According to the Global Burden of Disease Study in 2013, migraines were found to be the sixth largest cause of years lost due to disability, worldwide. Further, some sources suggest that migraines constitute the third most common disease in the world with an estimated global prevalence of 14.7% — affecting around 1 in 7 people.

However, migraines are more common in women, and according to the NHS, they affect as many as 1 in every 5 women, and only about 1 in every 15 men.

What are migraines?

Believed to be a neurological condition, migraines are intense, often pulsing, debilitating headaches that can also be followed by a host of other symptoms.

Most migraine-sufferers experience their first migraine headache between ages of 10 and 40.

Unlike headaches caused by tension, migraines tend to be more severe, and can also be described as a throbbing pain, rather than a consistent, dull one. In addition, migraines are also believed to typically cause headaches affecting only one side the head — but the pain may shift from one side to another. In about a third of migraine-sufferers, however, the headaches affect both sides simultaneously.

Also, unlike sinus-related headaches, which are often accompanied by nasal congestion, facial pressure, and fever, migraines have their own set of symptoms.

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What are the symptoms of migraines?

The acronym ‘P.O.U.N.D.’ is considered an easy way to remember the symptoms of migraines. Here, P stands for pulsating pain; O for one-day duration of severe untreated attacks; U for unilateral, i.e., one-sided, pain; N for nausea and vomiting; and D for disabling intensity.

However, migraine symptoms can vary widely among people — leading at least half of all migraine-sufferers to think that they have sinus or tension headaches, and not migraines, according to Harvard Health.

In addition to the symptoms contained in P.O.U.N.D., migraines may also be accompanied by:

• nausea or vomiting;
• extreme sensitivity to sound, light, touch or smell;
• dizziness;
• tingling or numbness in the face, or fingers, toes, nose, and other extremities;
• fatigue;
• pain behind an eye, ear, or temple; and
• visual disturbances called an aura that 25% of migraine-sufferers experience, which can lead one to experience halos, sparkles or flashing lights, wavy lines, and even temporary loss of vision.

Moreover, called a ‘migraine hangover‘, in several cases, tiredness and irritability lasts another two days after the headache subsides. Muscle pain, weakness, and either food cravings or a lack of appetite may also follow the period of intense headaches.

Also, symptoms like constipation, mood swings, food craving, stiffness in the neck, increased thirst and urination, and yawning frequently may also signal the onset of an episode, according to some experts.

What causes migraines?

Scientists are still trying to understand the underlying cause(s) behind migraines, but neurologists believe that migraines may be caused by changes in the brain’s nerve cell activities, or blood flow — with the latter believed to, at least, worsen migraines, even if it hasn’t necessarily caused them. However, what causes these changes is also uncertain, but experts note that they may be associated with a host of environmental and genetic factors.

In fact, 70% of those who experience migraine headaches, have at least one close relative with the problem — making a strong case for the influence of genetics on migraines.

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At the same time, triggers like changing weather, fluctuating sleep patterns, mental or emotional stressors like depression and anxiety, medications or diets, and sensory stressors such as bright lights or strong smells have also been associated with migraines.

Given the higher prevalence of migraine among women, experts are also exploring possible correlations of migraines with sex hormones. “About five days prior to the onset of bleeding, that’s when the estrogen drops — and that drop is related to this triggering of migraine,” Jelena Pavlovic, a neurologist at the Montefiore Medical Center in NYC, explained in a Nature report. “It’s not the absolute levels of hormones, but more the fluctuations in hormones that cause the migraine attacks,” Antoinette Maassen van den Brink, a pharmacologist at the Erasmus University Medical Center in Rotterdam, the Netherlands, added. Similarly, a Dutch study from 2004, had also lent credence to the theory had sex hormones may have a role to play in migraines, by finding that 26% of individuals undergoing male-to-female transition had reported experiencing migraines.

How can migraines be treated?

Migraines can’t be cured yet. But for trigger-induced migraines, the simplest solution is to avoid the trigger. However, since that’s not always possible, there are medications to help ease the symptoms of migraines.

But in addition to prescription medications that help manage symptoms better, doctors can also recommend lifestyle changes, or even hormone therapy, to prevent frequent onsets of migraines.

However, experts believe that research on migraines is still lacking, resulting in more than half of those that experience migraines, never diagnosed. According to some migraine-researchers, this is likely because it affects women more, and as we know, women’s pain often receives less medical attention than men’s. “If migraine affected men at the same rate, we would have much better studies… A lot of the biases and stigma associated with migraine have to do with it being a disorder of women,” Pavlovic remarked.