The development of migraine isn’t fully understood. In males, stress, physical activity, and lack of sleep seem to be among the most common triggers.

Migraine is a neurological condition that can cause headaches and other symptoms like nausea or light sensitivity.

Anybody can develop migraine, but after puberty, females develop migraine at a much higher rate than males. It’s thought this may be at least partially due to fluctuating levels of estrogen and progesterone at different points in the menstrual cycle.

Researchers have identified many common triggers for migraine. This article focuses on the most common triggers for males and examines the role that hormone levels may play in the development of migraine.

Researchers still aren’t completely sure what causes migraine, but they’ve linked it to stimulation of pain-sensitive nerve endings along the trigeminal nerve. Why this occurs isn’t fully understood, but researchers have identified some common triggers.

Stress

In a 2021 study led by researchers in the Netherlands, study authors surveyed 5,725 women and 1,061 men about their migraine episode triggers.

Males reported stress as their most common trigger. It was reported among 69% of men. In contrast, the most common trigger in women was menstruation. Stress was the second most common trigger in women, reported in 76.7% of people.

Research examining the link between stress and migraine episodes is ongoing. It’s thought that stress could lower the cortical spreading depression threshold of your neurons, a wave of brain cell activity that leads to pain and symptoms with migraine.

Learn more about the connection between stress and migraines.

Physical exertion

Physical exercise or exertion is a common migraine trigger. In the 2021 study, physical exercise or sexual activity was reported as a trigger in 45.8% percent of males compared to 41.7% of females.

Several factors may contribute to the development of migraine episodes after exercise, such as:

Although exercise may trigger migraine episodes in some people, regular physical activity may also be protective against migraine episodes in the long term.

Learn more about the connection between migraine and exercise.

Sunlight and bright lights

In the same 2021 study, 63.2% of men reported exposure to bright light as a migraine trigger. Bright lights were also a trigger in 68.5% of women. It’s unclear why bright light or sunlight may trigger migraine episodes in some people.

Lack of sleep

Lack of sleep was reported as the third most common trigger in males in the 2021 study. It was reported by 60.3% of males and 67.7% of females.

The specific reason why lack of sleep leads to migraine is still largely unknown.

Not eating enough and dehydration

Skipping meals was reported as a trigger in 42.4% of men in the 2021 study. Several mechanisms have been proposed as to why skipping meals may increase migraine episode frequency, such as:

  • low blood sugar
  • caffeine withdrawal for those who consume caffeine
  • dehydration

In a relatively small 2020 study involving adult women, researchers found that higher daily consumption of water was associated with lower migraine headache frequency.

Low blood sugar

Low blood sugar may trigger migraine episodes by increasing sympathetic nervous system activity. Eating more frequent small meals has been proposed as a strategy for preventing migraine episodes.

Certain foods or drinks

Certain foods and drinks are linked to migraine episodes, including:

  • caffeine
  • alcohol, reported as a trigger in 45.5% of males in the 2021 study
  • chocolate
  • aged cheese
  • fermented foods

Learn more about certain foods that may trigger migraine episodes.

Research suggests that people with migraine are more likely to have major cardiovascular disease. Potential contributing factors include:

  • dysfunction of endothelial cells that line your blood vessels
  • impaired ability of your blood vessels to relax
  • excessive activation of platelets, which are cells that help your blood clot
  • shared genetic pathways
  • common underlying causes
  • use of anti-inflammatory drugs

Researchers are still examining the role of hormone levels in the development of migraine in males. Females develop migraine about 3–4 times more often than males, and it’s thought that the difference is largely due to hormonal differences.

In females, estrogen levels fluctuate with the menstrual cycle and seem to increase the susceptibility to migraine episodes during menstruation. These hormonal changes might increase migraine episode susceptibility by increasing neuron excitability in the brain.

One study published in 2019 found that males with lower levels of testosterone had a higher chance of developing migraine, possibly due to changes to the hypothalamus.

In a 2018 study, researchers found that higher levels of estradiol, a form of estrogen, and lower levels of male sex hormones were linked to a higher risk of migraine in males. It’s thought that a drop in estrogen tends to trigger migraine episodes.

The most typical symptom of a migraine episode is a throbbing pain on one side of your head that can be severe. Other symptoms can include:

Some people experience an aura before a migraine episode. Potential symptoms of an aura include:

Learn more about migraine symptoms.

Some research suggests that males are less likely to seek medical care for their headaches than females. However, speaking with a doctor about your headaches can help you develop a treatment plan and reduce your symptoms.

It’s a good idea to see a doctor if you experience:

  • migraine episodes more than once a week
  • difficulty managing migraine episodes
  • severe symptoms or worsening symptoms

It’s important to get urgent care if you’ve had a migraine that’s lasted more than 72 hours or aura symptoms that last longer than an hour, according to the United Kingdom’s National Health Service (NHS).

Treatment options for migraine episodes include:

Learn more about managing migraine.

Making changes to your lifestyle habits such as eating at the same time each day and staying active may help you prevent migraine episodes. It’s important to see a doctor if your symptoms get worse or are affecting your life.