Living With Migraines

How to Prevent Migraine Headaches

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How to Prevent Migraine Headaches

There are many ways to prevent migraine headaches. Some ways to avoid migraine include:

  • Avoiding certain foods and alcohol.
  • Preventative medications.
  • Using relaxation techniques.
  • Learning coping strategies including stress management.
  • Regular exercise.

That date you had with a friend to catch up over coffee? Canceled. That critical work meeting where you had to give a presentation? You slogged through it or had to reschedule that too. Once a migraine starts, it can derail your plans, throwing off your ability to work, perform at school, or keep commitments to your family and friends. 

Even just getting through the day can be a painful, long haze. That’s why many people with migraine want to do everything they can to prevent them from getting an attack in the first place.

How to Prevent Migraine

Suppose you suffer from moderate or severe migraine affecting your quality of life. In that case, your doctor may prescribe you medication designed to prevent migraine and reduce their frequency and severity. 

Although, ideally, preventive treatment eliminates headache pain, this is often not the case. Usually, some amount of pain persists. And according to the Agency for Healthcare Research and Quality, many people with migraine don't stick to preventive treatment over time. Up to 30 percent do so because they experience medication side effects such as drowsiness, vomiting, sleep issues, or more—meaning the treatment can feel worse than the disease.

Migraine Prevention Medication

For people with chronic migraine (defined as 15 or more headache days per month) who haven't benefited from other migraine treatments, a drug class known as calcitonin gene-related peptide (CGRP) monoclonal antibodies were approved by the Food and Drug Administration in 2018 as the first preventive medicines for migraine. While these drugs are shown to be more effective and carry fewer side effects than other migraine prevention options, getting them prescribed by a doctor can take effort. They can cost $600 a month, with varying insurance coverage.

These treatment difficulties are a large part of what spurred Mable’s founding team of migraine researchers to start the company. Unlike others, Mable gives you a proprietary DNA test to help determine which migraine treatments are likely to work best for you. Based on the latest clinical advances in the field and your unique genetic makeup. 

From there, a headache specialist can prescribe you medication and offer follow-up care. You can receive your prescriptions through the mail, and you can take this quiz to get started with the process.

Lifestyle Tips to Help Prevent a Migraine

Besides the importance of getting on a treatment that has a greater chance of working for you, there are other steps you can take to help prevent a migraine before it starts. These include:

Keep a Migraine Diary

Keeping a migraine diary can help you recognize possible trigger signs and warnings before you get an episode and whether these episodes seem to follow a pattern (such as your menstrual cycle if you're a woman). 

When you get a migraine, try logging information such as the date, how long the attack lasted, how bad it was (as mild, moderate, or severe, or on a scale of 1 to 10), other symptoms you experience (such as sensitivity to light or dizziness), medications you take and if you have side effects from them, and any changes to your routine that may have contributed. The Migraine Trust has a headache diary template you can use.

Get Consistent Sleep

Not sleeping enough, sleeping too much, or changes to your sleep schedule (such as jet lag) can all contribute to a migraine episode. According to The Migraine Trust, migraine attacks are more likely between 4:00 and 9:00 in the morning, which may be because of a timing mechanism due to sleep or circadian rhythms, which control your sleep-wake patterns over 24 hours. That's why good sleep hygiene is so important: try to get up and go to sleep simultaneously each day, even on the weekends. 

Although it's recommended to get 8 hours of sleep a night, your personal sleep needs might be fewer or more, so see what amount of sleep feels best to you and stick with it. Going outdoors during the day is also helpful because it helps your brain and body clock stay on schedule when it gets dark at night.

Eat And Drink Consistently, Too

Skipping meals can also contribute to migraine attacks. Food or drink triggers are highly personal to each person with migraine, so try to determine which (if any) can affect you by using a migraine diary. If you know certain foods can spur a migraine, try to avoid them as much as you can. 

It’s also a good idea to limit caffeine to 200 mg a day, according to an August 2020 study of the role of caffeine in migraine published in the journal Nutrients. This is about 1-2 cups of coffee. Dehydration is also a common migraine trigger, so carry water with you throughout the day and take small sips. Don’t wait until you feel thirsty, which means you are already a little dehydrated.

Get Regular Exercise

Exercise is not just good for your body, but it can also help prevent migraine. A June 2020 study published in the journal Current Pain and Headache Reports found that aerobic exercise can suppress inflammatory modulators and stress hormones such as cortisol that contribute to migraine. 

Clinical trials have also shown that aerobic exercise significantly reduces migraine frequency, intensity, and duration. The most beneficial exercise appears to be high-intensity training like running. Still, if you can't do high-impact exercise, low-impact options like yoga are also helpful.

