No one knows exactly what causes migraines, but when the painful attacks happen, those afflicted must pull down the blinds, cover their heads and wait for the pounding to pass. Some people see flashing lights and get nauseated, while others only get a throbbing head pain.
But while the roots of the disease are mysterious, there's no shortage of factors that can cause the painful headaches. From red wine and sex to lightning, here are 10 surprising triggers for migraines.
Sensitive Brain Cells
Despite how common they are, scientists don't fully understand what actually happens during migraine headaches. But one theory holds that the brains of migraineurs are fundamentally more sensitive than those of other people, said Frederick Freitag, the director of the headache clinic at the Baylor University Medical Center in Texas. When people get a migraine, over-excitable brain cells may trigger an electrical wave that spreads across the brain. This wave seems to trigger the release of prostaglandins and serotonin and dilated blood vessels — all of which can cause a killer headache.
While many people identify triggers, such as certain cheeses, red wines or hunger, that seem to set off the throbbing pain, it's tricky to figure out because headache frequency is so variable and can by caused by multiple triggers interacting, Freitag said. So while that throbbing head pain may be caused by the glass of Merlot with dinner, it's also possible that other factors play a role as well.
Many migraine sufferers are women, and that's no surprise: Hormonal shifts may play a role in triggering migraines. A 2012 study in the Journal of Headache and Pain found that nearly half of women who suffered from migraines were likely to experience the pounding pain during their periods. But while hormones may be the cause, they could also be a cure: Another study found that the love hormone oxytocin may reduce headache frequency.
Nearly 85 percent of migraine sufferers say they are extremely sensitive to bright or flashing light during their attacks. But a recent study found that trigger wasn't as strong as suspected: When patients were subjected to flashing lights, they had a small uptick in headache frequency, but not enough to prove the lights reliably triggered the headaches.
Lightning on the Brain
Another kind of flashing light may also trigger a pounding head — the lightning from a thunderstorm. A 2012 study published in the journal Cephalagia found that patients were about 28 percent more likely to suffer migraines on days when lightning struck near their homes. Though it's not clear how exactly the lightning strikes could cause throbbing headaches, one possibility is that changes in the charge in the air could disrupt the brain's electrical waves.
While that Chanel No. 5 may smell sexy to some, for migraine sufferers, it can be a ticket to a day spent in bed. A 2011 study in Cephalalgia found that many patients say perfumes and other strong odors reliably triggered attacks.
While going without that pretzel roll may sound like a good idea, many people say that hunger causes their migraines. A 2005 Cephalalgia study found that hunger was often tied to migraines, especially migraines with aura, or flashing lights. By contrast, going without food didn't reliably cause the everyday tension headaches that most people have occasionally.
Wine and Cheese
A romantic dinner with wine, chocolate and cheese can be a minefield for a migraine sufferer. Many patients report that certain foods trigger splitting headaches. But while food-based triggers are common, with red wine, chocolate and cheese being the most frequent culprits, experts haven't figured out which chemicals are actually responsible, according to a 2012 study in the journal Neurological Sciences.
Weird Air Pressure
Lightning isn't the only weather-related phenomenon that can cause a throbbing headache. Past studies have shown that rapid changes in barometric pressure can change the charge concentration in the air and in turn flood the brain with serotonin, Freitag said. That serotonin release could cause head pain.
What doesn't cause migraines? Among the most commonly cited triggers, simply being stressed can spur the flashing lights and head pain of a migraine, several studies suggest. In a 2012 study in the Journal of Health Psychology, personal stress was listed as the most common cause of migraine pain.
Live Science newsletter
Stay up to date on the latest science news by signing up for our Essentials newsletter.
Tia is the managing editor and was previously a senior writer for Live Science. Her work has appeared in Scientific American, Wired.com and other outlets. She holds a master's degree in bioengineering from the University of Washington, a graduate certificate in science writing from UC Santa Cruz and a bachelor's degree in mechanical engineering from the University of Texas at Austin. Tia was part of a team at the Milwaukee Journal Sentinel that published the Empty Cradles series on preterm births, which won multiple awards, including the 2012 Casey Medal for Meritorious Journalism.