With symptoms including a one-sided pounding headache, nausea, sensitivity to light, blind spots and an inability to concentrate it’s easy to see why the World Health Organization has listed migraines among the top 20 most disabling lifetime conditions.

But, although the condition is principally genetic and is more likely to impact women – one in five women are affected (compared to one in 15 men) – a migraine attack can also be caused by internal and external factors such as fluctuating hormone levels, changes in weather and periods of stress. ‘Identifying what causes migraines for you,’ says Dr Andrew Dowson, Chairman of the Medical Advisory Group for the migraine charity Migraine Action, ‘can help reduce your risk of a migraine attack.’

Biologically speaking, a migraine is a disorder of the brain. “Affectively the brain is more sensitive to change,” says Dr Dowson. Indeed, when the cells in the brain that sense pain (nociceptors) detect a change or trigger – see below – they release compounds that act as neurotransmitters (neuropeptides). These increase the sensitivity of other brain cells and cause them to release neuropeptides, too. As an increasing number of cells freak out, they encourage the brain’s blood vessels and muscle tissue to relax, increasing blood flow to the area – which can cause aura symptoms. Eventually, cranial vessels leak, causing swelling and migraine pain.

When it comes to identifying what causes migraines for you, the options are as seemingly endless as Carly Rowena’s leggings collection. But, according to Dr Katie Munro of The National Migraine Centre, there are factors that are more common than others. ‘

HORMONE CHANGES

Serena Williams recognizes her menstrual cycle as a player in her migraine matches. And she’s not the only one with 50% women associating the two. The Migraine Trust says it’s the drop in estrogen levels, that occurs in the time before your period, that can trigger a migraine attack. Your contraceptive could also be playing a role – pills with 20 micrograms of estrogen have been found to cause the least headaches.

SKIPPING MEALS

Another missed breakfast or late lunch grabbed at the office? The blood sugar lows from not eating regularly, or sufficiently, can result in an attack.

DEHYDRATION

The same goes for fluids. According to American researchers, drinking more can reduce frequency and intensity of migraine attacks. Dehydration causes reduced blood flow to the brain and a loss of electrolytes, which can cause nerves in the brain to produce pain signals. Migraine Action recommends drinking 1-2 liters of water per day.

TOO MUCH (OR TOO LITTLE) SLEEP

Might sound strange but when it comes to what causes migraines, getting some extra sleep with a Sunday morning lie-in might not be the best idea. According to the American Headache Society, sleep disturbances can increase proteins associated with initiating and sustaining chronic pain. Eight hours shut-eye per night is the magic sweet spot says Migraine Action.

OVER EXERTION

We don’t need to real off the benefits of moving more to feel good but, when it comes to preventing migraine attacks, there’s a fine line between your activity having positive and negative effects. Aim for 30 minutes of moderate intensity exercise (jogging, swimming, cycling, brisk walking), three times per week says The Migraine Trust.