Migraines, Headaches, and Sexual Function in Women
We've all heard the joke that goes with Migraine and headache stereotypes, "Not tonight, dear. I have a headache." Those of us who have primary headache disorders such as Migraine know it's no joke. Migraines and headaches can seriously impair our intimate relationships.
Researchers at the University of Pavia in Italy recently released the results of a study they conducted about sexual function in women treated for primary headaches.
"Primary headaches are common in women and impact on their quality of life and psychosocial functioning. Few data are available on sexuality in female headache sufferers."1
"to assess sexual function and distress in women treated for primary headaches in a tertiary (specialized) university center."1
- 100 study participants were recruited from 194 women consecutively observed over a three-month period in the clinic.
- The International Headache Society's International Classification of Headache Disorders, 2nd Edition, (ICHD-II) was followed to diagnose Migraine with aura, Migraine without aura, and tension-type headache (both episodic and chronic).
- A detailed patient history was taken, including pharmacological history.
- Anxiety and depression were assessed using the State-Trait Anxiety Inventory and the Beck Depression Inventory.
- The Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-Revised were administered to all participants.
Study outcome measures:
"The main outcome measures are sexual symptoms and distress in women treated for primary headaches."1
- More than 90% of the study participants had significant impairment of sexual function, while 29% reported sexual distress.
- Hypoactive sexual desire disorder (HSDD) (persistent or recurrent lack of interest in sex that causes personal distress3) was diagnosed in 20% of the participants, and an additional 17% reported lack of interest without distress.
- The FSFI domain and full-scale scores did not significantly differ by headache diagnosis.
The women with chronic tension-type headache (CTTH) displayed a high rate of sexual distress and a strong negative correlation between desire, arousal, and full-scale FSFI
score and number analgesics/month.
- Depression was positively correlated with sexual distress only in the women with CTTH.
"In the present study, the majority (more than 90%) of women treated for primary headaches reported significant impairment of sexual function, mainly in the pain domain, while 29% reported sexual distress. Both migraine and tension-type headache were associated with sexual symptoms, including HSDD, but women with CTTH seem to be more prone to develop sexual distress."1
Our results suggest that sexual function should be routinely assessed in specialized headache centers."
Summary and comments:
The glaring question the numbers point to is, "Why is there such a link between primary headache and sexual dysfunction and distress?" The study authors noted many possible explanations, including:
- the adverse effects that pain exert on sexual desire, stimulation, and activity;
- the possibility that such chronic conditions may be capable of inducing impairment of genital arousal and the function of orgasm;
- comorbid conditions such as depression may play a role in influencing sex drive;
- medications used for Migraine and headache prevention may interfere with central and peripheral sexual response;
- the social dynamics between couples may be impacted in a way to result in a negative attitude toward intimacy and sexual behavior.
If we stop and think about it, much of this is pretty much common sense. When we're in pain; nauseous; extremely sensitive to light, sound, smell, and movement; it's difficult to be interested in intimacy and have any sexual desire. Certainly, it's not a situation any of us want to find ourselves in.
The idealists among us might say that good relationships will survive without intimacy and sexual activity, and that may be true. Still, when that part of relationships suffer, the rest of the relationship can be stressed as well. It's essential to know and remember that there is no embarrassment or shame when and if this occurs. Yes, it's personal, but it's also medical. It's something we can and should discuss with our partners and with our doctors. Being aware of the problem and addressing it can make us feel better emotionally and reinforce for our partners that all parts of our relationships matter.
1 Nappi, Rossella E., MD, PhD; Terreno, Erica, MD; Tassorelli, Chrisina, MD, PhD; Sances, Grazia, MD; Allena, Marta, MD; Guaschino, Elena, MD; Antonaci, Fabio, MD, PhD; Albani, Francesca, Albani, MD; Polatti, Franco, MD. "Sexual Function and Distress in Women Treated for Primary Headaches in a Tertiary University Center." J Sex Med 2012;9:761–769. DOI: 10.1111/j.1743-6109.2011.02601.x.
2 Rowan, Karen. "Not tonight, dear: Sex problems linked to headaches." Health on Today. March 1, 2012.
3 Mayo Foundation for Medical Education and Research. "Low sex drive in women." MayoClinic.com. January 20, 2012.