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9 Warning Signs of a Migraine

Migraine attacks often start with subtle clues. Here’s how to spot them — and what can help

Beth Howard and Kristen Fischer,

Updated August 24, 2026

AARP

En español

Updated August 24, 2026

Older woman holding a small mirror with her eyes closed while touching her temple in discomfort

Thomas Trutschel/Photothek/Getty Images

Key takeaways

Migraines affect about 12 percent of people in the U.S. For some, they ease with age; for others, they can become more pronounced or appear for the first time later in life.
Warning signs of a migraine include fatigue, mood changes, yawning, dizziness and neck stiffness.
Treatment options range from lifestyle changes and medications to preventive therapies, neuromodulation devices and behavioral approaches.

There are headaches, and then there are migraines. These intense attacks — often with blinding pain, nausea or vomiting, sensitivity to light and sound, and sensory disturbances like flashing lights — affect more than 40 million people (or about 12 percent) in the U.S., most of them women.

“Headache, and more specifically migraine, has troubled individuals from the dawn of time,” says Dr. Brian Grosberg, director of the Hartford HealthCare Ayer Neuroscience Institute Headache Center in West Hartford, Connecticut.

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Migraines don’t always follow a predictable path with age. People who have experienced migraines throughout their lives may “age out” of them as they get older; for others, migraines can get worse with age or appear for the first time later in life, says Dr. Claire Ceriani, an assistant professor of neurology and director of the Headache Fellowship Program at Thomas Jefferson University in Philadelphia. And the tough part: You can’t predict whose migraine may improve with age, she says.

But now there’s much more you can do about it — including several promising new drugs and therapies.

Headache versus migraine

Is your pain a headache or a migraine? There are a few ways to tell them apart.

If your headache disables you in some way — you can’t participate in your usual daily activities, like going to work — it may fall into the migraine category (and there are several types of migraine). Another clue: If your headache causes nausea, light sensitivity or both, it’s likely a migraine, Ceriani says.

Medical imaging or blood work can help your doctor diagnose a migraine.

Doctors aren’t totally sure what causes them, Ceriani says, but genetics may play a role in about half of migraine cases. For the other half, environmental factors — loud noises, weather shifts or bright lights — may be to blame, she adds.

Warning signs of migraine

The period of time right before a migraine attack is called the prodrome. If you treat the migraine during this phase, which can occur anywhere from hours to days before the migraine starts, you may be able to thwart it or ease symptoms.

Estimates vary, but anywhere from 40 to 80 percent of people with migraines experience a prodrome phase. Warning signs that a migraine is imminent include:

1. A shift in energy levels: You may feel fatigued or hyperactive.

2. Mood changes: You may feel depressed or euphoric.

3. Changes in appetite: Getting hungry or wanting to avoid food can be common before a migraine strikes.

4. Food cravings: Some people say they have intense food cravings before a migraine starts.

5. Persistent yawning: Ongoing yawns can be a sign that migraine is on the way.

6. Bowel or bladder changes: Increased urination or constipation can be indicators of an impending migraine.

7. Feeling lightheaded or dizzy: These can be indicative of vestibular migraine, in which you may experience more vertigo issues than head pain, Cerini says.

8. Neck stiffness: Your neck may feel stiff or painful before a migraine.

9. Aura: About 20 percent of people with migraines experience aura, nervous system symptoms that can include bright spots, flashes of light, vision loss, feeling pins and needles in your arms and legs, trouble speaking, or weakness or numbness on your face or one side of the body. While some experience aura before a migraine attack, others experience it during a migraine.

Understanding migraine triggers

While warning signs can tell you a migraine is on the way, trigger are factors that can set that process in motion, Ceriani explains.

The most common trigger is changes in sleep cycle, such as sleeping in, staying up later than normal or jet lag. Weather changes, such as bright light or pressure changes from storms, are another common trigger, Ceriani says.

Alcohol and hormonal shifts can also trigger a migraine.

The trick is figuring out what triggers your migraines and then experimenting with the available treatments.

