by admin | Jan 22, 2014 | Men & Headaches
MEN GET MIGRAINE TOO
Although migraine headaches are more common in women, who account for 75% of migraine sufferers, men do experience migraine headaches.You just don’t seem to hear about it as much—until it affects your favorite football or hockey player.
Men’s symptoms are no different from women’s symptoms, although men are not affected by hormonal fluctuations like women are. What is different, though, is that men are somewhat less likely to seek medical care for their migraines—and when they do, they are less likely to receive a migraine diagnosis.
Middle-aged men with migraine are 42% more likely to suffer a heart attack than are non-migraineurs.
What are some unique facts about men and migraine?
Men are somewhat less likely to seek medical care for their headaches than women are, and are also a little less likely to receive an appropriate migraine diagnosis. This is unfortunate, since having migraine increases a man’s risk of having a heart attack. We do not yet know whether controlling migraines prevents this risk, but being under the care of a physician helps to monitor the risk—and take action if necessary.
Other Headaches in Men
Tension-Type Headache
Tension-type headache, the most commonly occurring headache, occurs almost equally in men and women.
Chronic Daily Headache
This headache type occurs in both men and women, and is somewhat more prevalent in women. However, a study of chronic daily headache found that men were more likely to report disability than were women.
Cluster Headache
Cluster headaches occur far more prevalently in men than in women. In the past, an 8:1 male to female ratio had been reported. More recently, a 5.4:1 male to female ratio had been reported, and now, the ratio has dropped to 2.1:1, suggesting lifestyle changes for women have increased their risk and reduced the difference in the ratio. Cluster headache is defined as severe or very severe unilateral pain occurring around, behind, or above the eye/orbit or in the temporal area, and occurring anywhere from once every other day to 8 times a day, lasting 15 minutes to 3 hours.
The headache pain must be accompanied by at least one of the following:
- Tears
- Red eye
- Nasal congestion
- Runny nose
- Forehead or facial sweating
- Pupil constriction or droopy eyelid (ptosis is the technical term)
- A sense of restlessness or agitation
Sex Headaches
Contrary to popular belief, sexually-induced orgasmic headaches occur more commonly in men. There are two types. Pre-orgasmic headaches are a dull ache in the head and neck, associated with awareness of tight neck and jaw muscles during sexual activity, that increases during increasing sexual excitement. Orgasmic headache is a sudden, severe, explosive headache occurring at orgasm. Understandably, this can be quite alarming the first time it occurs. It would be best to see your doctor for evaluation to make certain it is not a sign of something more serious.
Posttraumatic Headaches and Traumatic Brain Injury
Men and women both experience head trauma, and are thus both affected by posttraumatic headaches. However, recent emphasis on post-traumatic headache due to traumatic brain injury in football and other sports, as well as in returning Iraq and Afghanistan War soldiers, suggests that there may be a male predominance.
If you are a man with persistent headaches, seek medical help. It might prevent more than just headache pain.
by admin | Jan 6, 2014 | Triggers
Cocoa and Blood Pressure?
Ten blood pressure studies were compared; five of tea intake and five of cocoa intake. In the cocoa studies, 64% of the subjects were men and 36% women; 34% of all subjects had high blood pressure. In the tea studies, 71% were men, 29% were women, and 49% had high blood pressure. (Four studies used black tea, and one used green tea.) None of the tea studies reported any significant alterations in blood pressure. In the cocoa studies, four of five reported a reduction of both systolic (top number) and diastolic (bottom number) blood pressure after cocoa consumption. The study reporting no change utilized the lowest dose of cocoa. Blood pressure was most likely to be reduced in young individuals with mild essential hypertension.
The authors concluded that “the magnitude of the hypotensive effects of cocoa is clinically noteworthy; it is in the range that is usually achieved with monotherapy of beta-blockers or angiotensin- converting enzyme inhibitors.” They also emphasized the importance of dark chocolate, noting that milk products inhibit the absorption of the polyphenols.
Cocoa for Migraine
A study presented at the 2009 International Headache Congress provided evidence that a cocoa-enriched diet (in rats) suppressed proteins associated with inflammation in the trigeminal ganglia. This suggested that a cocoa-enriched diet in migraine sufferers might help to suppress migraine headaches. Obviously, more research will be necessary.
Volunteers? I know it’s time for my next dose of chocolate.
by admin | Nov 13, 2013 | Types of Headaches
Posttraumatic Headaches
Posttraumatic headaches are headaches that occur following a head or neck injury. This type of headache is often associated with dizziness, fatigue, or memory problems, especially in the early phase of symptoms. In the majority of cases, posttraumatic headaches will resolve within a few months. However, sometimes, posttraumatic headaches can be chronic.
There is no specific headache type which characterizes the posttraumatic headache. The headache symptoms may mimic either tension-type headache or migraine headache, and is actually most commonly a hybrid mixture of the two.
Treatment is symptomatic. Surprisingly, as common as this headache type is, there have been no controlled trials of medications for the treatment of posttraumatic headache.
by admin | Oct 10, 2013 | Comorbidity
Chronic Headache and Migraine – What’s your childhood got to do with it?
One of the common myths about migraine is that it is more common in women because women are more emotional. This is not the case. However, we are finding that there is a subset of migraine sufferers for whom past negative experiences that contain emotional links may make pain worse.
