Dear Doctor, 

I have been having constant migraines that force me to swallow like four pain killers every week.  I was advised to take a lot of water and rest which I have done for the last two months but nothing has changed about the migraines. When I talked to a friend, she jokingly asked me about the last time I had sex and I told her it was like a year ago when I broke up with my boyfriend. Could this be what is causing the nagging migraines?

Pamela, Gacuriro

Dear Pamela,

A migraine is a severe one sided headache occurring intermittently, most especially in young women. This is associated with nausea, vomiting, visual disturbances and photophobia. A person gets some relief by resting in a quiet dark room.

One attack typically lasts from few hours to 2, 3 days. The pain is severe enough to interrupt one’s work. Exact cause for a migraine is not known, but there are different hypothesises. 

It is said they occur due to a trigger of events that stimulate the release of inflammatory neurohormonal chemicals in the brain that leads to inflammation of one or more of the nerves and constriction of blood vessels in the brain leading to headache. It is also attributed to low levels of serotinin, the hormone responsible for the feeling of well being in a person. 

Factors that can trigger an attack vary from bright lights, loud sounds, mental stress, chocolates, and hormones particularly estrogens (hence more in women). The most common type of treatments include taking pain killers, antidepressants, ergot alkaloids, acupressure, herbal preparations, e.t.c. but no permanent cure is available.

A person suffering from migraine is advised to adopt measures for physical as well as mental relaxation to minimise the number and severity of migraine attacks. 

Most of the times during a headache, women may not like to have sex. But studies have shown that sex helps to relieve headaches of migraine in both men and women. Attacks are less in sexually active individuals.  

This could be because sexual activity triggers release of neurohormonal chemicals that prevent vasoconstriction and reduce inflammation locally in the brain; factors responsible for triggering a migraine attack. These chemicals also block the pathways of pain similar to the effect produced by pain killer tablets, thus reducing pain and providing relief. 

Moreover, it gives a sense of well being and relaxation to an individual. Sex also helps to reduce depression. These factors combine to reduce pain during migraine in a person. Taking pain killers frequently to relieve pain in conditions like migraine causes side effects of these drugs such as burning pain in the abdomen, peptic ulcers, aggravation of asthma, e.t.c.

Long term use of pain killers is associated with risk of kidney toxicity. Hence if something simple like a sexual intercourse reduces pain, it seems a better option as these side effects can be prevented. 

But, I would like to add a word of caution here. Sexual activity done should also be disciplined and discrete. Irresponsible sex can lead to multiple health related problems.  

One should avoid multiple sexual partners to avoid sexually transmitted diseases, HIV and other infections. Insist on protected sex to avoid acquiring sexually transmitted diseases and unwanted pregnancy.

If protective measures are not taken, there is not only risk of becoming sick at present but also developing carcinoma of cervix later in life which would be more disabling than a migraine.