Sex Migraine Is For Real: Loyola Neurologist

Migraine Sex

Migraines & Headaches After Sex (HAS) More Common Than Reported (1)

‘Not tonight honey, I have a headache’ may not be an excuse in avoidance after all,  because for some, especially men, migraines and headaches develop after sexual intercourse, making them avoid it. It is estimated that only as many as 1% of migraning adults actually report experiencing migraines or severe headaches after they have had sex. (2) The real percentage is considered much higher but generally goes under-reported since there is a feeling of discomfort talking about it on the part of the patients who suffer this type of a migraine and doctors who should be asking if the patients suffer this type of an ordeal.

According to Dr. Jose Biller who is the chair of Loyola’s Department of Neurology, and is certified in Headache Medicine by the United Council for Neurologic Subspecialties, “Many people who experience headaches during sexual activity are too embarrassed to tell their physicians, and doctors often don’t ask. Headaches associated with sexual activity can be extremely painful and scary. They also can be very frustrating, both to the individual suffering the headache and to the partner.” (3)

Though a fair percentage of headaches associated with sex (HAS) are considered benign and not life-threatening, others need running neurological diagnostics to look at and rule out dangerous causes such as brain aneurysm, stroke, cervical artery dissection or subdural hematoma etc. It is confirmed that HAS are 3-4 times more likely to occur in men than women.

Basically, the study has identified 3 types of HAS:

Type

Area Intensity Timing

1

Head and Neck Dull

Before Orgasm

2

Back of the head Intense Pain lasting hours

During Orgasm

3

Half Head, Any side Mild To Extreme Pain

After Sex

The cause for the third type of HAS has been identified as internal leaking of spinal fluid extending from lower portions of the skull to lower spine. The pain worsens when a person stands as the brain sags down. Relief is felt when the person lies down.

The different types of HAS require different types of treatment and management. However, the best bet still is on exercising regularly, keeping weight under control, not consuming too much alcohol and reducing exposure to known migraine triggers.

SOURCES

  1. Image Credit: Couple Lying In Bed Back-to-Back Stock Photo; Image by Ambro; Free Digital Photos; Web June 2014; http://www.freedigitalphotos.net/images/CouplesPartners_g216-Couple_Lying_In_Bed_BacktoBack_p76440.html
  2. Headaches during sex likely more common than reported; Science Daily News; Web June 2014; http://www.sciencedaily.com/releases/2014/06/140610100303.htm
  3. Sex headaches: More common than you’d think; Loyola Medicine Publication; Web June 2014; http://loyolamedicine.org/newswire/news/sex-headaches-more-common-youd-think

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Stop To Smell The ‘Lavender’: Being Pain-Free

lAVENDER FOR mIGRAINES

Therapeutic Grade Lavender Essential Oil Proves More Effective Than Drugs In Treating Migraines (1)

Since real cures for migraines have not been found yet, migraineurs often make do with taking drugs on a long-term basis that tackle some but not all of the symptoms associated with a migraine episode. So the injections, patches, magnetic stimulators, pills, nasal delivery techniques address pain mitigation or at most one other symptom migraineurs experience during their intense episodes. As migraineurs are usually in for the long haul, their drug intake is also long term as is their experience with unnecessary medication side effects and that is why a lot of us start to explore natural options.

Lavender has long been used in the management of anxiety in natural, holistic and traditional medicines. For the first the first time the effect of therapeutic grade lavender oil was studied in the treatment of migraine pains. The study conducted by the Department of Neurology, School of Medicine, Mashad University of Medical Sciences, Mashad, Iran. The report of the study was published in the online version of PubMed’s April 2012 issue. Abstract of the research details may be accessed (2)

A total of 47 participants who had been clinically diagnosed with migraine were studied. They were divided in two groups randomly – the case group and the control group.

The case group was instructed to apply 2-3 drops of therapeutic grade essential oil on their upper lip at the onset of migraine pain. They were to inhale the emanating vapours for 15 minutes and grade the severity of their migraine pain at intervals of 30 minutes for the next 2 hours.

The control group was given the very same instructions except that they were provided scented paraffin to apply to their upper lips for inhalation of vapours. Neither of the groups knew what they were being given in the unlabelled bottles.

The lavender group not only reported a 71% improvement in the severity of their symptoms, they also reported significantly fewer migraines than the placebo group. In other words, lavender helped migraine sufferers about three quarters of the time. (3)

Compared to the efficacy rates of high dose Tylenol at 50%, 57% for Ibuprofen and 59% for Imitrex, lavender oil scores beautifully over pharmaceutical drugs and comes with negligible side-effects if any at all compared to the drugs.