This is particularly true in the case of repressed emotions, such as those that occur because of adverse childhood experiences. A history of adverse childhood experiences has been shown to be associated with an increased incidence of depression and anxiety as well as an increase in migraines.
The types of adverse childhood experiences that have been studied include emotional abuse, physical abuse, sexual abuse, witnessing domestic violence, exposure to household substance abuse, exposure to household mental illness, parental separation or divorce, and imprisonment of a household member. A scale of Adverse Childhood Experiences has been developed for study, and it has been found that the higher the score, the higher the prevalence of headaches. It is of note that this affected both women and men.
And it makes sense, when you think about it. A child’s brain is still developing, and is more likely to be affected by things they need help making sense of, things that are scary or traumatic. Occurrences of revictimization in adulthood were high, and were associated with depression and anxiety as well as increased pain. These studies suggest that adverse childhood experiences may serve as risk factors for chronic headache, including transformed migraine. Not everyone who developed chronic headache disorders also experienced depression or anxiety; these occurred more commonly but independently of one another.
Abuse and Comorbidity
In this population, there was also an association found with comorbid disorders. Emotional abuse was found to correlate with an increased prevalence of IBS, chronic fatigue syndrome, and arthritis. Physical neglect was also associated with arthritis, and with uterine fibroids in women. Physical abuse was associated with endometriosis. In general, those who had multiple types of adverse childhood experiences were more likely to have more comorbid conditions, and more types of painful conditions.
Pain and Emotions
A very interesting study of fibromyalgia patients compared them to other pain patients in their pain response to sadness and anger. Both groups showed a decreased pain threshold and pain tolerance as a consequence of these emotions. The women with fibromyalgia were not more emotional than the other women, but they did report experiencing more pain, even though when measured formally, the levels of pain threshold and pain tolerance decrease were similar. In other words, they had a differing emotional experience to the pain. This suggests that migraine, headache, and fibromyalgia sufferers who have a history of adverse childhood experiences might benefit from cognitive behavioral therapy, which can help you reframe the meaning of emotional experiences.
References:
1. Tietjen GE, Brandes JL, Digre KB, et al. History of childhood maltreatment is associated with comorbid depression in women with migraine. Neurology. 2007;69:959-968.
2. Tietjen GE, Brandes JL, Peterlin BL, et al. Childhood maltreatment and migraine (Part III). Association with comorbid pain conditions. Headache. 2010;50:42-51.
3. Tietjen GE, Brandes JL, Peterlin BL, et al. Childhood maltreatment and migraine (Part II). Emotional abuse as a risk factor for headache chronification. Headache. 2010;50:32-41.
4. Tietjen GE, Brandes JL, Peterlin BL, et al. Childhood maltreatment and migraine (Part I). Prevalence and adult revictimization: A multicenter headache clinic survey. Headache. 2009;50:20-31.
5. Anda, R, Tietjen, GE, Schulman, E, Felitti, V, Croft, J. Adverse Childhood Experiences and Frequent Headaches in Adults. Headache. 2010;50:1473–1481.
6. van Middendorp, H, Lumley, MA, Jacobs, JWG, Bijlsma, JWJ, Geenen, R. The effects of anger and sadness on clinical pain reports and experimentally-induced pain thresholds in women with and without fibromyalgia. Arthritis Care & Research. 2010;62:1370–1376.
by Christina Peterson, M.D.
by admin | Jul 17, 2013 | Migraine
What is Chronic Migraine?
What is chronic migraine? The International Headache Society’s International Classification of Headache Disorders, 3rd edition, has defined chronic migraine as 15 or more headache days a month that has lasted for three months or more, and that on eight or more days a month has the features of a migraine headache.
What Causes Chronic Migraine?
Why some people get chronic migraine and some people don’t is not always entirely clear. There is some evidence that chronic migraine may be on a spectrum of headache frequency between episodic migraine (less than 15 days a month) and transformed migraine, which is migraine occurring very frequently, similar to chronic daily headache, but with clear migraine features to the headaches. Research into why headaches become chronic has shown the following risk factors for headache chronicization. This research did not focus on chronic migraine specifically, but looked at chronic daily headache.
Risk factors for chronic migrane are:
- History of head or neck trauma
- Female
- Habitual snoring
- Sleep apnea and other sleep disorders
- Obesity
- High caffeine intake
- Smoking
- Coexisting pain disorders
- Overuse of pain medications
- Major life changes (moving, getting married, etc.) were associated with the onset of chronic headache
1. Bigal ME, Rapoport AM, Sheftell FD, Tepper SJ, Lipton RB. Chronic migraine is an earlier stage of transformed migraine in adults. Neurology. 2005; 65(10): 1556-1561.
http://cep.sagepub.com/content/26/6/742.abstract [Accessed July 17, 2010].
3. Bigal M, Sheftell F, Rapoport A, Lipton R, Tepper S. Chronic Daily Headache in A Tertiary Care Population: Correlation Between the International Headache Society Diagnostic Criteria and Proposed Revisions of Criteria for Chronic Daily Headache. Cephalalgia. 2002:432 -438. Available at:
http://cep.sagepub.com/content/22/6/432.abstract [Accessed July 17, 2010].
by Christina Peterson, M.D.
updated July 17, 2013
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