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My wife has them. She finally got off the pill and that helped somewhat. Imitrex was great if she used it early enough. Her first symptoms manifest as sinus trouble.
The neurologist had her stay away from a group of foods that produce several chemicals ralated to the headaches. Aged cheese - which is most cheese other than cream - onions, many processed meats, msg - is nearly all soups, alcohol. There may have been a few more. Now she eats almost all organic. I guess the foods can build up over time and you don't recognize one as a trigger due to the time thing. She has since added back the foods. It seems the birth control pills worked most of the magic.
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