Why Do Women Get Migraines?

Learn why some women get migraines and how to prevent them.

Sanaz Majd, MD,
October 27, 2010

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Mandy is a 44-year-old advertisement executive, whom I occasionally see in my office with debilitating migraine headaches. These headaches are so severe that she ends up missing work two to three times a month, which seem more frequent than usual. The headaches begin gradually, and appear to occur quite randomly. Mandy has never been able to pinpoint a cause of these headaches, and even though they happen infrequently, they are causing her to miss work and she’s afraid that her job may be at risk. She wants me to help put a stop to them.

Before I get to more of Mandy’s migraine story, let’s back up and talk about migraines in general.

What is a Migraine?

Migraines are chronic headaches that tend to come and go, and often begin early on in life. But they are different from your run of the mill headache. For starters, they’re more painful and tend to be more  severe. Mandy noticed that if she did not stop her migraine right in its tracks from the beginning, she often feels like she just got run over by a never-ending-train. Some migraine sufferers get visual warnings, such as  zig-zag lines or blinking lights, before the onset of the headache. These warnings are called auras; Mandy is one of those people who gets the headache without the aura.

Both men and women get migraines, but women are three times as likely as men to have them. Migraines are often found in those with a family history of them. Mandy’s mom happens to get migraines too.

What Are the Symptoms of a Migraine?

So what do migraines feel like? For Mandy, she notices that the pain is usually on one side of the head, such as the right or the left side, and she characterizes it as a “throbbing” type of pain, which is a common description of the quality of these headaches. Along with the actual headache, migraines often  cause other associated symptoms. Mandy reports that she often has some nausea, with or without vomiting, and sensitivity to bright light and/or noise when she experiences these headaches. Moving around makes the pain worse and all she wants to do is to crawl up into bed. When she goes to sleep and then awakens, the headache is often much improved or sometimes even resolved.

But when Mandy experiences these headaches, she is often in the middle of her work day and is unable to just simply “nap it off.” So what can she do to prevent them in the first place?

Find Your Migraine Triggers

Migraines are caused by chemical or electrical problems in the brain. And there are certain triggers than can cause a migraine in those more susceptible towards them. It’s important to find your personal triggers so that you can help prevent migraines from happening to you in the first place. Here are the common triggers I reviewed with Mandy:

  • Foods: Common food triggers include aged cheese, pickled foods, citrus, onions, nuts, bananas, raisins, soy products, caffeine and yeast products such as bread. But Mandy hasn’t noticed a link between any of those foods and her headaches. She also does not consume any processed meats since she is a vegetarian and rarely drinks any alcohol, which are both common triggers. 

  • Medications: Hormonal contraceptives, pain medications, or cimetidine (or Tagamet) for heartburn/acid reflux are also known migraine triggers. But the only medication Mandy’s been taking is some acetaminophen for her headaches.

  • Smells: Migraines can be triggered by certain smells and fumes, such as tobacco smoke and perfumes. Mandy makes sure to ask all her friends to smoke outside since she noticed that her headaches worsen around her friends that smoke.

  • Hormones: Unlike many other women, including Mandy’s mother, Mandy’s headaches do not seemed to be triggered by the hormonal changes that accompany her periods every month.  

  • Skipping Meals: Mandy denied skipping meals—another common migraine trigger—because even though she’s busy at work, she is not able to function without eating her three meals a day.

  • Sleep and Stress: Mandy has noticed that her headaches often begin while she’s at work, specifically on meeting and conference days. Even though Mandy is very good at her job, since she’s been promoted to an executive position, she’s had to conduct large meetings…and she is greatly afraid of public speaking. Each night prior to a meeting, she finds herself unable to sleep in anticipation of the next day. Ah-ha! Her lack of sleep and stress level seems to correlate with her migraines.


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