Lavender headache pillows stuffed with dried lavender petals and buds, lavender puches that may be embedded into scarves or tied to handkerchiefs may also be used to manage migraines. Other versatile ways of using lavender to counter migraines may be learnt at the Lavender Bee Farm website. (4)

SOURCES

  1. Image Credit: Lavender Bee Stock Photo; “Lavender Bee” by Simon Howden; Free Digital Photos; Web January 2014; http://www.freedigitalphotos.net/images/Flowers_g74-Lavender_Bee_p42074.html
  2. RESEARCH ABSTRACT: Lavender essential oil in the treatment of migraine headache: a placebo-controlled clinical trial; NBI Resources – Pub Med; Web January 2014; http://www.ncbi.nlm.nih.gov/pubmed/22517298
  3. Essential Lavender Oil: A Natural Solution for Migraines and Anxiety; Conscious Life News; Web January 2014; http://consciouslifenews.com/essential-lavender-oil-natural-solution-migraines-anxiety/#
  4. Lavender Therapy for Migraine Headaches; Lavender Bee FARM; Web Jaunuary 2014; http://www.lavenderbeefarm.com/headache.shtml

FOR VIDEO: Lavender for Migraine Headaches; Nutrition Facts; Web January 2014; http://nutritionfacts.org/video/lavender-for-migraine-headaches/

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FDA Grants Approval To Rizatriptan Benzoate ODT For Acute Migraine Treatment

Migraine Blog Rizatriptan ODT

Rizatriptan Benzoate ODT approved by FDA and launched in the market.  Image is not of said drug (1)

Pharmaceutical company Breckenridge’s drug Rizatriptan Benzoate has been given the green flag for immediate launch by the U.S Food and Drug Administration. The drug comes in the form of orally disintegrating tablet (ODT). It is available commercially in packs of potency/dosage 5 mg and 10 mg.

Breckenridge’s drug Rizatriptan Benzoate ODT is manufactured and supplied by Natco Pharma Limited. Just like Merck & Co. Inc’s Maxalt MLT, Rizatriptan Benzoate ODT is a prescription drug used in the management and treatment of acute migraine.

The FDA granted final ‘go ahead’ for the Abbreviated New Drug Application (ANDA) for Rizatriptan Benzoate ODT some nine months prior to expiration of the pediatric-exclusivity period for the challenged Orange Book patent (April 1, 2014).

‘Breckenridge’s patent challenge regarding Rizatriptan Benzoate Orally Disintegrating Tablets is a continuing part of its larger aggressive Paragraph IV strategy commenced a few years ago. Since the beginning of 2011, Breckenridge has filed twelve (12) Paragraph IV patent challenges and intends to continue that trend in the next several years, focusing on niche Paragraph IV opportunities with certain barriers to entry.’ (2)

SOURCES:

  1. Image Credit: FreeDigitalPhotos.net; Yellow Tablet; Image by rakratchada torsap; Web July 2013; http://www.freedigitalphotos.net/images/agree-terms.php?id=10096441
  2. Breckenridge Pharmaceutical, Inc. Announces Approval of Rizatriptan Benzoate ODT (Orally Disintegrating Tablets): BioSpace.com; Web July 2013;  http://www.biospace.com/news_story.aspx?StoryID=301892&full=1

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Bridging the Gaping Divide With Pain Self-management Tools

Most migraineurs are aware that the medical fraternity has yet not arrived at the cause of migraines. We know of triggers and the way the pain unfolds or what happens inside of the brain hours before, during and after a migraine episode but are still clueless about what causes migraines and why or how the pain stops.

Though a good number of migraineurs do consult a ‘migraine specialist’ or a ‘headache specialist’ after enduring the onslaught of merciless pain years after they first experienced their episodes, they often take back selective important tips back from the doctor’s office. A relatively new program called painACTION.com developed by Inflexxion now offers many tools to the migraineur that can help them manage their symptoms better when they are out of the doctor’s office and back into their lives.

Better Pain Management With Online Self-help Application (1)

This free and non-promotional program is available online and is believed to be especially beneficial to those who are chronic migraineurs. The tool was studied by researchers at Inflexxion using 185 participants to test the clinical efficacy of this web-based program. The program uses various symptom-based management techniques and offers a wide range of tips on relaxation and on getting support groups, doing daily activities to do etc.

