If you’re living with migraine, you know how disruptive and even debilitating the pain can be. Fortunately, if you learn to recognize the first signs of a coming attack, you might be able to head off or lessen the pain of migraine.

Although people experience migraine differently, the attacks may follow a particular sequence of stages. The phases of migraine are defined by timing and types of symptoms. Understanding the stages and symptoms can help you take preventive action, such as avoiding triggers and using medication to lessen the symptoms overall.

Stages of Migraine

There are four migraine stages:

• Prodrome
• Aura
• Headache
• Postdrome

The prodrome phase occurs a few hours to days before a migraine. You might experience symptoms including yawning, irritability, depression, sensitivity to light or sound, fatigue (persistent exhaustion that doesn’t improve with rest), or difficulty sleeping.

The aura phase occurs from five to 60 minutes before the onset of the migraine. Symptoms may include visual changes or tingling sensations in various parts of your body.

The migraine headache itself can last from four to 72 hours, causing symptoms such as pain, nausea, vomiting, and irritability. Afterward, you may feel tired and have trouble concentrating or thinking as clearly as usual. This postdrome phase may last for 24 to 48 hours.

Symptoms of Migraine

Intense head pain is the most common symptom of migraine, but migraine causes many other symptoms that can be just as debilitating. Symptoms of migraine can differ between individuals and types of migraine.

Pain

Migraine commonly causes head pain that gets worse with physical activity. Migraine pain is often intense enough to be disabling and can prevent people from going to work, attending school, or participating in other routine activities. Migraine pain is often described as throbbing, pounding, or pulsating. The pain may occur on one side of the head, affect both sides, or travel back and forth.

Some people experience neck or abdominal pain during migraine attacks. Although most attacks last from a few hours to a few days, some people progress to chronic migraine that may be daily or continual.

Aura

Up to one-third of people with migraine experience an aura before the head pain starts. The most common types of migraine are defined by whether they’re preceded by an aura, one of the four possible phases of a migraine.

Auras involve changes in perception such as visual disturbances (flashing lights, zigzag lines, or blind spots), hearing music or noise with no source, or tingling and numbness in one arm or leg or on one side. In some people, aura manifests as a strange smell, a sudden personality change, or a cognitive (related to thinking or memory) disruption such as difficulty speaking.

Auras don’t always happen before a migraine attack, but when they do, they last from several minutes to an hour. It’s rare but possible to experience an aura that’s not followed by a migraine attack.

Vision Changes

In addition to the visual effects that come with aura, migraine can cause blurred vision, temporary blindness, and photosensitivity. Also known as photophobia, photosensitivity is extreme sensitivity to light, either natural or artificial. Photosensitivity is such a common symptom in those with migraine headaches that it’s considered part of the criteria for a diagnosis of migraine.

Gastrointestinal Problems

Migraine commonly causes nausea and vomiting. In fact, nausea and vomiting with headache are also among the diagnostic criteria for migraine. Constipation and food cravings may occur a day or two before migraine as part of the prodrome stage.

Other Symptoms

Depression and anxiety are common in people with migraine, just as in all chronic conditions.

Migraine can also cause fatigue, weakness, dizziness, mood changes, and cognitive symptoms such as confusion and trouble speaking. Rarely, migraine results in fainting, uncontrollable jerking movements, or weakness and numbness on one side of the body.

Migraine Triggers

A variety of experiences and circumstances can trigger migraine, depending on the person. Common triggers include:

• Lights
• Sounds
• Smells
• Stressful situations
• Changes in weather
• Hormone fluctuations
• Certain foods (especially aged cheese and processed or very salty foods)
• Missed meals
• Aspartame (an artificial sweetener)
• Monosodium glutamate (MSG, a flavor-enhancing chemical)
• Alcohol (especially wine)
• Caffeinated beverages
• Changes in sleep (either too little or too much or jet lag)
• Intense physical activity
• Certain medications, including birth control pills

Keeping a migraine diary can help you identify your migraine triggers. Avoiding triggers when possible helps some people ward off migraine attacks. Sharing your migraine diary with your doctor will help them figure out the best treatment and prevention plan for you.

Does Migraine Go Away?

Many people can ward off migraine attacks by taking preventive medication or avoiding certain triggers. Medications and nondrug therapies can also be used after a migraine starts to shorten its length and reduce its severity. In some people whose migraine began during adolescence and follows a pattern related to the menstrual cycle, migraine attacks become less common and often stop altogether after menopause. Some people experience migraine throughout their lives and become experts at recognizing warning signs and taking steps to ease migraine attacks. By learning to identify your early symptoms and working with your doctor to form a preventive action plan, you may be able to better manage the effects of migraine.

Talk With Others Who Understand

MyMigraineTeam is the social network for people with migraine and their loved ones. On MyMigraineTeam, more than 84,000 members come together to ask questions, give advice, and share their stories with others who understand life with migraine.

Have you identified warning signs of a coming migraine attack? What steps do you take to reduce the length or severity of migraine? Share your experience in the comments below, or start a conversation by posting on your Activities page.