Understanding Symptoms of Migraines in Women

• Researched and written by: Shivangani Singh

• Edited by: Vaibhavi Kodnani

• Medical inputs and review by: Dr Poonguzhali Liston, MBBS, MS OBG, FMAS, DRM, FRM, CIMP, EDHM

TL;DR

• Migraines are a neurological condition that affects women more often, shaped by hormonal factors and a genetic tendency that can run in families.[1,2]

• A migraine attack progresses through four stages: prodrome, aura, headache, and postdrome, each with different symptoms and timelines.[3]

• Symptoms go beyond head pain and include neurological, gastrointestinal, sensory, and whole-body changes that vary from person to person.[4]

• Tracking patterns with a migraine diary can help identify individual symptoms and triggers, leading to effective migraine management over time.[5,6]

• Acute relief, preventive strategies, and lifestyle changes can help reduce the intensity and frequency of an attack. However, certain red flags of migraine require immediate medical attention.[7]

Understanding Stages of Migraines in Women

Migraines are more than just headaches; they are a complex neurological condition. Researchers have not yet discovered the exact cause of migraine, but genetics seem to play a role.[1] Women are three times more affected by the condition than men due to hormonal changes during the menstrual cycle, postpartum, and perimenopause.[2]

From the beginning of a migraine attack to its resolution, the experience unfolds in distinct phases. While a migraine headache usually lasts anywhere from 4 to 72 hours, understanding these stages can help you spot early warning signs and manage your symptoms better.[1]

Migraine attacks may progress through four stages, though not everyone experiences all of them:[3]

• Prodrome (Early warning stage): Occurs a few hours to 3 days before the headache. Subtle changes like mood shifts, fatigue, frequent yawning, or food cravings signal the beginning of a migraine attack.

• Aura (Sensory disturbance stage): Experienced by some women before or during the headache. It may include visual changes (like flashes or blind spots) or tingling sensations in the face or hands, and difficulty speaking. 

• Headache (Attack stage): This is the most intense phase, where throbbing head pain occurs, often on one side. The migraine usually lasts 4–72 hours and may worsen with physical activity.

• Postdrome (Recovery stage): After the pain subsides, many feel drained, confused, or unusually tired for up to a day.

Symptoms of Migraines in Women

Migraines involve more than head pain. Symptoms can affect the whole body and vary from person to person. Each stage has a different set of symptoms, though some of them may appear in more than one stage.

Neurological or cognitive symptoms

Neurological or cognitive symptoms often appear early before a migraine begins and may return after the headache fades. These symptoms include changes in thinking, energy levels, and behaviour due to altered brain activity.[8]

• Mood changes

• Brain fog

• Fatigue

• Excessive yawning

• Sleep disturbances

Causes: These symptoms are linked to changes in levels and signalling of brain chemicals like dopamine and serotonin responsible for regulation of mood, sleep, and focus.

Stage: Most common during the prodrome, but may also be present during the postdrome.

Relief tips[9]

• If you have mood changes: Practice the 4–7–8 breathing technique (inhale for 4 seconds, hold for 7, exhale for 8), step outside to get fresh air or practice light stretches, or reduce stimulation around you and rest in a quiet space. You could also journal your thoughts and communicate your needs to those around you.

• If you have brain fog: Break tasks into smaller steps, avoid multitasking, and reduce distractions. Take short breaks in between work to improve focus. You could practice alternate nostril breathing (close one nostril, inhale through the other, switch, and exhale) and do a gentle side neck stretch. 

• If you have fatigue or excessive yawning: Get quality sleep for 7–8 hours and avoid overexertion during the day. Eat a meal or snack every 3–4 hours and drink 2–2.5 litres of water throughout the day. To maintain energy levels, go on a light walk or practice simple yoga stretches like gentle side neck stretch, neck rotation, cat–cow, and thread the needle. 

• If you have sleep disturbances: Maintain a cool, dark, and quiet environment to rest, avoid screens before bedtime, and aim to sleep and wake up at the same time every day, including weekends. If you are unable to fall asleep within 20 to 30 minutes, get up and engage in an activity such as gentle stretching or reading a book.

Gastrointestinal symptoms

Migraines don't just affect the head; they can also impact your digestion through the gut–brain connection. You may notice stomach-related issues before or during an attack, which can make it harder to eat or manage your symptoms effectively.[10]

• Nausea or vomiting

• Diarrhea

• Constipation

• Acidity

• Food cravings

• Loss of appetite

Causes: This happens because migraines can affect your nervous system and disrupt levels of brain chemicals, which affects how your digestive system works. Serotonin, in particular, also acts in your gut, and changing levels can speed up or slow down digestion, leading to nausea, vomiting, or changes in your bowel habits.[11]

Stage: Nausea and vomiting are most common during the headache phase, while other symptoms may occur during the prodrome stage.

