Are Migraine Sufferers Sexier?

Researchers find a link between migraines and sex.

From the WebMD Archives

If you're a migraine sufferer, sex may be the last thing on your mind -- especially when painful migraine symptoms force you to seek solitude in a dark, quiet room. Yet new findings suggest that sex may be linked to migraines and headache relief.

According to a study published in the journal Headache, young adult migraine sufferers (men and women) reported having 20% more sexual desire than other adults who had headaches (but not migraine headaches).

This study found that migraine headaches and sexual desire are at least partially affected by serotonin, a neurotransmitter in the body that has a "feel good," calming effect. With migraine headaches, there are lower levels of serotonin, yet serotonin is released in abundance during sexual activity that leads to orgasm.

How Is Serotonin Linked to Migraine Sufferers?

Serotonin has been shown to have a major effect on mood and emotion. In the body, serotonin neurons are connected to many physiological functions including sleep, wakefulness, eating, sexual activity, impulsivity -- even memory and learning.

Along with migraine headaches, low levels of serotonin in the brain are associated with clinical depression, sleep, and pain disorders such as fibromyalgia, says pain specialist Harris H. McIlwain, MD, a Tampa-based rheumatologist and author of the book Diet For A Pain-Free Life.

In addition, when estrogen levels plummet for women before menstruation, levels of serotonin also change. As a matter of fact, serotonin deficiency is related to premenstrual syndrome (PMS), menstrual cramps, increased pain, and eating disorders -- all common problems in women.

Doctors often prescribe antidepressants to raise levels of serotonin, McIlwain tells WebMD, while triptans, a newer class of drugs that treat migraine headaches, work by imitating serotonin and stimulating receptors in the brain.

What Causes Migraine Headaches?

Experts are not completely sure what causes migraine headaches. According to Howard S. Smith, MD, director of pain medicine, Albany Medical Center and professor of anesthesiology at Albany Medical Center, migraines appear to be the result of a complex cyclic contact between the cranial blood vessels and the trigeminal nerve.

In his book The Women's Guide to Ending Pain, Smith explains that with a migraine, some "triggers" such as food, stress, fatigue, or poor sleep, activate neurons that are in charge of releasing a selection of neuropeptides -- substance P and neurokinin A.

Substance P helps nervous system cells send messages to each other about painful stimuli. It's thought that when substance P levels are elevated in the body, they may produce higher levels of pain. The release of these chemicals causes an increase in blood flow to the brain. The distended blood vessels and inflammatory response stimulate the trigeminal nerve to send out impulses back to the brain for processing, resulting in a migraine headache.

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What Do Migraine Sufferers Feel?

With a migraine, sufferers may feel dull, throbbing, constant, and severe pain. Migraines may last a few hours to several days and can happen occasionally or repeatedly within days. Migraine sufferers often report headache pain on one side of the head, with the pain usually felt in the front or side of the head.

About 20% of migraine sufferers have warning signs called "auras," visual disturbances that manifest as flashing lights, stars, distorted shapes, or a "blind" spot and inability to see on one side. The aura is caused by a change in brain activity in the visual cortex section of the brain.

These auras may precede a migraine headache by hours or days. While pre-migraine auras are often associated with irritable moods, some experts now speculate that the aura may cause euphoria or hyper-energy in some migraine sufferers, which may trigger a higher sex drive.

Do Migraine Headaches Occur Mostly in Women?

There are more female migraine sufferers than male, with 18% of women and 6% of men having migraine headaches. The gender difference increases from start of menstruation, peaks at about 42 years of age, and then declines.

Interestingly, half of all women migraine sufferers report menstruation as a key trigger. Migraine headaches may also start when women first use oral contraceptives (although low-estrogen oral contraceptives often improve migraines).

It's thought that estrogen levels are a key factor in the higher incidence of migraine headaches in women, yet it's not well understood why. Fluctuations in estrogen levels may cause changes in body chemicals such as prostaglandins, neurotransmitters -- including serotonin, dopamine, and noradrenaline -- melatonin, opioid regulation, prolactin release, and other key chemicals.

Because estrogen levels fall around the time of menstruation and trigger migraine headaches in some women, doctors often prescribe low-dose contraceptives for women with menstrual migraines to try to keep the level of estrogen from falling.

However, two-thirds of women with migraine headaches find they improve with natural menopause (surgical menopause often results in worsening of migraine). Estrogen replacement therapy has a variable effect on migraines, with about half of migraine sufferers taking estrogen showing improvement and half finding their migraine headaches worse.

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How Can Sex Help Migraine Sufferers?

Occasionally orgasm can relieve migraine headaches, says Randolph W. Evans, MD, clinical professor of neurology at Baylor College of Medicine.

Although the mechanism is not known, Evans tells WebMD that orgasm is a complex neurophysiological-endocrinological event that could relieve migraine headache in two ways:

  • Stimulation of the posterior vagina and sexualactivity may activate inhibitory pain-modulating circuits. Theories are that this is a physiologic reflex related to the birth process to produce pain relief when the cervix and pelvis are stretched.
  • Endorphin release that occurs after sexual arousal andorgasm may relieve or reduce migraine headaches. Endorphins are morphine-like pain relief hormones made by the brain; they are associated with a happy, positive feeling and can keep pain messages from reaching the brain.

These mechanisms might be responsible for the "temporary" relief of pain -- but not for permanent and total relief. Experts believe there is another factor related to sexual orgasm that suppresses migraine headache pain or suppresses the migraine process.

Alternately, a few studies have found that about 5% to 10% of migraine sufferers report sexual activity is a migraine headache trigger (equally for men and women), while other studies show that physical exercise can also trigger migraine headaches.

WebMD Feature Reviewed by Brunilda Nazario, MD on December 20, 2007

Sources

SOURCES: American Headache Society: "Headache Hygiene Tips." The International Headache Society: "Epidemiology of Headache." WebMD Medical Reference: "Women and Headache: Migraine." WomensHealth.Gov: "Migraine Headaches." Migraine Awareness Group: "Migraines: Myth and Reality." Evans R.W. Handbook of Headache (2nd Edition), Lippincott Williams & Wilkins, Dec. 1, 2004. Howard S. Smith, MD, director, pain medicine, Albany Medical Center; professor, anesthesiology, Albany Medical Center. Randolph W. Evans, MD, neurologist; clinical professor of neurology, Baylor College of Medicine. The Women's Guide to Ending Pain: An 8-Step Program, Howard S. Smith, MD, and Debra Fulghum Bruce, PhD. Caba M. Komisaruk BR. Beyer C. "Analgesic synergism between AP5 (an NMDA receptor antagonist) and vaginocervical stimulation in the rat," Pharmacol Biochem Behav. 1998; 61: 45-48. Orgasm and Migraine: Expert Opinion. Case histories submitted by Randolph W. Evans, MD. Expert Opinion by James R. Couch, MD, PhD. (Headache 2001; 41: 512-514). Houle TT. Dhingra LK. Remble TA. Rokicki LA. Penzien DB, "Not tonight, I have a headache?" Headache, June 2006; 46: 983-990. Harris H. McIlwain, MD; pain specialist, Tampa, Fla.; author, Diet for a Pain-Free Life. Fieve R. Bipolar II.

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