Stages of migraines

Reviewed by Dr Shabina Siddiqi

We all know migraines cause throbbing pain, but do you know what other symptoms migraines can cause? In this article we explore the stages of migraines, from the first subtle signs to feeling drained once the pain has stopped. If you experience migraines we have advice as well as migraine treatments to help you carry on with daily life as much as possible and feel prepared for any future attacks. 

Symptoms of a migraine

There isn’t just one type of migraine or one symptom to be aware of. The most common type of migraine is one without an aura. However other forms can include: migraine with aura, a migraine aura without a headache, menstrual migraines or stress migraines amongst others.

Some of the common symptoms of a migraine are:

• A throbbing pain on one side of your head
• Light, noise and aroma sensitivities
• Nausea
• Vomiting 
• Feeling very tired

What are the stages of migraines?

You may not always know when a migraine is going to happen. However some people may notice certain things like stress or food can trigger a migraine attack. Learning what triggers your migraines can help you to avoid migraine attacks in the future, for example avoiding caffeine or other foods. 

Migraine attacks tend to follow a pattern of symptoms and stages. As the migraine develops it progresses through the stages. Although, not everyone will experience migraines in this way and the stages can overlap. For adults there are four stages which include: 

• Prodrome
• Aura
• Headache
• Postdrome

Prodrome 

Prodrome is the premonitory stage of a migraine. Prodromal symptoms can occur from between hours to a couple of days before the headache starts. It’s the very first stage of a migraine and often goes unnoticed. 

Symptoms

These symptoms are often subtle yet they are a warning sign of a migraine. Symptoms of prodrome can include:

• Feeling tired
• Yawning frequently
• Mood changes such as feeling high or low
• Neck stiffness
• Urinating more than usual
• Food cravings
• Feeling thirsty 

Recognising these symptoms can help you to prepare for a migraine attack by resting, having a nap or lying in a darkened room if you can. If you use triptans like Sumatriptan you could take one, as they’re most effective when taken at the first signs of a migraine. 

Aura

An aura typically occurs before the headache phase and continues into it. The cause is not fully understood, but it's defined as neurological symptoms such as visual disturbances or motor or sensory disturbances which may last for only a few minutes or up to an hour.

About a quarter of people with migraine have aura, however not everyone who has migraines experiences the aura stage. Migraine without aura is the most common type of migraine. 

Symptoms

Symptoms of aura include:

• Visual changes and disturbances such as dark or coloured spots or flashes of light
• Vision loss
• Pins and needles in an arm or leg
• Numbness
• Difficulty speaking
• Dizziness 

Headache

The headache stage is the main stage of a migraine. It’s more than just a headache. At the start of an attack you may feel moderate to severe pain on one side of your head, as the attack develops this can spread to both sides or the whole of your head. This pain is usually described as a throbbing pain. 

Symptoms

At this stage in your migraine you might:

• Feel severe to moderate pain in your head
• Vomit
• Feel nauseous
• Be sensitive to light, sound, smell and movement

The duration of this stage varies between individuals and can last from a few hours to around 72 hours. Migraine treatment works most effectively when taken early on in the attack stage.

You might find that the attack slowly fades away or stops suddenly after you’ve been sick. Sleep is also a common way to end the headache stage of an attack, the average amount needed is two and a half hours. 

Postdrome

Postdrome also known as migraine recovery or a migraine hangover is the final stage of a migraine. The headache usually settles gradually and you may feel drained or fatigued.

This stage can last a few hours or days and again varies between individuals, some people don’t experience this. 

Symptoms

You might experience similar symptoms to those in the prodrome stage such as feeling: 

• Tired
• Confused
• Hungry
• Drained
• Low or in a bad mood 

It’s important to look after yourself during this final migraine stage, make sure to stay hydrated, eat regularly and rest if you can. 

Treatments for migraine

Using a headache diary can help you to keep track of the migraine symptoms you experience. You can also make note of any triggers you may have, such as stress and the stages you go through when getting a migraine. Knowing what a migraine feels like for you can help you be prepared for your next migraine. 

Alongside lifestyle changes, like making sure to drink 6-8 glasses of water a day or taking regular screen breaks you can use medication to cope with migraines. We offer a range of migraine treatments online: 

Vydura (rimegepant)

Vydura is an oral wafer that’s placed under the tongue which can treat an ongoing migraine or prevent migraines. It can be taken by adults who experience migraines with or without aura. You can find out more about Vydura here.

Sumatriptan

Sumatriptan tablets can be used alongside other pain relief and anti-sickness medication to help with migraine attacks. Taken early in the migraine stage they offer effective relief, find out whether sumatriptan is suitable for you here. 

Rizatriptan

A type of triptan, like sumatriptan, Rizatriptan helps to relieve migraine symptoms. Available as a tablet, it can also be used with pain relief and anti-sickness medicine for fast and effective relief. Your migraine symptoms should improve within two hours of taking the medication, find out if it’s safe for you to take here. ​​​​​​​

References
https://www.nhs.uk/conditions/migraine/
https://migrainetrust.org/understand-migraine/stages-of-a-migraine-attack/
https://jnnp.bmj.com/content/jnnp/45/3/223.full.pdf