Relief tips[12]

• If you have nausea/vomiting/diarrhea/loss of appetite: Drink fresh ginger tea or suck on ginger candy to help with nausea. If you’ve been vomiting, passing loose stools, or don’t feel like eating, drink electrolytes such as coconut water and oral rehydration solution (ORS). Additionally, have light, bland meals (plain rice, toast, soup) every few hours. Try to rest in a dark, cool, and quiet room until you feel better.

• If you have constipation: Increase your water intake to 2–2.5 litres throughout the day. Add fibre-rich foods to your diet such as oats, fruits like apple, guava, pear, dals, and psyllium husk. Engage in light physical activity such as walking for 20–30 minutes. 

• If you have acidity: Eat light, easy-to-digest foods such as khichadi or soups. Avoid spicy meals, tomato-based curries, citrus fruits, vinegar, pickles, chutneys, hot sauces, caffeinated beverages, and alcohol. After your meals, sit upright for a few minutes or take a light walk. 

• If you have food cravings: Eat balanced meals to stabilise blood sugar levels and prevent cravings, and if you’re still craving specific foods, choose healthier alternatives when possible. You can also delay a craving by distracting yourself—take a short walk, talk to a friend, or engage yourself in a task. 

Aura symptoms

Some women experience migraine with aura, which are temporary neurological disturbances that typically happen shortly before a headache, though they can sometimes continue into it. Aura symptoms are usually short-lived, lasting 5 to 60 minutes, but can feel intense.

• Visual aura (flashing lights, blind spots, zig zag lines, coloured spots)

• Sensory aura (numbness or tingling like “pins and needles” sensations in the hands or face)

• Language aura (difficulty finding words or understanding what others are saying)

• Motor aura (weakness or temporary partial paralysis on one side of the body)

• Brainstem aura (double vision, slurred speech, vertigo, ringing in the ears (tinnitus), lack of coordination (ataxia))

Causes: Aura happens when a wave of unusual electrical activity spreads slowly across your brain—a process called cortical spreading depression. As this wave moves through different parts of the brain, it temporarily disrupts how those areas function, which is why aura symptoms differ depending on which region is affected.

For example, activity in the brain's visual processing areas can cause visual aura. Areas that control sensation, speech, movement, or balance can lead to sensory, language, motor, or brainstem aura, respectively.[13,14]

Stage: Occurs during the aura stage, typically before the headache begins, though it can sometimes overlap with it.

Relief tips

• If you have a visual aura: Rest in a dark, quiet room and close your eyes. Avoid screens or bright lights. Avoid sudden movements. 

• If you have a sensory aura: Take a break from whatever you’re doing until the sensation passes. Gently massage the affected area. Practice slow, deep breathing.

Warning: For language, motor, and brainstem aura, seek immediate medical care.

Head and pain symptoms

The most recognised part of a migraine is the head pain itself. A migraine headache is usually intense, throbbing, and often felt on one side of the head, though it can shift or affect both sides.[15]

• Throbbing or pulsating head pain

• One-sided head pain (though it can affect both sides)

• Eye pain or pressure

• Neck and shoulder pain

• Jaw pain

Causes: Migraine pain is linked to changes in brain activity that affect nerves and blood vessels, leading to inflammation and increased sensitivity to pain signals. This is what can cause symptoms like pulsating pain and pressure around the head and face.[15]

Stage: Headache 

Relief tips

• If you have head or eye pain: Use cold compress such as a cooling cap for 20–30 minutes to numb the area and reduce inflammation. 

• If you have neck or shoulder pain: Use a warm compress to release muscle tension. Perform a gentle side neck stretch 3–4 times on each side: sit straight, tilt your head to the right, hold for 30 seconds, then repeat on the left.

• If you have jaw pain: Avoid chewing hard foods and use a warm compress to soothe the area.

• For general relief: Shift to a low-stimulation environment and rest for 30 minutes. Avoid screens, loud sounds, and strong smells. Rest in a side-sleeping position with your neck and head slightly elevated and supported by a pillow. 

Sensory symptoms

Migraines heighten the body’s response to external stimuli, making normal sensations feel overwhelming. These symptoms often worsen migraine discomfort.[16,17]

• Light sensitivity (photophobia)

• Sound sensitivity (phonophobia)

• Smell sensitivity (osmophobia)

• Tactile sensitivity (allodynia or pain from normally painless touch, like wind, cold, or light contact on the skin or scalp)

Causes: These occur due to heightened activity in sensory pathways of the brain, making it over-responsive to stimuli. This increased sensitivity can cause symptoms where even mild light, sound, or touch feels intense or painful.

