Individual Triggers

Many scientists think migraine is a vascular disorder caused by a tightening (constriction) and sudden opening (dilation) of the blood vessels in the head, neck or scalp.
Others believe that the throbbing pain of migraine is caused by an abnormal release of neurochemicals in the brain, such as serotonin or noradrenaline.
Migraine sufferers may be born with a hypersensitive nervous system that makes them prone to the headaches. Then, a lifestyle or environmental "trigger," such as a hormonal change or a certain food or chemical, can provoke an attack.
A simple change in lifestyle to avoid personal triggers may minimize the frequency of migraines in some patients.


	alcoholic drinks (especially red wine)
	foods containing a chemical called "tyramine" (for example, aged cheeses, sour cream, and yogurt)
	chocolate
	dairy products
	foods with additives such as nitrites, MSG, or aspartame.

A change in caffeine intake, either up or down, can also trigger migraine.
Other lifestyle factors, such as change in sleep habits and even overuse of headache medicines, may sometimes provoke migraines, as can environmental factors, such as:


	change in weather (often the approach of a low-pressure weather front) or temperature
	high altitudes
	bright or fluorescent lights or sunlight
	loud noises
	strong odors

The role of hormones in provoking migraine helps explain why three times as many women as men suffer from this type of headache. Because of the impact of hormones, women who are pregnant, using birth control pills, or going through menopause often experience an increase or decrease in the frequency of headaches.

Migraines can also be triggered by emotional factors, including not only negative feelings like frustration, anxiety or depression, but also by relaxation and positive feelings such as excitement. "Someone can go through a very stressful time--no headache--and then the weekend or holiday comes and they can finally relax, and the headache comes on," Levin says.

For this reason, experts say that keeping a personal "headache diary" may help in determining the best treatment approach. The diary should include characteristics of each attack, including triggers as well as the date and length of the attack, preheadache symptoms, level of pain (on a scale of 1 to 4, for example), sensitivities during the headache, medicine taken within 48 hours before the attack started, and other observations.