A variety of factors contribute, here's what you need to know.

By Kasandra Brabaw
Updated May 26, 2019 @ 7:00 am
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If you suffer from migraine headaches, or know anyone who does, you’re well aware that they’re not “just headaches.” Your typical headache wouldn’t be considered a disease, but migraine is a neurological disorder, Matthew Robbins, MD, a neurologist at NewYork-Presbyterian/Weill Cornell Medicine, tells InStyle. And a painful one.

But what causes migraine? For a long time, the medical community was stumped, especially because migraines have many, many triggers that are personal to everyone — from changes in the weather, to certain foods for example. Triggers may seem like they cause your migraines, but there’s something else at the root, Dr. Robbins says. There’s only one reason scientists have determined, for sure, that people get migraine headaches: genetics.

“A complicated series of genes makes you susceptible to migraine,” Dr. Robbins says. If one or both of your parents get migraines, there’s a 50 to 75 percent chance that you will, too, according to the American Migraine Foundation (AMF). But you won’t always. Migraine is a complex genetic disorder, meaning that many different genes have to come together to make you predisposed. And even then, you’re just predisposed — you’re not guaranteed to get migraines. “It’s possible that your mom has migraine, but you never get it,” Dr. Robbins says. The reverse is also true: You could suffer from migraines even though neither of your parents ever has. This lack of clarity is probably what brought you to this very article: Why. Do. I. Get. Migraines. UGH.

That brings us back to those triggers. While we might want to call triggers the “cause” of migraines, they’re really just the thing that sets your brain off. The brains of people who have migraine are hypersensitive to certain stimuli, Dr. Robbins says. Think of it as if your brain gets really excited when it comes across one of your triggers. Except, in this case, “excited” is a bad thing because it causes throbbing pain in your head and, for some people, other symptoms like nausea, sensitivity to light, and blurry vision. In fact, there are many different types of migraine, depending on the associated symptoms, according to the International Headache Society’s classification.

Unfortunately, one of the most common triggers is one you can’t do much to control. Dr. Robbins sees many patients who are triggered by their menstrual cycle, or more accurately, the hormone fluctuations menstrual cycles cause. The menstrual migraine window starts two days before your period and continues for the first three days of your flow, according to the American Migraine Foundation.

Menstrual migraine is one of the most difficult types to treat, the AMF says. While people can try to avoid most other triggers, it’s pretty difficult to avoid your period. Sometimes, continuous birth control can help, Dr. Robbins says. And doctors will also try using preventative medications either targeted to the menstrual window or throughout the month.

Other common triggers include: stress, changes in sleep (both not sleeping enough and sleeping too much), caffeine or alcohol, changes in the weather (some people are sensitive to barometric pressure), and dehydration, Dr. Robbins says. Some people also report food triggers, but those are more difficult to verify, he says. In general, it’s a good strategy to track your triggers and attempt to avoid them. If you notice a migraine hit each time you’ve had a messed up sleep schedule, try to prioritize getting consistent shuteye to prevent another attack. Someone who’s triggered by dehydration, for example, should make sure they’re drinking enough water.

Of course, most people with migraine don’t have just one trigger. And it’s not always possible to control them, especially triggers like stress and changes in the weather. Just like the causes of migraine, there’s no one-size-fits-all treatment to the disorder.
If you have migraine, your best option is to meet with a neurologist and develop a personalized treatment plan based on your triggers and the frequency of your attacks. “Anyone who has headaches severe enough to wonder whether or not they should see their doctor should see their doctor,” Dr. Robbins says. If headaches are seriously messing with your life — frequently making you miss work or cancel plans with friends — it’s worth making an appointment. Your primary care physician may refer you to a neurologist for an official diagnosis.

Even if you don’t have migraine, recurring headaches could be caused by another neurological disorder or could be the symptom of something else. So it’s always best to get checked out.