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What causes migraines?

what causes migraines

What causes migraines? Understanding the triggers, symptoms & treatments

Migraines are far more than a bad headache. For many people, a migraine headache is a debilitating neurological condition that can disrupt work, sleep, and overall quality of life. 

Understanding what causes migraines is the first step towards effective treatment, better control, and long-term relief.

While migraine causes vary from person to person, certain patterns, triggers, and underlying neurological mechanisms are well recognised. 

This page helps you understand migraine triggers, why they occur, what causes migraines in females, and how best to manage them.

Understanding migraines: What actually happens in the brain?

Before exploring migraine causes and treatment, it helps to know what a migraine is. A migraine is a complex neurological event involving:

  • Changes in brain activity
  • Altered nerve communication
  • Inflammation of blood vessels
  • Overreaction to internal or external triggers

This is why a migraine headache often comes with symptoms like:

  • Nausea
  • Visual disturbance
  • Sensitivity to light or sound
  • Dizziness (yes, migraine causes dizziness in many cases)
  • Neck stiffness
  • Tingling sensations

Because migraines involve multiple pathways in the nervous system, migraine causes are rarely just one thing — they are a combination of factors.

What causes migraines? The most common underlying factors

Although there isn’t one single answer to what causes migraines, research shows several key contributors:

1. Genetics and family history

Migraines often run in families, and studies show that people with a close relative who gets migraines are more likely to experience them. This genetic link influences how the brain processes pain and responds to triggers.

2. Hormonal changes (especially in women)

A major contributor to what causes migraines in females is hormonal fluctuation, particularly involving oestrogen. Many women experience migraines around:

  • Their menstrual cycle
  • Pregnancy
  • Perimenopause
  • When starting or stopping hormonal contraception

This explains why migraines are three times more common in women than men.

3. Nervous system sensitivity

People who suffer from migraines often have a more sensitive nervous system. Certain environmental, emotional, or physical triggers can overstimulate the brain, leading to a migraine attack.

4. Chemical imbalances in the brain

Serotonin fluctuations are strongly linked to migraine attacks. When serotonin levels drop, blood vessels can swell, contributing to pain and inflammation.

Migraine triggers: What triggers migraine attacks?

While it’s essential to understand the biology behind migraines, day-to-day migraine triggers play a major role in determining when an attack occurs. Knowing what triggers migraine episodes helps you prevent them more effectively.

1. Food-related triggers: What food triggers migraine?

Certain foods are known to be common triggers. While not everyone reacts to the same foods, the most frequent culprits include:

  • Aged cheeses
  • Chocolate
  • Caffeine (too much or withdrawal)
  • Processed meats containing nitrates
  • Alcohol, especially red wine
  • Artificial sweeteners (e.g., aspartame)
  • MSG-containing foods

If you’re wondering what food triggers migraine for you personally, keeping a food and symptom diary can be extremely helpful.

2. Lifestyle triggers

Your daily habits have a strong influence on how migraine triggers occur. Common lifestyle-related triggers include:

  • Poor sleep or changes in sleep patterns
  • Stress and emotional tension
  • Skipping meals
  • Dehydration
  • Excessive screen time
  • Intense physical exertion without proper preparation

These factors affect the brain’s sensitivity and may bring on a migraine headache when combined with other triggers.

3. Environmental triggers

Your surroundings can also answer the question, “What causes migraines?”
 Environmental triggers include:

  • Bright or flickering lights
  • Loud noises
  • Strong smells (perfumes, smoke, chemical fumes)
  • Changes in weather or barometric pressure
  • Heat and humidity

These external conditions may not cause migraines alone, but they can activate the brain’s pain pathways when other triggers are already present.

4. Hormonal triggers

As mentioned, hormones are a major influence on what causes migraines in females. Migraine attacks can appear more frequently:

  • During menstruation
  • After childbirth
  • During menopause
  • With hormonal contraceptive use

For many women, this is one of the most consistent and predictable migraine triggers.

Less common but important migraine causes

Although less frequent, the following can also explain migraine causes for some individuals:

1. Medication overuse

Painkillers taken too frequently can paradoxically lead to more headaches, known as rebound headaches.

2. Sensory overload

People with neurological sensitivity may experience migraines triggered by:

  • Busy environments
  • Rapidly changing visuals
  • Intense odours

3. Physical imbalances

Jaw tension, neck strain, or poor posture can sometimes contribute to migraine headache frequency.

Migraine causes dizziness: Why do some people feel lightheaded?

A common but often overlooked symptom is dizziness. Many patients ask why migraine causes dizziness.
 This happens because:

  • The migraine affects the inner ear balance system
  • Blood flow changes temporarily
  • The brainstem becomes overstimulated

This type of migraine is sometimes called vestibular migraine and can occur even without a headache.

Migraine causes and treatment: How are migraines managed?

Once you understand your migraine causes and triggers, treatment becomes more effective. Migraine management usually includes:

1. Identifying and avoiding triggers

A personalised trigger diary helps pinpoint what triggers migraine episodes.

2. Medication

Depending on your symptoms and frequency, medications may include:

  • Acute pain-relief medicines
  • Preventive medicines
  • Anti-nausea medications

3. Interventional pain techniques

In advanced cases, modern treatments may include:

  • Botox injections for chronic migraine
  • Nerve blocks
  • Neuromodulation therapy

4. Lifestyle management

Creating healthier routines helps reduce the intensity and frequency of attacks:

  • Regular sleep
  • Hydration
  • Stress management
  • Balanced diet

Together, these approaches form a comprehensive plan for long-term relief.

Migraine causes and cure: Is there a permanent solution?

While there is no universal “cure”, many people experience dramatic improvement with the right treatment, lifestyle adjustments, and guidance from a specialist. Early diagnosis and tailored care can significantly reduce migraine frequency and severity.

Trust Dr Mohamed El Toukhy for expert migraine care

As a Leading Consultant Anaesthetist & Pain Management Specialist in Dubai, Dr Mohamed El Toukhy brings world-class expertise to patients struggling with migraines and chronic pain. 

With a Fellowship and Diploma in Pain Management, extensive UK training, and specialist experience in interventional pain medicine — including Botox for chronic migraine, nerve blocks, neuromodulation, and targeted spine and joint treatments — Dr El Toukhy provides advanced, personalised care for lasting relief.

Book your appointment today and take the first step towards a migraine-free life.

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