s. After that, many people experience a decline in migraine severity and frequency.
• Hormonal changes: Hormonal fluctuations related to menstruation, pregnancy and perimenopause can contribute to migraines. While it’s clear that estrogen and migraines are connected, how hormonal changes affect migraines vary from person to person. There are some women who only get migraines before and during their periods. Some women experience fewer migraines after menopause, but this isn’t always the case.

Many migraine sufferers experience headaches in response to triggers, such as:

• Caffeine: Excessive intake of caffeine and caffeine withdrawal may trigger migraines in some people.
• Stress: During times of increased stress or tension, people with migraines are more likely to experience more frequent and/or severe headaches.
• Diet: Some people experience migraines when they skip or postpone meals. Chemicals and preservatives in certain foods can trigger migraines, including nitrates found in pepperoni, lunch meats and hot dogs.
• Light: Exposure to light from a TV, computer or fluorescent bulb may lead to migraines in some people. Flashing lights can also cause these headaches.
• Fatigue: Changes in sleep patterns or schedules that leave you overly tired may contribute to migraines.
• Intense sensory stimuli: Some people get migraines due to loud noises or strong odors.
• Weather: Barometric pressure, altitude and wind speed changes have been linked to migraines.

Over time, keeping a migraine journal can help you identify triggers, so you can make lifestyle changes and come up with strategies to avoid migraines.

Whether you have relatives with migraines or you’re the first person in your family to develop them, treatments are available to help you manage chronic headaches. Talk to your healthcare provider if migraines interfere with your ability to work, sleep or keep up with your daily routine or if they increase in frequency or severity. You should also let your medical provider know if over-the-counter medications and other self-care interventions fail to fully alleviate pain. Together, you can explore treatment options that can ease migraine pain and potentially reduce the frequency of headaches.

Published March 2023.