Friday, March 23, 2012

Sex: Trigger or Treatment

Yesterday, I wrote about Primary Headaches & Sex. Without revealing too much of my personal life / relationship with my husband, I'd like to talk a bit more about the topic.

Each relationship is different, just as each person's experience of pain is different. So, you have to work together and find what works for both you and your partner.


In women with primary headache conditions, sexual intercourse has been known to
Both to ease migraine pain and to trigger a headache, but its effect depends on the person and the circumstances... There are two schools of thought on this topic: One holds that sex, especially an orgasm, releases certain chemicals in the brain that work to alleviate a migraine; the other holds that sex can actually cause a headache by increasing blood pressure and causing a dilation of the cerebral blood vessels. You'll have to do your own experimenting to find out whether sex has any effect on your migraines (Sex: A Cure for Migraine or a Potential Trigger?).
This is interesting to me, but it's just like anything else... it could trigger a migraine in some, or alleviate a migraine to another... or even differ with the same person, since triggers are cumulative.

People love to give advice on how their second-cousin's-mother's-friend did such-and-such to get rid of his/her migraines... one of these treatments (or "cures") is having sex - I've had several people make this claim. I'm guessing that these people have never experienced a migraine before. I start getting symptoms long before I feel the head pain, so trying to have sex in an attempt to prevent or alleviate a migraine can be difficult. Not to mention, migraine symptoms don't make you feel very sexy, and your body may be too sensitive to even hug your significant other... much less do anything more.

Perhaps trying to have sex earlier in the migraine cycle might help - but you don't always know when one is coming (especially if you have chronic migraines), and it may be like other treatments for migraine pain that give some temporary relief and then the pain worsens again quickly... did it really help? But, I have to say that I wish that having sex could prevent and/or alleviate migraines!

I'm not a doctor or therapist, but there are some things that stand out to me as important for relationships (these apply to those with and without chronic pain).


Living with chronic pain has many challenges. One of the most pervasive is not knowing - for example, not knowing when each flare of pain will come or go. Without knowing when the pain will come and go (or increase and decrease), it can be difficult to commit to a date night or other planned relationship time.

People living with chronic pain may experience a significant decrease in stamina, ultra-sensitivity (where one's body hurts with even the slightest touch), etc. These are challenges that the person in pain and his/her partner need to try to work around... finding a balance that meets the needs of each individual, as well as your relationship with one another.

To complicate things a bit more, migraines may be linked to depression. Depression and/or anti-depressants can lower one's sex drive. There are a lot of medications used to treat people with chronic pain that can decrease one's sex drive.


The most important thing to remember is that it's vitally important to keep the lines of communication open. Be honest with one another about what you want and need, and what you're able to contribute - if you, your significant other, or both of you suffers from chronic pain, it's even more important. Without being obsessive about it, have an open and ongoing dialog about your relationship, including your sex life.


It's important to find ways for each of you to express your love to the other. Work with your partner to find a compromise between what you and he/she wants, needs, and are able to do. Example:  if one partner wants to have sex daily, but the other partner is only able to participate once a week... a compromise may be to have intercourse once a week, and participate in other intimate activities together throughout the week.


It's important to be creative in finding ways to express your love to one another, especially when faced with the challenges of chronic pain. Showing each other how important they are to you can be done in many ways other than intercourse. Here are just some ideas (other than sex) to be intimate with your significant other:
  • Hold hands
  • Kiss
  • Hug (we make sure that we hug at least once a day)
  • Sit together without any technology (no phones, TV, computer) and just talk/listen to one another (give your significant other your undivided attention, even if only for a few minutes)
  • Massage
  • Laugh together
  • Play games with each other
  • Take a bath or shower together
  • Snuggle together on the couch
  • Cook together
  • Go shopping together (we enjoy going grocery shopping together because we also enjoy cooking together)
  • Watch TV or a movie together
  • Compliment each other
  • Write love notes
  • Listen to each other share about your day
  • Forgive each other quickly
  • Whisper to each other
  • Go to a play/musical together
  • Go for a walk together
  • Go out to eat together
  • Dance with each other
  • And the list goes on...

