Migraines, like other chronic illnesses, can put a real damper on intimacy.
To keep the spark alive, couples may need to strengthen other parts of their relationship.
"[Chronic] migraine can create strain, and if unspoken, create distance. It's not just a physical reason; if it's a man, they stop wanting to have sex after a while,'' says Rodney Shapiro, PhD, a family therapist and psychiatry professor in San Francisco.
Knowing your migraine triggers -- such as certain foods, smells, barometric changes, lack of sleep, and (for women) the onset of your period -- can help you plan better for intimacy. Taking medication to prevent or ease a migraine's intensity may also help. So can couples' counseling and a healthy lifestyle that includes regular exercise.
"'I have a headache' really means something in my case," says Denise Dunn, 55, who runs an agricultural diagnostics lab in central Florida.
Dunn has had migraines since childhood. She says her migraines worsened after she suffered a neck injury. She gets a dull headache most days and gets slamming migraines a few times a month. She takes a migraine-specific prevention medicine every day, which Dunn says makes the headaches less painful but does not prevent them, and another medication when a migraine strikes.
Migraines make some people particularly sensitive to light, sound, and touch. "When I'm in a migraine pattern, I don't want anybody to touch me," Dunn says.
That can take a toll on your sex life. But it’s not just sex that suffers.
"It affects your relationship in general, because you become less interactive," Dunn says. "Part of intimacy is being able to enjoy things with your spouse.''
That makes it even more important to communicate and compromise. Her husband is understanding and their marriage is "sound," Dunn says. "We're not the kind of people who, if we don't have rip-snorting sex, will break up. We love each other and we enjoy each other's company."
Migraines and Hormones
Most migraine sufferers are women. And for about half of all women who get migraines, a classic migraine trigger is the approach of their menstrual period, when estrogen and progesterone levels are declining. So for those women, tracking their menstrual cycle may help plan better times to have sex. But migraines can also strike mid-cycle, when women may be more sexually receptive -- making it trickier to plan sex, says Cincinnati headache specialist Vincent Martin, MD.
Pregnancy hormones may also play a role in migraines. During pregnancy, migraines may increase in frequency or worsen in intensity, and migraines in women with auras often worsen. But in some women, these headaches may improve during pregnancy. Some women also may have their first migraine during pregnancy. Nonpharmacologic treatments are important in managing migraines during pregnancy, but treatment with preventive therapy may be needed.
For men and women, midlife is the peak time for migraine vulnerability. For many women, migraine declines after menopause -- often if they are taking estrogen for other menopausal symptoms such as hot flashes, Martin says.