It was observed that those who used the program reported better stress and pain management skills, were more confident in their ability to handle an episode. The study as well as it’s findings were reported in the medical journal The Journal of Head and Face Pain, titled ‘A Randomized Trial of a Web-based Intervention to Improve Migraine Self-Management and Coping’. (2)

According to the lead author and researcher, Jonas Bromberg, PsyD, Director of Health Communications and Senior Research Scientist at Inflexxion, “Self-management training should help patients learn how to identify, avoid, and manage headache triggers, and learn to perform other essential prevention, management, and coping behaviors. The integration of behavioral support in the medical care of migraine is essential in helping people with migraine to manage their condition more effectively, safely manage their prescription pain medications, avoid disease progression, and reduce the high cost of migraine and migraine-related disability to individuals and society.” (3)

This free online program is particularly beneficial to those who live and work in areas which do not have easy or ready access to neurologists, mental health support services or behavioural experts.

SOURCES:

  1. Image by Jeroen van Oostrom; Freedigitalphotos.net; February 2012;  http://www.freedigitalphotos.net/images/view_photog.php?photogid=413
  2. Technical report of the study may be accessed at: A Randomized Trial of a Web-Based Intervention to Improve Migraine Self-Management and Coping; Wiley Online Library; February 2012; http://onlinelibrary.wiley.com/doi/10.1111/j.1526-4610.2011.02031.x/abstract
  3. Migraine Self-Management Improved And Migraine-Related Psychological Distress Reduced By painACTION.com; Medi Lexicon News; February 2012; http://www.medilexicon.com/medicalnews.php?newsid=241832

The web-based program may be accessed through this link: http://painaction.com/

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Why NICE (U.K) Will Not Recommend Botox As Migraine Preventative Any Time Soon

National Institute for Health and Clinical Excellence (NICE) in the U.K will not be endorsing the use of purified botulinum toxin A (Botox) as a preventative for migraineurs anytime yet. According to sources, there is not enough evidence that confirms the efficacy of Botox in pain management. This news comes as a bit of a surprise especially because back in the summer of 2010, Medicines and Healthcare Products Regulatory Agency (U.K) had approved the use of Botox in migraine management. Here is a news report that runs in News- Medical.Net written by Dr. Ananya Mandal MD (1):

Botox Being Injected Into a Migraineur (2)

“Botox – used as an anti-wrinkle agent – is unlikely to be recommended for the treatment of chronic migraines on the NHS in England and Wales. According to the National Institute for Health and Clinical Excellence (NICE) draft guidelines there is insufficient evidence that it works.

Migraines are severe headaches, which are often accompanied by nausea and vomiting and finding light or sound painful. Chronic migraines are defined as headaches at least 15 days a month, eight of which have to be migraines.

In July 2010, Botox was approved as a preventive treatment for chronic migraine in the UK by the Medicines and Healthcare Products Regulatory Agency. Botox is injected into at least 31 sites around the head and neck every 12 weeks. However, how the neurotoxin might prevent chronic migraines is unknown. The therapy uses a purified version of botulinum toxin A and it is thought to block overactive nerve impulses which trigger excessive muscle contractions.

NICE is deciding whether the injection should be offered across the NHS in England and Wales. NICE said the injections had been “shown to have some benefit” such as in a trial involving 1,384 patients, published in the journal Headache. However, it said the effect was small and may have been confused by the way the studies have been conducted. A review in the Drug and Therapeutics Bulletin in February 2011 said there is “limited evidence” for using Botox.

Prof Carole Longson, director of the health technology evaluation centre at NICE, said, “Our independent committee is asking Allergan to provide further information and analysis as part of this public consultation, so that it has sufficient evidence to develop sound advice for the NHS regarding the use of Botox for the prevention of headaches in adults with chronic migraine. Without this additional evidence, potentially we will be unable to advise the NHS that this drug is good value for money for these adults because there are currently too many uncertainties.” NICE estimated the cost to the NHS would be £349.40 for every 12-week cycle of treatment.

Allegan said it was “working constructively” and would provide new evidence to NICE which it said would demonstrate “that treatment with Botox is both a cost effective and clinically meaningful treatment option for patients suffering from this debilitating condition”.

The chief executive of The Migraine Trust, Wendy Thomas, told the BBC, “I’m a bit disappointed really. For these people with chronic migraine, they’ve already tried various preventative treatments which have failed. For these people their only hope is Botox. It doesn’t work for everybody – it can change people’s lives or not make very much difference.”