Stage: Most common during headache but light and sound sensitivity can occur during prodrome and persist into the postdrome.

Relief tips

• If you have light sensitivity: Rest in a dark or dimly lit room, wear sunglasses indoors or outdoors, and avoid screens or reduce brightness. 

• If you have sound sensitivity: Stay in a quiet environment, use earplugs or noise-cancelling headphones, and avoid crowded or loud spaces.

• If you have smell sensitivity: Skip strong perfumes, instead use mild or neutral scents. Avoid strong-smelling foods like garlic or raw onion. Keep your space well-ventilated to prevent odours. 

• If you have tactile sensitivity: Wear loose, comfortable clothing and avoid tight accessories or anything that puts pressure on the skin. Be in a comfortable environment with optimal temperature. 

Ear, nose, and balance symptoms

Migraine can also affect your ears, nose, and balance.[18,19,20]

• Ear pressure

• Ringing in the ears (tinnitus)

• Nasal congestion

• Watery eyes

• Dizziness

• Vertigo

• Imbalance

Causes: These symptoms happen when the trigeminal nerve (which carries sensation from your face) and your autonomic nervous system (which controls involuntary functions like heart rate, breathing, and digestion) become overactive. This affects your face, sinuses, and inner ear, causing balance disturbances.

Stage: Most common during headache, but can also occur during aura and continue into the postdrome.

Relief tips

• If you have ear pressure or tinnitus: Rest in a quiet environment and avoid loud noises or headphones, since further sound exposure can worsen the ringing. Try gentle relaxation techniques such as deep breathing to reduce discomfort. 

• If you have nasal congestion or watery eyes: Stay hydrated to help thin mucus and ease congestion. Use steam inhalation for 5–10 minutes to relieve pressure. Rest in a clean, well-ventilated space to avoid additional irritation from dust or strong odours.

• If you have dizziness, vertigo, or imbalance: Sit or lie down immediately to prevent falls and cool down with a wet towel on your neck or a splash of water on your face. Inhale slowly through your nose and exhale through your mouth until the dizziness eases. Sip an electrolyte drink and have a light snack such as fruits or nuts. Stay put until your balance returns, then rise slowly, pausing a few seconds before walking. 

Whole body symptoms

Migraines can affect the entire body, not just the head.[21]

• Breathlessness

• Feeling too hot or too cold

• Sweating

• Increased thirst

• Frequent urination

Causes: These symptoms happen due to dysfunction in the autonomic nervous system, which regulates your involuntary functions such as body temperature, breathing, and fluid balance. This disruption can cause symptoms that feel unrelated to your head but are still part of the migraine process.[22,23]

Stage: May begin in the prodrome and continue through the headache and postdrome phases.

Relief tips

• If you have breathlessness: Sit near an open window or in front of a fan to get some cool air. Practice pursed lip breathing—breathe slowly through your nose for 2 seconds, pucker your lips and exhale through your mouth for 4 seconds. Avoid any physical exertion until you feel better.

• If you have hot or cold sensations: Dress in layers so you can adjust quickly, use a fan or blanket as needed, and stay hydrated, since dehydration can worsen temperature swings.

• If you have sweating/increased thirst/frequent urination: Keep your environment cool and wear light, breathable clothing. Sip water throughout the day rather than large amounts at once, and include an electrolyte drink (coconut water or ORS) if you're sweating heavily. Avoid caffeine or alcohol, which can worsen dehydration.

Berry's Insights: How to Record Your Symptoms in a Diary?

Keeping a migraine diary is one of the simplest ways to manage your migraine better. It helps you track your attacks, personal triggers, and how your body responds to treatment over time. When done consistently, it can reveal patterns and help you take early action which can reduce migraine attacks over time. Here’s everything you need to track in your migraine diary:[5,6]

Attack basics

Start by recording the core details of every migraine episode. This helps you understand the frequency and intensity of your migraines. 

• Date

• Time of onset

• Duration (in hours)

• Pain intensity (0–10 scale)

• Location (right or left side, behind the eye, whole head)

• Number of painkillers taken to manage the attack

Aura (if present)

Note any warning signs before or during the attack. Tracking aura is important because it helps in identifying migraine subtypes and patterns.

• Type: Visual/sensory/language/motor/brainstem aura

• Description: flashing lights, zig-zag lines, blind spots, pins and needles sensation, numbness, word-finding difficulty, one-sided weakness, double vision

• Duration (in minutes)

Associated symptoms

Tick all that apply during the attack. This gives a complete picture of how your migraines present beyond just pain. These symptoms include:

• Nausea/vomiting

• Light sensitivity (photophobia)

• Sound sensitivity (phonophobia)

• Smell sensitivity (osmophobia)

• Dizziness/vertigo

• Neck stiffness

• Fatigue/brain fog

Triggers (last 24 hours)

Be specific; this is key to identifying what may trigger a migraine attack.

