Identifying your personal triggers is one of the most powerful steps in managing migraine. Triggers vary widely between individuals, and what affects one person may not affect another.
Migraine is a neurological condition — triggers don't cause migraine, they activate it in someone who is already predisposed. The same is true for many other conditions (asthma, epilepsy, autoimmune disease). This is why triggers vary so much between people: the underlying biology differs.
Estrogen drop in the late luteal phase (just before and during menstruation) is a major trigger. Up to 70% of women with migraine report menstrual-related attacks.
Mid-cycle estrogen surge can also trigger attacks in some patients.
Combined oral contraceptives, hormone replacement therapy, and some IUDs can change migraine patterns — sometimes making them worse, sometimes better.
Migraine often improves during pregnancy (especially 2nd and 3rd trimesters) and after menopause, though patterns vary.
Both too little and too much sleep can trigger attacks. Shift work, jet lag, and irregular sleep schedules are common culprits.
Fasting or low blood sugar is a frequent trigger. Eating regular meals helps stabilize migraine threshold.
Even mild dehydration (1-2% body weight) can trigger attacks in susceptible people.
Barometric pressure drops, high humidity, sudden temperature shifts, and bright sunlight are commonly reported.
Bright or flickering lights, loud sounds, strong smells (perfume, cleaning products, smoke).
Red wine is the most commonly cited trigger, though any alcohol can trigger attacks — usually within a few hours.
Tyramine content (also in cured meats, fermented foods, some soy products) is a possible trigger.
Both excess and withdrawal can trigger migraine. Daily intake should be kept consistent.
Found in some processed foods, Chinese food, deli meats. Evidence is mixed but patient reports are common.
Aspartame in particular has been reported as a trigger, though evidence is limited.
Work deadlines, arguments, major life events.
Many patients report migraine attacks on weekends, vacations, or after a stressful project ends — the "let-down" effect.
Both are more common in people with migraine and can lower the threshold for attacks.
Burnout, sleep deprivation, and prolonged stress all contribute.
Vigorous activity can trigger attacks, especially in hot weather or at altitude.
Some patients report migraine with sexual activity — usually benign but should be discussed with a doctor.
Poor posture, especially with prolonged screen time.
Concussion and even minor head injuries can trigger or worsen migraine patterns.
Using acute migraine medications (triptans, NSAIDs, acetaminophen) more than 10-15 days per month can cause medication-overuse headache (MOH), which makes migraine patterns worse.
Some blood pressure medications (especially nitrates) and certain supplements can trigger attacks.
Combined oral contraceptives can worsen migraine with aura — important to discuss with a provider.
The most reliable method is a migraine diary. Track each attack along with:
After 3-6 months, patterns usually emerge. Apps like Migraine Buddy, Bearable, and BonTriage can simplify tracking and surface patterns automatically.
Trying to avoid every possible trigger can backfire — anxiety, restriction, and loss of normalcy can themselves lower the migraine threshold. Focus on the 2-3 triggers that are most clearly linked to your attacks, not on eliminating everything.
When lifestyle changes and standard preventive medications don't bring attacks under control, procedures like TEMMA target the underlying migraine pathway directly — without daily medication.
Learn About TEMMA