Did you know that migraine is the leading cause of disability worldwide in women aged under 50? And in a study of 1161 people with migraine across 7 countries – almost 79% of whom were female – 28% were aware they get migraines and 64% called their migraine ‘headache’.
With other figures showing that 3 times more women live with migraine than men, clearly it’s time to take control of migraine. In this article, we’ll uncover the difference between a headache and a migraine, the causes of migraines, and the answer to the important question of how long do migraines last?
“A key difference is that headache is just 1 symptom of migraine – it’s not the whole story,” says Dr. Ann Nainan, family doctor and Healthily expert. “Migraine is a neurological condition that’s more complicated.”
| Migraines | Headaches |
|---|---|
| •are “more than a bad headache”, according to the American Migraine Foundation. They’re a disabling neurological condition | •are very common and most people get them – they’re usually tension-type headaches |
| •can involve severe headaches and sometimes other symptoms such as sensitivity to lights, noise and smells, as well as nausea or vomiting | •the main symptom is head pain that you can feel in different parts of your head |
| •can be more complicated to treat than headaches | •usually respond quickly to painkillers |
There are 4 phases of a migraine. You might not go through every phase and every migraine attack can be different.
An entire migraine attack can last from a bit more than a day to slightly more than a week – but they’re not typically that long. Generally, a migraine attack lasts 1–2 days.
The 4 phases of a migraine are:
How long it lasts: Several hours to several days
What to expect: Symptoms can appear up to 72 hours before the actual migraine kicks in. These symptoms can include:
If you tend to get prodrome with your migraines, you may be able to prevent a headache developing by taking medication and avoiding triggers during this phase. Read more in our migraine prevention article.
How long it lasts: 5–60 minutes. But for about 20% of people, aura can last longer than 60 minutes.
What to expect: Around 25% of people with migraines experience aura – symptoms that happen before an attack. Aura symptoms may include:
“A migraine aura without headache is possible – but auras do typically happen before the headache phase so the aura can be a warning sign to you that a headache is coming,” says Dr. Ann.
Migraine with aura sometimes gets mistaken for an ocular migraine – find out about the difference here.
How long it lasts: 4–72 hours
What to expect: It’s most common to get pain on 1 side of your head, but it can shift to the other side, or happen on both sides. Find out more about the symptoms of this phase in ‘what are the symptoms of a migraine attack?’
How long it lasts: 24–48 hours
What to expect: Sometimes called the ‘migraine hangover’, you might get fatigue, body aches, dizziness, trouble concentrating and sensitivity to light.
Even though the headache is over, some people find that postdrome can be just as debilitating. You may benefit from avoiding triggers during this time and you may get relief from relaxation techniques such as yoga. Find out more about treating a migraine as it’s happening in our article, How to get rid of a migraine.
This quote from the National Migraine Centre’s website sums up a migraine attack, day by day:
“When I get a migraine, it makes me very ill and really puts me out of action. I can feel it coming on and then the full-blown migraine emerges and I feel terrible. As the second day progresses, the pain finally begins to lessen. The third day leaves me with a vague pain and feeling absolutely shattered.”
Status migrainosus is a particularly severe and long-lasting migraine headache. Although you can prevent them with the right treatment, attacks can last longer than 72 hours. If you have one you might sometimes need hospital treatment because symptoms can be severe.
“We don’t yet know the actual cause of migraines,” says Dr. Ann.
But there are theories about how and why migraine pain happens:
What we do know for sure is that there are risk factors that might make you more likely to get migraines.
Migraines are the third most common illness in the world. They affect around 39 million Americans and a massive 1 billion people across the globe. Here’s who is most at risk of getting them:
“We don’t know exactly why this is but most theories put it down to hormonal differences and changes that women experience,” says Dr. Ann.
Research suggests the link between female hormones and migraines is based on:
Jelena Pavlovic, a neurologist at the Montefiore Medical Center in New York City, thinks gender bias is to blame for the knowledge gap on why women are more likely to get migraines.
“If migraine affected men at the same rate, we would have much better studies,” says Pavlovic. “A lot of the biases and stigma associated with migraine have to do with it being a disorder of women.”
“People with migraines usually have their own particular triggers,” says Dr. Ann. “These could even be shaped by your genes making you more likely to react to a specific trigger.”
The triggers you react to can change as you get older.
