If you’ve ever had a migraine, you know the feeling of wanting to put a drill to your head to somehow rid yourself of the pain, pressure, and throbbing. They destroy your day, and they can force you to seek a dark, quiet room for hours on end.
Unfortunately, migraines are (relatively) common: about six to nine percent of men get them.
“While migraines typically start in your earlier years, 30-40% of men start to get migraines between 20-40 years of age,” Gary Jay, MD, neurologist at UNC Health Care, tells MensHealth.com.
While there’s no cure for migraines, there are ways to treat them — and to do that, you have to understand what causes them. Here’s our guide on how to alleviate the hell that is migraines.
A migraine can be best described as a headache on steroids.
“The pain is often described as throbbing or pulsing and usually begins on one side of the head, and typically last from 4 hours up to 3 days,” says Zubair Ahmed, MD, neurologist at the Cleveland Clinic.
Migraines are worsened by physical activity, light, sound, and even smell. You may also experience nausea and/or vomiting.
They can also be accompanied by auras, which affect about 20% of migraine sufferers.
“Migraines are a genetic condition. It is hardwired into some patients. Even in those patients who live a perfect lifestyle, avoiding other triggers and take all the right medications— if they have strong family history of migraine and genetically predisposed to the condition, at some point in their life they will develop migraine,” says Ahmed.
Apart from genetics, migraines are often caused by lifestyle factors.
“Living a healthy lifestyle is fundamental towards controlling migraine headaches. Certain triggers like poor diet, lack of exercise, inadequate sleep, repeated head trauma or stress, can develop migraine headaches,” says Dr. Ahmed.
As of now, there is no cure for migraines.
“There is no specific cure for migraine, but the condition can be managed with taking the right medications and having a healthy lifestyle – just as in other chronic conditions,” says Ahmed.
Here are a few ways to treat them:
1) Take riboflavin or magnesium supplements. “Some supplements including vitamin B-2 (riboflavin) and magnesium have been shown to be beneficial in preventing migraine,” says Ahmed. A 2018 review published in the journal Headache found that those who took 600mg of magnesium reduced the occurrence of migraines. And taking 400 mg of riboflavin has been shown to decrease migraines by about 2 per month.
2) Keep stress to a minimum. Stress can be a significant trigger. “Stress releases many chemicals in the brain that can either trigger migraine or make migraine worse. During stressful times, chemicals including epinephrine and cortisol are released into the blood. And as stress from the work week subsides and the chemicals decline, people may experience a weekend headache sometimes referred to as a ‘let-down migraine’, says Ahmed.
3) Get a prescription for medications. Migraine medications are divided into two different categories: abortive and preventative, says Jay.
Abortive medications are taken when your migraine begins, with the purpose of stopping your migraine in its tracks. One of the most commonly prescribed are called triptans, which work by stimulating serotonin in the brain that constricts blood vessels and reduces inflammation to reduce pain.
There are a few options when it comes to preventative medications. “Beta blockers, typically used to decrease blood pressure, have been found to help prevent migraines and are approved by the FDA,” says Jay. Anti-seizure drugs have also been found to help prevent migraines, including divalproex (Depakote), valproate (Depacon), and topiramate (Topamax).
You can also try the latest treatment approved in May 2018 by the FDA. Erenumab (Aimovig®) blocks a molecule called calcitonin gene related peptide (CGRP), which is elevated in patients who have migraines and is self-injected once a month.
“Although long-term side effects are unknown, it has been helpful for some of our patients,” says Dr. Ahmed.
4) Have sex. Seriously. A 2013 study found that 60% of people who had sex during a migraine reported improvements in their migraine and decreased pain.
5) Stop eating processed foods. Your junk food habit might be making your migraines worse. “Dietary triggers are different for each patient. It is important to identify triggers by keeping a food diary. Once identified, triggers should be avoided,” says Jay.
“Monosodium Glutamate (MSG), in many foods, especially soups, pizza, chips, and Chinese food, has been shown to cause migraines,” says Ahmed. This also includes sodas, energy drinks, and other caffeinated beverages, especially those that contain artificial sweeteners, says Jay.
6) Avoid certain types of alcohol. “Alcohol that contains congeners are more likely to cause migraines,” says Jay. Congeners are a byproduct in fermented and distilled alcohols, like wine, beer and whiskey. Clear liquor like vodka, on the other hand, may not have the same effects.
7) Get Botox. It’s not just for wrinkles: since the FDA approved its use for migraines in 2010, Botox has become a popular migraine treatment. While this treatment is reserved for people with chronic migraines (defined as 15 days a month or more with migraine symptoms), those who received only two treatments reported a 50% decrease in symptoms. It works by injecting the botulinum toxin into nerve endings that makes its way to the brain and blocks chemicals sending pain signals. Each treatment typically involves 31 injections throughout your head and neck.