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Migraines don't just occur on their own--something has to trigger them. Triggers can be almost anything.

For the nearly 65 percent of women who have migraines immediately before, during or right after their periods, that something may be changes in estrogen levels. Although the exact relationship between hormones and headaches isn't clear, hormonal fluctuations-- especially during menstruation and pregnancy--seem to trigger headaches in many women with migraines.

Certain foods appear to trigger headaches in some people. Common offenders include alcohol (especially beer and red wine); aged cheeses; chocolate; fermented, pickled or marinated foods; monosodium glutamate ( key ingredient in some Asian foods, certain seasonings and many canned and processed foods); aspartame and caffeine.

Other common migraine triggers include:

~Stress and fatigue
~Changes in weather, season, altitude level or time zone
~Changes in sleep patterns, including too much or too little sleep
~Bright lights
~Unusual odors
~Certain medications, including cimetidine (Tagamet), nifedipine (Procardia) and theophylline (TheoDur, Theo-24)
~Low blood sugar, changes in mealtimes, skipped meals or fasting
~Intense physical exertion, including sexual activity
~Tobacco, including secondhand smoke

Although much about headaches still isn't understood, some researchers think migraines may be caused by changes in the trigeminal nerve system--a major pain pathway in your brain--and by imbalances in the brain chemical serotonin, which regulates pain messages going through this pathway.

During a headache, serotonin levels drop. Researchers believe this causes the trigeminal nerve to release substances called neuropeptides, which travel to your brain's outer covering. There they cause blood vessels to become dilated and inflamed. The result is severe headache pain.

Other studies using brain scans have shown that the volume and amount of blood reaching the brain drops during migraine attacks. This has led some experts to speculate that migraines occur when blood drains from the blood vessels in the center of your brain to outer blood vessels. Because levels of magnesium, a mineral involved in nerve cell function, also drop right before or during migraines, it's possible that low amounts of magnesium may cause nerves in the brain to misfire.

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