A Closer Look at Migraine: Causes, Risks, and How to Manage It According to the Latest Research

Migraine is one of the most widespread neurological conditions globally, affecting millions of people regardless of gender or age. Although it is often underestimated as "just a headache," it is, in fact, a complex and multifaceted medical issue accompanied by numerous physical, psychological, and social challenges. The information presented below is entirely based on the findings and conclusions of the scientific publication “Migraine: A Review on Its History, Global Epidemiology, Risk Factors, and Comorbidities”, published in 2022 in the journal Frontiers in Neurology.

The authors include researchers and medical professionals from various academic and university institutions in Iran and Cyprus: Parastoo Amiri, Somayeh Kazeminasab, Seyed Aria Nejadghaderi, Reza Mohammadinasab, Hojjat Pourfathi, Mostafa Araj-Khodaei, Mark J. M. Sullman, Ali-Asghar Kolahi, and Saeid Safiri. The team consists of experts in integrative medicine, neurology, traditional medicine, public health, and social sciences, offering a truly comprehensive perspective on the problem. The following questions and answers have been carefully selected to help migraine patients and their loved ones better understand the nature of the condition, its triggers, and the available options for managing symptoms more effectively.

Expert Insights

1. How common is migraine, and why is it such a significant public health issue? Quote: “Migraine affects over one billion people globally each year and is one of the most common neurological disorders, with high frequency and morbidity—particularly among young adults and women. It is associated with a wide range of comorbidities—from stress and sleep disorders to suicide... Migraine is a burden that impacts a person’s economic status, family relationships, and work or school activities.”

Explanation: This highlights that migraine is not just “a regular headache,” but a serious and widespread condition that profoundly affects quality of life, productivity, and mental health.

2. What are the main biological and demographic risk factors for migraine? Quote: “Risk factors include: older age, head trauma, lower socioeconomic status, excessive use of caffeine or medications, stress, sleep disturbances (e.g., snoring), obesity, chronic pain conditions, and inflammatory disorders.”

Explanation: Many biological and social factors are known to increase the risk of migraine. Prevention requires attention to lifestyle choices, stress management, and the treatment of underlying conditions.

3. What role do hormones play, and why are women more affected? Quote: “Women experience migraine about twice as often as men… The most focus has been placed on the levels and fluctuations of sex hormones. High estrogen levels and significant fluctuations are linked to worse migraine outcomes... Migraine may be influenced by menstruation, pregnancy, menopause, as well as by the use of hormonal contraceptives and hormone replacement therapy.”

Explanation: This confirms the key role of estrogen in the development of migraine in women and explains why it worsens during certain hormonal phases in their lives.

4. What are the most common comorbidities associated with migraine, and why are they important for treatment? Quote: “Common comorbidities include insomnia, depression, anxiety, gastric ulcers, angina, and epilepsy... There is a strong and significant connection between sleep and migraine—sleep disorders are associated with the type and severity of migraine. Depression, anxiety disorders, and even suicidal thoughts are significantly more common in migraine patients.”

Explanation: Effective migraine treatment often requires an integrated approach that also addresses accompanying mental and physical health conditions.

5. Is there a genetic predisposition to migraine, and can science offer personalized solutions? Quote: “Genetic factors play a major role in the development of both migraine with aura and without aura… Evidence suggests that migraine is about 42% heritable... Recent genetic studies have identified dozens of specific genes associated with migraine risk.”

Explanation: Understanding the genetic mechanisms behind migraine paves the way for more personalized and effective therapies. In the future, it may become possible to more accurately assess risk and choose the best treatment based on an individual's genetic profile.

Questions & Answers

1. Can migraine occur at any age? When does it usually begin? Answer: Yes, migraine can begin at any age, but it most commonly starts before age 45. Its frequency increases in early adulthood, peaks in middle age, and then gradually decreases. So, if you're experiencing your first symptoms as a teenager or young adult, you're part of the most affected group. Additionally, women are about three times more likely to experience migraines than men, largely due to the influence of sex hormones.

2. Is migraine connected to other health conditions, and how does this affect treatment? Answer: Migraine often coexists with other conditions—most commonly sleep disorders (such as insomnia or sleep apnea), depression, anxiety disorders, epilepsy, autoimmune diseases (like rheumatoid arthritis or psoriasis), and certain cardiovascular issues. These comorbidities can make treatment more complex but also allow for a more comprehensive medical approach. For example, treating depression or insomnia often leads to fewer migraine attacks.

3. Can lifestyle changes help reduce migraine attacks? Answer: Yes! Certain lifestyle changes have been proven to significantly reduce the frequency and severity of migraine attacks. Aerobic exercise (like walking, jogging, or swimming) helps decrease the duration and intensity of pain and reduces the number of headache days per month. Consistent sleep, a balanced diet, stress reduction, limiting caffeine and alcohol, and avoiding fasting are also key. Additionally, diets such as the ketogenic and modified Atkins diet have shown promising results for some patients.

4. Is migraine hereditary, and does family history matter? Answer: Yes, migraine has a significant genetic component. Large-scale genetic studies suggest that about 42% of migraine risk is inherited. If you have close relatives (parents or siblings) with migraine, your risk of developing it is higher. Genetics also influence how severe and frequent migraine attacks may be for an individual.

5. What are the most common migraine triggers? Answer: Stress is the most frequently reported trigger—more than half of patients say that stress leads to attacks. Other key triggers include sleep disturbances, skipping meals, certain types of light, strong smells, specific foods (like alcohol, chocolate, cheeses), excessive caffeine or medication use, and hormonal changes (especially for women—around menstruation, pregnancy, or menopause). Every patient should monitor and document their personal triggers to avoid them as effectively as possible.

Conclusion Migraine remains one of the major medical challenges of modern times—a condition with many faces and an often unpredictable course. As demonstrated by the authors of the cited scientific article, the most important step for patients is to understand their own condition, recognize potential risk factors, identify common triggers, and explore how lifestyle changes and close collaboration with healthcare professionals can reduce the impact of migraine. Managing migraine often requires a personalized approach, and being well-informed is the first step toward a better quality of life and improved health.

For more detailed information and scientific reference, see the original publication: Amiri P, Kazeminasab S, Nejadghaderi SA, Mohammadinasab R, Pourfathi H, Araj-Khodaei M, Sullman MJM, Kolahi A-A, Safiri S. Migraine: A Review on Its History, Global Epidemiology, Risk Factors, and Comorbidities. Frontiers in Neurology. 2022;12:800605. doi:10.3389/fneur.2021.800605