What are some common migraine triggers?

If you're one of the millions of Americans with migraine headaches, you know they can be intense and disabling. A migraine is the most common type of severe headache that prompts patients to seek medical attention. Scientists and researchers don't understand all of the causes of migraine headaches; however, many people with migraines find that their headaches seem to be brought on, or triggered, by one or more factors. 

One of the most common triggers of migraine headaches is stress. Many people with migraines report having a lot of stress in the hours and days before their headaches begin. Stress can cause your shoulders and neck muscles to tighten, contributing to head pain.

Migraines are much more common in women than in men, and fluctuations in the hormone estrogen (around the time of menstrual periods and during pregnancy, for example) can prompt migraines in some women. Taking birth control pills can also make migraines worse, although some women experience fewer headaches when they’re on the pill.

There are many foods that can trigger migraines in some people. The exact connection between diet and migraine headaches is not well understood, and there is a lot of disagreement about what foods might trigger migraines. Everyone's triggers are different, but people with migraines are often advised to avoid several types of food, including:

• Aged cheeses
• Artificial sweeteners, such as aspartame
• Cured meats, including hot dogs and bacon
• Foods containing the preservative monosodium glutamate (MSG)
• Pickled and marinated foods

Some people with migraines find they may be sensitive to other foods as well. Chocolate, which appears on most lists of dietary migraine triggers, may not be a trigger at all, according to recent research. It may be that before a migraine attack or before a woman's period, some people crave and consume chocolate, so the chocolate itself may not contribute to a migraine.

Alcoholic drinks, particularly wine, and caffeinated beverages, such as coffee and tea, are usually thought to be migraine triggers. However, new research suggests that caffeine in moderation does not appear to trigger migraines. It may be that overusing caffeine and subsequent caffeine withdrawal contributes to migraines in some people.

Dehydration, which can result from consuming too much caffeine, is another potential migraine trigger for some people.

For certain people, particular sensations act as migraine triggers. These include flashing or bright lights, strong smells and loud noises.

Changes in sleep patterns — getting too much or too little sleep — might prompt a migraine for some people.

Some people with migraine headaches notice that changes in the weather, such as storms, changing barometric pressure and temperature changes, seem to trigger their migraines. It may be that weather changes can cause an imbalance of brain chemicals, including serotonin, or worsen other headache triggers.

Some prescription medicines can prompt or worsen migraine headaches. Even over-the-counter and prescription drugs for migraines, if taken too often, can cause a headache instead of relieving pain.

Because everyone has different triggers, people with migraines are often asked to keep a "headache diary," where they write down the details of each headache — how long it lasts, what they ate and did before it started, how well the treatment worked, and any other important details. This information can help you and your healthcare provider figure out the best way to avoid migraine headaches and, if they occur, how best to treat them, either with over-the-counter migraine medication or prescription treatment.

Published January 2023.