Thursday, March 22, 2012

Primary Headaches & Sex

A recent study suggests that women treated for primary headaches display a higher rate of sexual symptoms and distress. The study found that 90% of women with migraines and tension-type headaches also have sexual problems, and 29% of these women are stressed about their sex lives.

The researchers observed 194 women consecutively over a 3-month period. They recruited 100 of these women. Different primary headaches were diagnosed, according to the International Classification of Headache Disorders - migraine with and without aura, and both episodic and chronic tension-type headache (CTTH). After collecting detailed pharmacological history, anxiety and depression were assessed using validating scales. Then, the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-Revised were administered.

The study authors found that
More than 90% of the women had a median FSFI full-scale score under the validated cutoff, while 29% reported sexual distress. Hypoactive sexual desire disorder (HSDD) was diagnosed in 20% of the women and the pain domain score (median 2, score range 0–6) was highly affected by the head pain condition. However, the FSFI domain and full-scale scores did not significantly differ by headache diagnosis. The women with CTTH displayed a high rate of sexual distress (45.5%) and a strong negative correlation between desire, arousal, and full-scale FSFI score and number analgesics/month (r: −0.77, P = 0.006; r: −0.76, P = 0.006; and r: −0.68, P = 0.02, respectively). Depression was positively correlated with sexual distress (r: 0.63, P = 0.001) only in the women with CTTH (Sexual Function and Distress in Women Treated for Primary Headaches in a Tertiary University Center, abstract).
The study researchers concluded that "women treated for primary headaches were found to display a high rate of sexual symptoms and distress. Both migraine and tension-type headache were associated with sexual pain and HSDD [i.e., low sex drive], but women with CTTH seem to be more prone to develop sexual distress (Sexual Function and Distress in Women Treated for Primary Headaches in a Tertiary University Center, abstract).

It should be noted that many women with headaches have depression (see Migraines Linked to Depression Risk in Women) and/or anxiety as well, which can also affect one's sexual satisfaction. Various medications can also affect sexual desire.

While it is far too early to make many assumptions based on this research, it does provide an observational pilot study assessing sexual function and distress in women treated for primary headaches in a tertiary university center. Further research is needed on sexuality and female headache sufferers.

This study was published in the Journal of Sexual Medicine.

Wednesday, March 21, 2012

Migraines Linked to Depression Risk in Women

A recent study suggests that women with a history of migraines have about a 40% increased risk for depression. The researchers at Brigham and Women's Hospital in Boston analyzed data from more than 36,000 women (aged 45 or older, who did not have depression and had answered questions about their migraine history) in the U.S. Women's Health Study. Dr. Tobias Kurth (senior study author) and his colleagues found that
more than 6,400 of the women had current or past migraines, and that during an average 14 years of follow-up, nearly 4,000 developed depression (Migraines May Raise a Woman's Odds of Depression).
The authors also found that
Women with any history of migraines were 36 percent more likely to develop depression than women with no history of the headaches, and there was no difference between migraines with aura and migraines without aura. The researchers also found that women with only a past history of migraine had 1.41 times the risk of developing depression (Migraines May Raise a Woman's Odds of Depression).
Depression is mental health condition that is characterized by persistent feelings of sadness, hopelessness, and despair; persistent fatigue / lack of energy; persistent feelings of worthlessness or guilt; impaired concentration and/or indecisiveness; persistent insomnia or hypersomnia (excessive sleeping); loss of interest in once pleasurable activities; recurring thoughts of death or suicide; significant weight loss or gain. Of course everyone feels down from time to time, but depression lasts for weeks (or more) and reduces your ability to function normally.

While it is premature to make many assumptions based on this research, the study confirms a long-suspected link between migraines and depression (i.e., comorbid disorders). Future studies should explore the link between migraines and depression for younger females (as this study only included age 45 and older) and males (of all ages). It should also be noted that the number of women with depression may be greater than the study showed, since the diagnosis was based on self-reporting.

This study is scheduled for presentation at the American Academy of Neurology annual meeting in New Orleans in April. Funding was provided by the U.S. National Heart, Lung and Blood Institute and the National Cancer Institute. (Note: Research presented at medical meetings should be considered preliminary until published in a peer-reviewed medical journal)
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