• Sleep (poor/excess/irregular)

• Stress (spike or drop)

• Meals (skipped/delayed)

• Exercise intensity

• Hydration levels

• Food (chocolate, cheese, fermented foods, caffeine, alcohol, etc.)

• Environment (bright lights such as sunlight or screens, weather changes, strong smells, loud sounds)

• Emotional (anger, anxiety, low mood, excitement)

• Travel

• Menstrual phase (especially important for women)

Quick insight: How to use your diary effectively

A diary works best when updated regularly and honestly.

• Record details as soon as possible after an attack begins

• Look for repeating patterns over weeks

• Share it with a doctor for better diagnosis and treatment

• Use insights to avoid known migraine triggers

When to See a Doctor?

While many women who get migraine can manage symptoms at home, certain warning signs need prompt medical attention. Recognising these helps doctors diagnose migraine correctly and rule out other serious conditions.[7]

Seek immediate medical care if you notice any of these red flags:

• A sudden, severe “worst-ever” headache

• New headache pattern or a drastic change in usual symptoms

• Headache with fever, neck stiffness, repeated vomiting, severe dizziness, or seizures

• Weakness, difficulty speaking, facial drooping, confusion, loss of consciousness, persistent numbness, or vision loss, especially if these are new or last longer than your typical aura

• Headache after a head injury

• Persistent vomiting or inability to keep fluids down

Non-urgent but important signs to discuss with a doctor:

• Your migraines are becoming more frequent, more severe, or harder to control or resolve quickly 

• You wake up from sleep regularly because of headaches

• Your headaches worsen with coughing, bending, or straining

• You need painkillers very frequently

• Your migraines have stopped responding to usual medication

• Your migraines are significantly affecting your work, sleep, daily functioning, or mental health, despite lifestyle measures

• Your migraines are linked to your menstrual cycle 

• You are pregnant, postpartum, or experiencing new-onset migraines during pregnancy

Treatment for migraine

There is no single cure since the exact cause of migraine is complex, but effective migraine treatments are available. These focus on relieving symptoms, reducing frequency, and improving quality of life.[24,25]

• Acute treatment of migraine: Used during an attack to relieve pain and associated symptoms. This includes migraine medications like pain relievers or triptans, along with rest and a low-stimulation environment.

• Preventive migraine care: Recommended if you have frequent migraine attacks. Migraine prevention aims to reduce how often attacks occur and how severe they are. This may include long-term preventive medication and supplements. 

• Lifestyle changes and trigger management: The SEEDS framework is helpful for effective migraine reduction over time. It includes sleep (getting 7–9 hours of quality sleep), exercise (aerobic movement 30–60 minutes, 3–5 times a week), eat (3 balanced meals a day and 2–2.5 litres of water), diary (consistent tracking to understand triggers), and stress management (breathing exercises, yoga).[26,27]

The Bottom Line

Migraines are much more than a severe headache. They involve various stages, with each one bringing a different set of whole body symptoms. This can include fatigue, nausea, vomiting, light or sound sensitivity, mood changes, neck stiffness, and brain fog. While there’s no cure for migraines, effective management is possible. 

Maintaining a migraine diary can help you understand patterns in your attacks, symptoms, and triggers. This can help you recognise what triggers an attack and the symptoms that indicate when it's about to begin. This way you can take early action and use specific strategies to manage it before it worsens. A doctor can guide you through acute and preventive care as well as lifestyle changes to manage your migraines better. 

FAQs on Migraine Symptoms in Women

What are the types of migraine headaches in women?

The common types are migraine without aura and migraine with aura, along with menstrual migraine, which is linked to hormonal shifts around your period.

What are the symptoms of a migraine attack?

Symptoms of a migraine attack include moderate to severe one-sided throbbing head pain which lasts for 4–72 hours and worsens with physical activity. In addition, accompanying symptoms include nausea/vomiting or sensitivity to light/sound.[1]

Can you prevent migraine symptoms?

You can reduce how often attacks happen by identifying and managing your triggers, following the SEEDS framework (sleep, exercise, eat, diary, stress management), and using medications your doctor prescribes for prevention.[26]

What triggers a migraine?

Common triggers include poor or irregular sleep, stress, skipped or delayed meals, dehydration, certain foods, and hormonal changes. A migraine diary can help you identify your individual triggers.

How can you reduce migraine pain?

Rest in a dark, quiet room, drink an electrolyte drink, eat a light snack, and use acute medications like pain relievers or triptans as advised by your doctor. Targeted relief measures like a cooling cap for head or eye pain, neck stretches for neck stiffness, and ginger tea for nausea can help as well. 

References

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