What Are Risk Factors for Migraine?

Family history of migraine

Research shows that having a close relative, such as a parent or sibling, with migraine increases your chances of developing it due to inherited genes that affect how your brain processes pain and reacts to triggers.

A 2019 study found a strong genetic basis for migraine, including rare genetic forms like hemiplegic migraine and more common types. Even the more common types of migraine have a genetic influence of 30% to 60%.

A 2023 study estimated that up to 42% of the risk of developing migraine is heritable. Both genes and environmental factors contribute to the complexity of the condition.

Female sex

A 2020 study, which grouped participants into female and male categories, found that female participants are more than twice as likely to experience migraine as males and prone to having more severe migraine symptoms. Some research suggests the risk may be three to four times greater in females.

Hormonal fluctuations, particularly related to estrogen, are a major contributing factor. These changes can occur during menstruation, pregnancy, or menopause or as a side effect of oral contraceptive use.

Hormonal changes can trigger or worsen migraine by altering certain neurotransmitters and brain chemicals, affecting your body’s response to pain.

Age

While a migraine can start at any age, it’s most common in late teens and early adulthood and typically becomes less frequent as people get older.

However, for some people, migraine may persist into older age due to changes in hormone levels and brain chemistry, which can cause the symptoms to develop or worsen.

Research indicates that some aging processes, specifically social aging and related stress, may influence migraine experiences in older adults. Social aging is based on society’s expectations, such as managing older parents’ emotional challenges or supporting younger colleagues as they adapt to the work environment.

Aging is also associated with an increased likelihood of having other health conditions that may worsen migraine attacks.

Underlying conditions

Certain underlying conditions can increase the possibility of developing migraine.

Depression

Changes in brain chemicals and neurotransmitter levels due to depression can increase sensitivity to pain and trigger migraine attacks. A 2020 study review found a strong link between migraine and major depressive disorder due to shared genetic factors and chemical pathways.

Sleep disorders

Sleep disorders like insomnia may increase the risk of migraine by causing sleep cycle disruptions, triggering abnormal brain activity, and altering the regulation of neurotransmitters and chemicals linked to migraine onset.

Hypertension

Research suggests a strong link between hypertension (high blood pressure) and migraine. The two conditions share similar pathways of development and may actually influence each other.

Hypertension may also increase the frequency of migraine headaches, causing people with episodic migraine to develop chronic migraine.

Head trauma

While headaches are common after a head injury, people with traumatic brain injuries (TBIs) may also be more likely to develop migraine. A 2023 study found that people with a TBI were 48.4% more likely to develop migraine. The risk of migraine was 67% higher after major head trauma.

Epilepsy

People with epilepsy may experience migraine due to the neurological disturbances caused by abnormal electrical activity in the brain. A 2023 study found an 80% increased lifetime risk of migraine in people with epilepsy compared to people without, consistent with results from earlier studies.

Smoking

Nicotine can constrict blood vessels, leading to decreased blood flow to the brain and triggering migraine episodes.

A 2023 review found that people who currently smoke have a higher chance of experiencing severe headaches or migraine than those who do not smoke. The chances of headaches increase with the quantity of cigarettes smoked and a longer smoking history.

Triggers that make migraine worse

Several factors can worsen migraine for people who are prone to migraine, making episodes more frequent or severe. These include:

• emotional stress
• lack of sleep or irregular sleep patterns
• hormonal changes, especially in people assigned female at birth
• certain foods
• environmental factors, including bright lights, loud noises, and strong smells
• changes in weather or barometric pressure
• intense physical activity
• overuse of acute pain medications

Can I prevent migraine?

While you may not be able to change certain migraine risk factors, such as genetics, there are steps you can take to prevent migraine:

• Manage stress through relaxation techniques like yoga and meditation.
• Track migraine triggers by keeping a headache diary to identify and avoid specific triggers.
• Maintain a regular sleep schedule with consistent patterns and adequate rest.
• Monitor your diet by avoiding known food triggers.
• Exercise regularly with moderate physical activity to reduce stress.
• Consider taking dietary supplements such as magnesium.
• Avoid exposure to bright lights, loud noises, and strong smells.
• Consider preventive medications by talking with a healthcare professional about options that may help.

Takeaway

Migraine risk factors include having a family history of migraine, being female, and having certain underlying conditions. Understanding and managing triggers can help reduce the frequency and severity of migraine episodes. Lifestyle changes and preventive strategies can further reduce your risk of migraine attacks.