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.

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)

Mommy Migraine, Infant Colic

A recent study suggests that there's an increased risk of infant colic in mothers with migraines. Amy Gelfand, M.D., from the University of California in San Francisco, and colleagues analyzed data from 154 mothers at their infant's 2-month-old well-child visit. "Mothers with a history of migraine were more than two-and-a-half times more likely to have a baby with colic than mothers who didn't have migraine," said study author Dr. Amy Gelfand. Based on this data, the study authors found that

Infants with a maternal history of migraine were significantly more likely to have colic than those without maternal history of migraine (28.6% vs. 11.1%, prevalence ratio 2.6 (1.2-5.5), p=0.02)... Infants with paternal history of migraine had a trend toward higher prevalence of colic (22.2% vs. 9.5%, prevalence ration 2.3 (0.6-9.4), p=0.24) (Infant Colic Is Associated with Maternal Migraine, abstract).

Infantile colic is "a condition in which an otherwise healthy baby cries or displays symptoms of distress (cramping, moaning, etc) frequently and for extended periods, without any discernible reason." One of the common colic remedies is known as the "five S's system" by Dr. Harvey Karp: swaddling, side-lying, shushing sounds, swinging / swaying, and sucking.

One theory that has surfaced is that colic may be an early manifestation of Migraine. People that are prone to Migraine react to overstimulation in different ways throughout their lives, and colic may be the way infants experience Migraine. With that being a possibility, some steps that can be taken to try to help soothe your colicky infant include: turning down loud music, decreasing stimulation, keeping a strict routine, and/or retreating to a dark, quiet room (note that these are common ways in dealing with migraines as adults). It may also be beneficial to keep a "colic / crying diary" to track colic flare-ups, anything that seems to calm the baby, and so forth (again, similar to an adult Migraineur's "headache diary").

While it is far too early to make many assumptions based on this research, it does provide another clue into the evolution of Migraine throughout an individual's life, and possible non-medication strategies that help some adult Migraineurs to try to relieve a colicky baby.

The findings were released online Feb. 20, and Gelfand and colleagues will present them in April at the American Academy of Neurology's annual meeting in New Orleans. (Note: The data and conclusions of this research should be viewed as preliminary until published in a peer-reviewed journal)

Ash Wednesday

I hope everyone has a blessed Ash Wednesday.

Today marks the first day of the Season of Lent, so I thought I'd do somewhat of a Lenten series. I haven't been feeling up to going to church in longer than I care to think about, and I'm behind on listening to them online; so I think this will help me to stay focused on the true reason for the Season of Lent.

Ash Wednesday is a somber day of reflection on what needs to change in our lives, in order to be fully Christian. The ashes are "a sign of humility before God, a symbol of mourning and sorrow at the death that sin brings to the world... [which] prefigures the mourning at the death of Jesus, but also places the worshiper in a position to realize the consequences of sin" (The Season of Lent). We are reminded that we are all sinners and need to repent. The attitude of penitence is reflected in the Lord's prayer: "And forgive us our sins; for we also forgive every one that is indebted to us" (Luke 11:4, KJV).

Ashes are applied to each person's forehead in the sign of the cross, as the words, "Remember that thou art dust, and to dust thou shalt return" (Genesis 3:19) or "Turn away from sin and be faithful to the Gospel" (Mark 1:15) are spoken. This symbolizes our mortality and our need for ongoing repentance, and reminds us of the day when we will stand before God and be judged. It represents the follower of Christ entering into a season of examination and abstinence, in order to deepen our relationship with the Lord.

I know that there are a lot of things that I need to do this Lenten Season, in order to better align myself with God. I pray that He guide me, and help give me the strength and courage to go on this journey.

"Create in me a clean heart, O God, and renew a steadfast spirit within me" (Psalm 51:10)

Migraine Brain

I've been fighting an ongoing battle with Migraine brain (I've actually been working on this post for about a week, but forgot to get it posted... how ironic!), which is often called "brain fog" (brain fog can be a symptom of several other chronic illnesses, including Fibromyalgia and sleep disorders). Symptoms of brain fog often include:

• Difficulty concentrating and/or processing
• Searching for thoughts and/or words

I'm actually doing significantly better with these changes... of course, it's taken me over 3 years to get to the point I'm at now. There are times that I see glimpses of the old witty, intelligent me. Other times, though, I can't even follow a simple conversation or read a short article. This brain fog can present itself during any or all of the phases of a Migraine attack.

