Migraine and NIH Women's Health Research

Signs, Symptoms, and Risk Factors

A migraine is a neurological disorder that includes moderate to severe throbbing or pulsing headaches, often on one side of the head. Migraine often occurs with other symptoms, which may include nausea; vomiting; weakness; and sensitivity to light, sound, or smells.^{1 , 2} Migraine is typically classified as migraine with aura or migraine without aura.^{2 , 3} Aura usually occurs 10 minutes to an hour before a migraine attack and may involve vision changes, difficulty speaking, and weakness or tingling in parts of the body.³ Migraine may be categorized as episodic or chronic, depending on how frequently attacks occur.⁴ Some women also experience menstrual migraine, which is characterized by migraine attacks that occur around the time of menstruation and are associated with hormonal fluctuations, particularly changes in estrogen levels.⁵

Migraine may run in families, and individuals with certain medical conditions—such as depression, anxiety, bipolar disorder, sleep disorders, and epilepsy—are more likely to experience migraine.^{2 , 3} Migraine attacks may be triggered by a range of factors, including stress and anxiety, hormonal shifts (e.g., menstruation, oral contraceptive use), changes in sleep, caffeine withdrawal, alcohol use, tobacco use or smoke exposure, physical exertion, strong odors, bright or flashing lights, loud noises, and sudden changes in weather or environment.^{1 , 2} Diet may also play a role.^{1 , 2} However, triggers vary considerably among individuals, and controlled studies often fail to confirm that any given trigger consistently provokes migraine attacks across people with migraine.

Impact on Women's Health

Women are about three times more likely to experience migraine than men.^{2 , 3} National survey data show that a higher percentage of adult women reported being significantly bothered by headache or migraine over the prior 3 months than men across all age groups, with the lowest prevalence in women aged 65 or over.⁶ Differences in migraine prevalence and symptoms between females and males are thought to be strongly influenced by hormonal factors, particularly fluctuations in estrogen during the menstrual cycle and across the life course, which can affect pain signaling, metabolic and inflammatory processes, and the brain pathways that are involved in migraine.^{2 , 3 , 5 , 7} Migraine often begins around menarche, may worsen or improve during pregnancy, and commonly changes during perimenopause and menopause.^{3 , 5} Hormonal birth control use can also influence the frequency and severity of migraine attacks.^{3 , 5} Evidence suggests that obesity—particularly during the reproductive years—may further exacerbate migraine frequency and severity in women.⁷ Abrupt hormonal changes, such as those that occur following the surgical removal of the ovaries before natural menopause, have also been associated with worsening migraine attacks.³

Diagnosis and Treatment

Migraine is diagnosed based on the patient's medical history, symptoms, and a physical and neurological exam, with tests used to rule out other conditions if needed.^{1 - 3} Migraine treatment aims to relieve acute symptoms and prevent future attacks using a combination of lifestyle intervention strategies and pharmacological and nonpharmacological approaches.³ Short-term medicines taken during the attack (e.g., triptan drugs, ergot derivative drugs, calcitonin gene-related peptide antibodies drugs, over-the-counter pain relievers, nausea relief drugs) can acutely stop an attack or prevent it from progressing, and preventive pharmacological options (e.g., anticonvulsants, beta-blockers, calcium channel blockers, antidepressants) or nondrug approaches (e.g., biofeedback, yoga, meditation, relaxation techniques) can reduce how often or how severely migraine occurs.³

Ongoing Research

Migraine is now understood to be a complex neurological disorder that involves interactions among the brain, sensory nerves, blood vessels, hormones, and signaling molecules.⁸ A growing area of women's health research focuses on understanding how hormonal changes across the lifespan (e.g., menstruation, pregnancy, menopause) affect migraine risk, symptoms, and treatment response.⁹ Other active areas of research include noninvasive treatments such as neuromodulation, the role of stress and other factors that may trigger migraine attacks, and the mechanisms through which mind-body approaches may help prevent or manage symptoms.⁹

The primary NIH organization for research on migraine is the National Institute of Neurological Disorders and Stroke (NINDS). NINDS supports a broad portfolio of basic, translational, and clinical research activities and studies aimed at understanding migraine pathophysiology and improving prevention and treatment. Current research focuses on the brain circuits involved in migraine, including the roles of neurotransmitters, hormones, immune signaling, and interactions between the central and peripheral nervous systems. NINDS-funded research also examines factors that influence migraine susceptibility, severity, and outcomes (e.g., sleep disturbance, mental health conditions, biological sex), helping to inform more targeted and effective approaches to care.

NINDS also invests in the development and evaluation of innovative migraine therapies, including novel pharmacologic targets, behavior-based and mind-body interventions, noninvasive neuromodulation, and other nondrug approaches like chiropractic care. This includes studies across the lifespan, such as pediatric and adolescent research like the Childhood and Adolescent Migraine Prevention (CHAMP) trial. In addition, NINDS promotes standardized data collection through common data elements and coordinates migraine research across NIH as part of broader pain research initiatives—such as the NIH Pain Consortium, Interagency Pain Research Coordinating Committee, and Helping to End Addiction Long-term (HEAL) Initiative—helping accelerate progress toward more effective, personalized, and nonaddictive migraine therapies.