“Migraine is not a homogeneous disorder,” says Dr. Alexander Mauskop, founder and director of the New York Headache Center in New York. “Every person has a slightly different version, and as a result, no single drug will be effective for every patient.” Finding a regimen that works requires trial and error.

It also often involves finding a pain specialist. “Migraines are often diagnosed as sinus headaches or tension headaches,” Mauskop says. “Even if [patients] are diagnosed correctly with migraines, they are often not offered the best treatments.”

His advice: Seek out a headache specialist. “Well over 90 percent of people who do can be helped,” he says, but only a quarter of patients get the right treatment, according to surveys.

A specialist will likely have you start by keeping a migraine diary, which is considered the best way to zero in on your specific triggers and gauge the effectiveness of the treatments to try. The diagnosis process is generally the same regardless of age, but doctors tend to be more cautious with older adults because a new or changing headache can sometimes signal a more serious underlying condition, Ceriani notes.

Lifestyle changes that focus on reducing triggers is often the first step toward pain relief, and medications can help stop a migraine in progress.

Treating a migraine

While over-the-counter painkillers (aspirin, naproxen sodium, ibuprofen, acetaminophen) can be effective for mild and moderate headaches, prescription drugs known as triptans, such as sumatriptan (Imitrex), are specifically designed for migraine. Triptans constrict blood vessels and block pain signals to the brain during a migraine.

In addition, ergotamine-based drugs, sometimes combined with caffeine, work by preventing blood vessels in the brain from expanding. Other migraine treatments include:

Oral calcitonin gene-related peptide (CGRP) antagonists (gepants) such as ubrogepant (Ubrelvy)
The nasal sprays zavegepant (Zavzpret), ihydroergotamine (Migranal, Trudhesa)
Antinausea drugs to help with feeling queasy

Ask for preventive therapies

Doctors can also prescribe medications to help stop a migraine before it starts, including certain types of oral medications used to treat high blood pressure, depression or seizures. These are taken daily, not just when a migraine strikes. “All of these medications may take weeks or longer for their benefits to be seen,” Grosberg says. People with chronic migraines (headaches for 15 or more days a month) have several options, including Botox shots. Patients typically get several injections around the head and neck every three months. The latest data show that with this preventive treatment, users have, on average, 1.6 fewer migraines a month but may experience double vision, drooping eyelids, and pain and tightness in the neck.

Behavioral treatments like biofeedback, relaxation or cognitive-behavioral therapy (CBT) may offer relief. They often address lifestyle challenges that are common migraine triggers, like stress, sleep disturbances and mood disorders.
Yoga can make a difference. A 2021 review of five studies published in the Journal of Clinical Neuroscience showed that practicing yoga lowered headache frequency.
Supplements and herbs may help. A review of studies showed that vitamin B2 (riboflavin) may help lower the frequency of migraines. In another study, patients who took 600 milligrams a day of magnesium saw a 41 percent reduction in the frequency of migraines compared to 15 percent in patients given a placebo. Additionally, omega-3 fatty acids, alpha lipoic acid, probiotics, coenzyme Q10, ginger and caffeine are other nondrugs that may offer relief, though more research is needed to provide conclusive evidence, according to a 2024 report in Frontiers in Nutrition. Always discuss the use of supplements with your doctor.

A key point, experts say, is that many people don’t realize there are treatments for migraines. If you deal with headaches more than just occasionally, talk to your primary care provider, neurologist or a headache specialist about your symptoms and possible solutions.

The key takeaways were created with the assistance of generative AI. An AARP editor reviewed and refined the content for accuracy and clarity.

Beth Howard is a North Carolina–based health and lifestyle writer. She has written for dozens of publications, including U.S. News & World Report, The Wall Street Journal, The Washington Post, Prevention, Better Homes & Gardens and Reader’s Digest.

Kristen Fischer is a contributing writer at AARP based at the Jersey Shore. She has also written for Health, WebMD and McKnights, and is the author of Zoo Zen: A Yoga Story for Kids.

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