Brain fog can be incredibly frustrating, discouraging, and disheartening. Especially when we were once very good at doing these tasks before our chronic illness, we can feel inadequate or even like we are a failure. It's so exhausting to have to try so hard to concentrate on something. This can be yet another aspect of chronic illness that others have difficulty understanding because we may sometimes struggle with things that come easily for them.

Thankfully, there are some tips and tricks that we can use to help make life with brain fog a bit more manageable.

Plan Ahead:  This means something completely different to me, in the context of chronic illness. I used to plan ahead for everything. I had lists, and always planned out my day, week, month, year... life. I used to always be busy, but was the queen of procrastinating on writing papers and such (in college)...

• Now, though, I can't know how well I'm going to feel or when I'll be able to actually complete tasks on my lists. I still keep those lists (so I don't forget... and because I feel a sense of accomplishment, when I can cross something off of a list), but they're ongoing lists. If some things need done by a specific date, I have that written down; and I try to prioritize things, so I know what to tackle when I do feel up to it. But, the lists I have now are much less restrictive because of the uncertainty of chronic pain.
• I try to start things long before I feel like I need to, so that I can (hopefully) get it completed and not have that last-minute panic. For example, I started wrapping Christmas gifts early to mid-November... I got a lot of it finished. Then a migraine hit that lasted for several weeks, leaving me unable to do anything productive. Luckily, I wasn't too far behind - because I'd started so far ahead of time.
• Starting ahead of time also allows for having to re-do tasks, which I have to do much more frequently now. For example, writing a blog post typically has to be done in small chunks of time, so it's a lot choppier than I like. I proofread and edit a lot, but even that has to be done in chunks. So, there's often a bumpiness that I dislike in my writing... but, I'm having to work with what I can do.

Use Resources / Tools:  I always have my phone with me; which means that I always have my calendar, a calculator, contact with others, among other things. I can write reminder notes to myself - including alarms for taking my daily medication (that I keep in a medication box), and ideas / things that come up in my head. I can help track how I'm feeling and such for the day, so that it's easier for me to enter into my health calendar.

• One of the most powerful resources we have is our computers. Especially if you're trying to read on your computer or tablet, take advantage of different options available to make it easier on you (including: changing the font size and/or color, adjusting the screen brightness).

Ask for Help:  I have trouble with this one! I'm getting better at it, but I still hate needing to ask for help. There are a lot of times that I can't figure out even the most simple things, I can't follow the most basic and simple conversation, I just can't make sense of anything at all. It's humbling, but also very embarrassing. I used to be so good at these things, and now I can't always do them because I have trouble concentrating and/or processing.

• Hopefully, your family and friends will understand that you have these processing difficulties, and not make you feel bad about the moments you deal with. It helps tremendously, knowing that your family and friends will help you work through the brain fog, without making you feel inadequate or embarrassed.

Have a Sense of Humor:  First, accept that you can't always concentrate and process as you once did. Then, work toward having a sense of humor about these situations. Being able to giggle about such situations as needing to re-read the same sentence so many times before understanding it can help to decrease the stress you feel about having brain fog.

Postdrome

POSTDROME (aka. migraine hangover) is the last stage of a Migraine attack that some Migraineurs experience, once the headache pain has subsided. The postdrome symptoms may continue for several hours or even days. Symptoms of this postdrome may include:

• Fatigue
• Weakness
• Irritability
• Mood changes (e.g., anxious, depressed)
• Scalp tenderness
• Cognitive and concentration difficulties
• Feeling "hungover"
• Head pain

My postdrome experience really is feeling "hungover" from everything that having a Migraine attack entails, but I also have a medication hangover from the meds I take for my worst migraines. Having both of these at the same time is rough. It's taxing on my body, and my mind starts to wonder when the next attack will be. I think I experience all of the above symptoms, though I believe my irritability is worse during the prodrome phase. Even my hair hurts. It's incredibly exhausting.

I'd like to add that it's just as annoying to tell a Migraineur experiencing postdrome symptoms that you've also had hangovers... as it is to tell a Migraineneur that you get headaches, too. They're NOT the same! NOT even close to the same! Now, I've never actually had a hangover from drinking too much alcohol... but when you get a hangover from drinking too much, that's YOUR choice and YOUR mistake - if you don't want a hangover, don't drink so much... simple! Getting a hangover from a Migraine attack is out of a Migraineur's hands... we know it's coming, but there's nothing we can do to prevent it.

• Headache does NOT equal Migraine attack.
• Migraine hangover does NOT equal hangover from drinking too much alcohol.