Menstrual Migraine

Almost two out of three women with migraine experience an episode around the same time as their period. The drop in estrogen that occurs before a woman's period causes this. However, menstrual migraine, as they are known, sometimes does not respond to migraine medications that work at other times. 

To help prevent the likelihood of menstrual migraine, low-dose estrogen birth control pills or a vaginal ring can be helpful to provide a continuous dose of hormones that eliminate the drop in estrogen. There are also "mini-prevention" methods. A doctor recommends non-steroidal anti-inflammatory drugs (NSAIDs), triptan, estrogen, or magnesium for 5 to 7 days before your period to reduce the likelihood of an attack.

Migraine Stress Management

Eighty percent of people with migraine self-reported stress as a trigger for a migraine. According to a December 2021 study published in The Journal of Headache and Pain, eighty percent of people with migraine self-reported stress as a trigger for a migraine. 

But the exact relationship between tension and migraine remains unclear, researchers found. Besides the physiological stress response, stress perception is subjective to each person. However, stress-oriented therapies were helpful for some people with migraine. These can include cognitive-behavioral therapy (talk therapy) for migraine and biofeedback.

While it isn’t possible to eliminate stress, there are many stress-management techniques you can try. Though some may not resonate with you, others might be pretty useful. Meditation and yoga can be helpful, and so can other forms of exercise, as mentioned. Getting enough sleep is also essential for managing stress. 

Migraine Support

Stay connected to people who keep you calm and happy, and supportive. Suppose you're struggling to manage stress regarding migraine or other parts of your life. In that case, a therapist can be an excellent resource to help you reframe your stressors and deal with what you can while letting go of what you can’t.

Keep in mind that even when you do everything right, it’s still possible to experience a migraine because an episode can come on unexpectedly. So if you’re following these migraine prevention steps and still get a migraine, don’t be too hard on yourself.

Migraine Prevention

Your best bet for preventing migraine is to follow the habits outlined above and get on a treatment that’s most likely to work for you. Mable’s team of headache specialists can determine a drug that can help reduce your migraine frequency and severity and monitor your condition over time—meaning you’ll have the support you need to prevent migraine even more effectively. 

See if preventing migraine is for you through DNA-informed treatment by taking this quiz.

Photo by Catalin Pop on Unsplash

SOURCES

1.       Agency for Healthcare Research and Quality, “Comparative Effectiveness of Preventive Pharmacological Treatments for Migraine.”

2.       The Migraine Trust, “Calcitonin Gene-Related Peptide (CGRP) monoclonal antibodies.” https://migrainetrust.org/live-with-migraine/healthcare/treatments/calcitonin-gene-related-peptide-monoclonal-antibodies/

https://effectivehealthcare.ahrq.gov/products/migraine-prevention/research-protocol

3.       Cleveland Clinic, “Migraine Headaches Prevention.” https://my.clevelandclinic.org/health/diseases/5005-migraine-headaches#prevention

4.       The Migraine Trust, “Keeping a headache diary.” https://migrainetrust.org/live-with-migraine/self-management/keeping-a-migraine-diary/

5.       The Migraine Trust, “Migraine and Sleep.” https://migrainetrust.org/live-with-migraine/self-management/migraine-and-sleep/

6.       Cleveland Clinic, “Headaches and Food.” https://my.clevelandclinic.org/health/articles/9648-headaches-and-food

7.       Nowaczewska M, Wiciński M, Kaźmierczak W. The Ambiguous Role of Caffeine in Migraine Headache: From Trigger to Treatment. Nutrients. 2020;12(8):2259. Published 2020 Jul 28. doi:10.3390/nu12082259

8.       Barber, M., Pace, A. Exercise and Migraine Prevention: a Review of the Literature. Curr Pain Headache Rep 24, 39 (2020). https://doi.org/10.1007/s11916-020-00868-6

9.       American Migraine Foundation, “Menstrual Migraine Prevention and Treatment.” https://americanmigrainefoundation.org/resource-library/menstrual-migraine-treatment-and-prevention/

10.   Stubberud, A., Buse, D.C., Kristoffersen, E.S. et al. Is there a causal relationship between stress and migraine? Current evidence and implications for management. J Headache Pain 22, 155 (2021). https://doi.org/10.1186/s10194-021-01369-6

11.   Cleveland Clinic, “Stress.” https://my.clevelandclinic.org/health/articles/11874-stress

An image oh a happy migraine-free family.

Map your DNA to help prevent your migraines.

You'll receive a Mable DNA kit to send us a DNA sample easily. Once we receive your sample, we'll use the latest advances in genomic and in genomic and neuroscientific research to help shorten the path to the migraine treatment that actually works for you.