Chronic Headaches: Is It Time to See a Doctor?
Updated May 2002 — While minor headaches affect almost everyone from time to time, chronic problems can be difficult to treat because different types of headaches require different treatments. But the good news is that those treatments are now better than ever before. Headaches are diagnosed by taking into account the frequency, timing and symptoms. Some types of headaches are more common in men than women, or vice versa. Others, such as migraines, affect both sexes equally. Some headaches are not headaches at all, but are symptoms of an underlying condition, such as anxiety or depression. In these patients, normal headache treatments do not work.
Headaches caused by stress may respond to medication but will quickly return. If distancing oneself from the source of stress is not possible, coping techniques - such as biofeedback, relaxation therapy or exercise - can be effective alternatives to pharmaceuticals.
Treatment for Migraines
Migraines, however, often require medication. Fortunately, new approaches to treating this type of headache have vastly improved.
Some migraine sufferers experience what is known as an aura, a set of visual or neuromuscular symptoms that precede the onset of the headache by several minutes or hours. Blood pressure medications can be effective on migraines with aura, and anticonvulsants often work on those without aura. A class of medication known as tryptophans work on both kinds. All migraine medications have side effects, but patients often choose to accept these side effects instead of the misery of migraines.
Gender-Based Differences
Women are at risk for headaches caused by hormone changes, particularly before they reach menopause. Menstrual headaches tend to occur during ovulation or the first day of menstruation, when hormones fluctuate most. These women often suffer from painful periods, because prostaglandins play a role in both conditions. For this reason, over-the-counter, nonsteroidal anti-inflammatory drugs (NSAIDs) can be useful in treating both the headache and cramps.
Men have traditionally been the target of cluster headaches, one of the most painful conditions known. However, more women have been diagnosed with this condition in recent years. Fortunately for both genders, some patients find relief from the stabbing, searing pain with medications known as calcium channel blockers or vasoconstrictors.
For the vast majority of patients who only experience an occasional headache, an aspirin or NSAID usually does the trick. But when headaches occur frequently or do not respond to over-the-counter treatments, it's time to see a headache specialist.
Consult your doctor before taking any medication. For a referral to a physician, call the Memorial Healthcare System Physician Referral Line at (800) 944-DOCS.