Fighting headaches with hormones.

• Author: Holtorf, Kent
• Position: Medicine & Health

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WITH REPORTS dating back to 1500 B.C.. headaches have one the longest histories of recognition of all medical disorders--but, beset by myths, unclear causes, and inadequate remedies, they remain one of the most poorly treated conditions in medicine today.

Headaches are one of the most common complaints, with almost everyone having experienced a "splitter" at least once in his or her lifetime. About 75% of individuals have endured a headache in the past year. Headaches can be occasional, chronic, or recurrent, and the pain can be mild or severe enough to disrupt daily activities dramatically, In the U.S., more than 45,000,000 people suffer from chronic headaches.

Headaches involve the network of nerve fibers in the tissue, blood vessels, and muscles in the head and base of the skull. There are various types of headaches, as well as considerable overlap of classifications and effective therapies. For instance, migraines and the muscle tension variety coexist in as many as two-thirds of sufferers. A lot of headaches, however, have a significant hormonal component that usually goes undetected or untreated. With prosper diagnosis, significant improvement be seen in the majority of sufferers.

Most primary headaches (those not due to underlying disease) fall under three categories: tension, migraine, and cluster.

Tension headaches--also called stress or muscle-contraction headaches--are the type experienced on occasion by most people. They typically are characterized by a dull, steady pain. Tension headaches often are described as tightness or vice-like pain around the forehead or back of the head. They usually occur gradually in the middle of the day and often are associated with stress, anxiety, and depression.

The severity of tension headaches typically grows as frequency increases. Chronic tension headaches usually will become more "migraine-like," being more severe and throbbing in nature. Well-known causes include inadequate sleep, poor posture, emotional or mental stress, depression, hunger, dieting, skipping meals, and over-exertion. Common hormonal causes, which usually go undetected, include low adrenal function and low thyroid. Also, while low estrogen and progesterone are known to be associated with migraine headaches, these hormones also can cause chronic tension headaches.

Migraines are the second most common type of headache. An estimated 30,000 people in the U.S. suffer from them. Women are about four times more likely than men to be afflicted. The word migraine, in Greek, means "half of the skull," as the pain usually is one-sided, but can extend further. Most migraine patients fail to get relief with current therapies. In fact, a large trial found that 64% of migraine patients are dissatisfied with their current remedies.

The exact cause of migraines is unclear but, it is known that they involve abnormal constriction and dilatation of blood vessels and the release of inflammatory chemicals from nerve fibers around these blood vessels. The sympathetic nervous system (which focuses on stress) subsequently is stimulated, causing the typical symptoms of nausea, vomiting, and photophobia (light sensitivity). Some people also experience a variety of mostly visual sensations--an aura before, or with, the onset of the migraine.

Commonly identified triggers of migraines include alcohol, cheese, preservatives, hunger, exertion, fatigue, perfumes, weather changes, and artificial sweeteners. Fluctuations in estrogen and progesterone are well-known triggers of migraines (though typically poorly treated), but low adrenal function and low thyroid are common contributors that often remain undiagnosed.

Standard medications for the acute treatment of migraines include triptans; nonsteroidal anti-inflammatories, or NSAIDS, such as aspirin and ibuprofen; ergots; narcotic pain medications; and Midrin.

Additionally, there are a number of medications that can be used to reduce the frequency and severity of migraines, including...