Most are grimly familiar with the dull pain associated with headaches. Headaches range in intensity, which makes it difficult to differentiate between a migraine and a tension headache. Both are highly common; tension headaches affect 47% of the American population, while 29.5 million Americans are affected by migraines, but the key difference is that a headache is a migraine symptom, alongside a number of other symptoms. Tension headaches and migraines are both common during menopause, and recognizing the differences between them is key to identifying an effective treatment method.
Difference 1: Triggers
Though little is understood about what ultimately causes headaches, it is generally accepted that in both tension headaches and migraines, abnormal brain activity disrupts blood flow, causing inflammation of the blood vessels and resultant pressure on the surrounding nerve pathways. Triggers for both tension headaches and migraines are highly individual, and may include caffeine withdrawal, alcohol consumption, stress, fatigue, loud noises, and bright lights. However, migraines can also be triggered by hormonal fluctuations (e.g.,menopause), changes in air pressure, and certain foods (e.g., red wine, dark chocolate, and cured meats).
Difference 2: Warning Symptoms
While a tension headache may occur without warning, a migraine often comes with warning symptoms, known as an “aura phase”. Symptoms may include nausea, tiredness, and vision disturbances - such as eye pain, blurred vision, seeing stars or zig-zag lines, tunnel vision, and temporary blind spots, making concentrating difficult.
Difference 3: Pain
The pain felt during a tension headache usually lasts between 30 to 60 minutes, and is usually felt across the front of the forehead or the base of the neck. While painful, a tension headache is unlikely to be debilitating. While these symptoms may occur as part of a migraine, the pain during a migraine is likely to be more throbbing and intense, and to be noticeably worse on one side of the head or behind one eye. Migraines typically last longer, ranging from approximately 6 - 24 hours.
Difference 4: Accompanying Symptoms
Both migraines and tension headaches can invoke sensitivity to light and sound, sweating, and fatigue. Alongside them, migraine symptoms may also include nausea, vomiting, increased urination, loss of appetite, and physical weakness.
Difference 5: After-Effects
After a tension headache has passed, the sufferer is likely to feel fully recovered and be able to continue with their daily routine, while a migraine often will linger after its most severe effects have passed. While the medical term is “postdrome phase”, this is known colloquially as a “migraine hangover” and is characterized by an inability to concentrate, tiredness, and neck pain.
If headaches are recurrent, debilitating, or increasingly severe, it's a good idea to find out what's causing them. Keep a written record (either on a notepad, a computer document, or even through a smartphone app) documenting the time that headaches or migraines began, their duration, the accompanying symptoms, what you were doing when each one began, what you ate and drank in the 24 hours prior to symptoms, and whether or not you were on your period. This will be useful when consulting with a doctor about your symptoms and identifying the most effective treatment methods.