Joanna Hamilton-Colclough, director of Migraine Action, said using Botox for her headaches had “absolutely transformed my life”. She said, “I’ve been having chronic headaches for 40 years – I wake up every day with a headache. After my first Botox treatment I woke up the next day feeling ill. At lunchtime I realized that I felt different because I didn’t have a headache. I’ve been able to work without a headache and sleep properly for the first time.” She admitted it did not work for everyone but added that clinical trials also suggested a 50 per cent reduction in migraine days for some patients.

Mrs Hamilton-Colclough said, “We don’t think the treatment is expensive when you take into account the cost to the economy from people needing time off work for migraine and to the NHS from A&E treatment.”

Professor Anne MacGregor, a migraine expert at St Bartholomew’s Hospital, London, said she was concerned Botox might be used as a ‘quick fix’ for chronic headaches. She added, “It’s not a blanket treatment but it might be appropriate for a small number of patients.”

A decision from NICE is expected in June.”

SOURCE:
1. Botox efficacy uncertain in treating migraine says NICE; Medical News.Net; February 2012; http://www.news-medical.net/news/20120218/Botox-efficacy-uncertain-in-treating-migraine-says-NICE.aspx

2. Image by Ambros; Free Digitial Photos; February 2012; http://www.freedigitalphotos.net/images/view_photog.php?photogid=1499

Acupuncture: A ‘Yes’ or A ‘No’ For Migraineurs?

This post has been drawn from Medicine News Today for the benefit of migraineurs:

In order to find out the effect of acupuncture compared with sham acupuncture in treating migraines, a team of investigators carried out a randomized controlled human trial. 480 individuals at 9 hospitals in China who experienced migraines for over one year, with two or three migraines in the 3 months prior to the investigation, were enrolled to participate in the study.


The researchers randomly assigned the volunteers to four groups. Those in one group received sham acupuncture, while participants in the other three groups received different types of acupuncture. Their ages ranged from 18 to 65 years.

In the United States and England, migraines affect approximately 16% to 18% of women and 6% to 8% of men. Evidence on how effective acupuncture is at treating migraines is mixed, as some studies suggest it is the placebo effect, instead of a therapeutic effect that relieves symptoms. Acupuncture distinguishes between real acupuncture points and non-acupuncture (sham) points.

Dr. Fan-rong Liang, Chengdu University of Traditional Chinese Medicine, Chengdu, China, explains: “We found that the outcomes following acupuncture were significantly better than with sham acupuncture during weeks 13-16, but the effect was clinically minor.”
After 16 weeks, approximately half to three-quarters of participants were better after sham acupuncture and proper acupuncture. The researchers said: “Acupuncture has a large effect on treating migraines, but the specific therapeutic effect may be minor.”
In an associated commentary, Dr. Albrecht Molsberger, Ruhr University, Bochum, Germany and the University of North Carolina, explains that according to previous evidence, acupuncture helps treat severe migraine attacks.

Molsberger explains: “On the basis of the existing evidence, acupuncture should be an option for the first-line treatment of migraine to supplement other non-pharmacologic treatment options.”
In a second randomized controlled trial, investigators in the Netherlands enrolled 490 patients from 64 general practices, 233 of them attended consultations to assess treatment of their migraines, as well as 257 in the control group. The researchers set out to examine whether a proactive approach by primary care physicians to patients with suboptimal migraine treatment would result in improvements.

In the Netherlands, only 8% to 12% of all patients with migraines used prophylaxis, while a considerable amount of individuals used too much medication for migraine attacks.

Even though more individuals took prescription medication to prevent migraines as a result of the approach, the researchers observed no clinically relevant effect after six months.

Dr. Antonia Smelt, Leiden University Medical Center, Leiden, the Netherlands, with co-authors, explained: “We found no clinically relevant effect of a proactive approach to migraine in primary care for patients who were using two or more doses of triptan per month.”

The researchers conclude:
“It is possible that the intervention resulted in better treatment for patients not using prophylactic medication at baseline who had two or more attacks of migraine per month. Future interventions in primary care should target these patients.”

 

SOURCE:

Migraine – The Enigma Of Trial Results; Grace Rattue; Medical News Today; January 2012; http://www.medicalnewstoday.com/articles/240139.php

Sharing Your Invaluable Experience

Hi everyone,

I have noticed considerable traffic on this blog which encourages me to write new posts every other day. However, I am surprised at migraineurs not leaving their views on the subject. 

It would be very considerate (and tis a Season of Giving) if more migraineurs share their experiences of medications, therapies, practices and other relevant data on managing pain effectively. Any help to a fellow-migraineur will be very very appreciated and very very welcome!

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