What Is A Migraine Prodrome?

When we first think of migraine symptoms, throbbing and sometimes debilitating headache pain likely immediately comes to mind, but people who experience migraines are familiar with the many challenging migraine symptoms that go beyond headache pain. Nausea, fatigue, and sensitivity to light, smell, and sound are common migraine symptoms that can cause discomfort or distress.⁴

Not only do a variety of symptoms accompany a headache during a migraine, but there are other symptoms associated with migraines that occur before or after headache pain. Migraines have four distinct phases and understanding these phases can allow people who suffer from migraines to identify and treat their headaches early.² In addition to the well-known and painful headache phase of a migraine, the prodrome, aura, and postdrome phases are commonly experienced stages that have unique symptoms. Recognizing the early phases of a migraine can help predict imminent headache and treat symptoms early.

The prodrome phase, also called the pre-headache or premonitory phase, marks the beginning of a migraine.¹ This calm-before-the-storm phase can last anywhere from a few hours to several days before headache pain.² Between 40% and 60% of people with migraines experience a prodrome phase, although some people experience no symptoms at all.³ While symptoms of migraine prodrome are sometimes subtle, they can often disrupt your day before the actual onset of migraine pain.

Symptoms of Migraine Prodrome

Recognizing migraine prodrome symptoms can help some people lessen the severity of the oncoming headache or even prevent it in some cases.¹ Migraine prodrome symptoms vary from person to person¹ and may include:

• Concentration problems. Difficulty concentrating is a migraine prodrome symptom that can cause frustration and make work or school challenging.²
• Mood changes. Unexplained mood changes such as irritability, anxiety, or depression are common to migraine prodrome, even if you have no history of mood disorder.^2,4
• Bowel habits and urinary frequency. Diarrhea or constipation are commonly experienced during this early migraine phase, as is an increased thirst and urination.^2,4
• Excessive yawning. Yawning during the migraine prodrome phase is not like yawning while tired. Yawning excessively without feeling tired may be a sign of migraine prodrome.^2,4
• Food cravings. Craving certain foods, especially sugary or salty food, is a common symptom of migraine prodrome. Some of these foods can end up being a trigger for migraine, which is why it’s important to recognize when cravings are a symptom of prodrome.^2,4
• Fatigue. Fatigue can occur at various phases during a migraine, including the migraine prodrome. Unlike normal tiredness, fatigue is often unexplained and can make everyday life difficult.²
• Phonophobia. Sensitivity to sound, also known as phonophobia, is a common migraine prodrome symptom. People experiencing phonophobia often find themselves seeking out a quiet place.²
• Photophobia. Sensitivity to light, or photophobia, is similar to phonophobia. Many people experience this symptom throughout multiple phases of a migraine.²

Treating Migraine Prodome

People who experience migraines should consult their doctors on the best course of treatment, including what to do during the migraine prodrome phase. Not every person with migraine will experience the prodrome phase, but if you do there are steps you can take. Taking medication, minimizing or avoiding trigger factors, and practicing relaxation techniques may lessen the severity of the oncoming migraine or even prevent headache in some cases.¹ Common migraine trigger factors that can be avoided during the migraine prodrome phase include:⁴

• Stress
• Alcohol, especially wine
• Excessive caffeine, such as coffee
• Bright lights, loud sounds, or strong smells
• Sleep changes, such as getting less or more sleep than normal
• Intense physical exertion, including sexual activity
• Foods like aged cheeses, salty foods, and processed foods
• Food additives such as the sweetener aspartame and the preservative monosodium glutamate (MSG), found in many foods

In addition to avoiding migraine triggers, some people who experience migraine prodrome treat individual symptoms of the phase. If you experience phonophobia, for example, seeking quiet places when possible or wearing earplugs can ease the symptom.²

Although it may not be possible to stop migraine pain entirely, understanding the symptoms of the early phases of migraine can help provide relief. To learn more about migraine prevention and treatment, check out the Excedrin Migraine Hub.