Question:

This is a somewhat sensitive question, but my doctor hasn't had any suggestions, so I thought I'd ask the two of you. Sexual intimacy almost always triggers a migraine for me. My husband is very understanding, but we both miss it. Is there anything I can do or any medication I can take to avoid these migraines? Thank you, Joanie.

Answer:

Dear Joanie;

Thank you for being brave enough to ask this important question. The effect of migraine on relationships, and intimacy in particular, is often overlooked despite how important these issues are.

There are a couple of potential reasons for migraine being triggered by sexual activity. The first is similar to migraine that is triggered by any physical activity or exertion. For some, however, the trigger is specific to sexual activity. For many, it seems to occur at or shortly after orgasm.

There are not well studied treatments specific to sexual induced migraine, but there are a variety of things that can be tried. First, if it related exertion, going slowly can be helpful. But it's less likely that this will solve your issues. If you have a migraine abortive therapy that usually works for you, like a triptan or an anti-inflammatory, you can try to take it prior to initiating sexual activity. If this is not effective or you value spontaneity, ask you doctor about "long acting" triptans, such as frovatriptan, which possibly could be effective if taken up to 24 hours in advance.

Thank you for your question,
Dave Watson and Teri Robert

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