Keeping a diary to track symptoms and triggers can help you work out what your triggers are, so you can avoid them and help cut your risk of having an attack.
You can also use the Healthily app tracker tools to help you do this.
Common triggers include:
“Patients often ask me about stress and migraines,” says Dr. Ann. “Stress is a common trigger of migraines, but like all triggers, it’s not the cause – in other words not everyone who has migraines has them due to stress.”
To find out about managing stress, read our article on migraine prevention.
Symptoms of migraines can vary from person to person. The most common symptoms of migraine attacks are:
“Some people ask about less common symptoms because a migraine can feel so overwhelming and it’s hard to know what is due to migraine and what isn’t,” says Dr. Ann.
No, migraine doesn’t cause fever. If you experience, or someone else experiences, a headache with fever and other symptoms such as a stiff neck and confusion, this could be a sign of something more serious and you should get emergency medical attention.
Yes, they can. You might get dizziness during the postdrome phase which comes after the actual headache. Dizziness can also be a symptom of vestibular migraine.
Anyone who’s had a migraine or gets them regularly will know how bad they are, but it can be hard to get across just how painful and debilitating they really feel.
“It can be easy for people who haven’t had one to think it’s just a headache and not understand how migraine stops someone in their tracks,” says Dr. Ann.
If you’re wondering whether you might get migraines, or you want to explain to people in your life what it’s like, or help explain to your doctor how much it affects your life, here’s how some women have described their migraine attacks online:
“The top of my skull feels like it’s being pressed down on”
“The first symptom is a disturbing aura that takes over my vision. It’s as if there’s a glass shattered in front of me and I can’t see. My vision literally disappears or I see a psychedelic pattern. That lasts for about 20 minutes”
“I thought I was having a stroke or some kind of brain failure because my vision went out in my right eye”
Others describe the pain as “stabbing”, “intense” and “pounding”
Serena Williams’ migraines updates appeared in the press when she said she realized stress "or just overworking at my computer" was a major trigger. She says she gets “throbbing pain” and that until she found the right treatment for her, the migraines were “debilitating and…really awful to deal with"
Khloe Kardashian migraine updates appear regularly in the media. She previously tweeted: “I wish people understood how debilitating migraines can be. I get so frustrated when people tell me to push through and it’s just a bad headache. If only they knew!! That feeling is torturous and indescribable”
Comedian Whitney Cummings speaks out about her migraines on Twitter and in interviews. Managing to get them diagnosed and under control, she told People Magazine: “I remember being like, do people just move through the world without a throbbing head? The absence of migraines felt like an opioid. That's how wild it was”
There are different kinds of migraines that can give you different symptoms and you may need specific treatments. Keeping a symptom diary can help you and your doctor work out which kind of migraines you have.
Research shows that almost 2 in 3 women with migraines get them around the same time as their period. These menstrual migraines:
Here’s what the research tells us:
Read more about hormonal headaches in perimenopause.
Other symptoms can include those which you’d get with other types of migraine, such as:
You may also get symptoms which are unique to vestibular migraine, such as:
See a doctor urgently if you experience sudden dizziness or scalp tenderness for the first time.
Studies haven’t found as strong a link between food and abdominal migraines. But there is evidence for:
“If you’re regularly experiencing migraine symptoms, or they’re particularly severe, you should see a doctor,” says Dr. Ann.
Although there’s no specific test to diagnose migraines your doctor should be able to identify them based on your symptoms.
If you’ve recorded your migraine patterns in a diary, using this information can help you and your doctor work out what’s wrong.
If you haven’t recorded your patterns, your doctor may ask you to keep track of them.
Here are some questions recommended by the American Migraine Foundation which you can try to answer in your migraine diary, to help you get a diagnosis and on track with treatment:
Treatment can involve preventing attacks as well as relieving symptoms during a migraine attack. “There is also self-care that includes trigger management,” says Dr. Ann.
To find out about treating a migraine as it’s happening, read our article on how to get rid of a migraine. To stop different types of migraine from happening in the first place, read our article, how to prevent migraines.
See your doctor urgently if you:
Call for an ambulance or go to the emergency department immediately if you or someone else experiences:
These symptoms may be a sign of a more serious condition, such as a stroke or meningitis, and should be assessed by a medical expert as soon as possible.
Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.