Put an End to

Headaches

Migraine
What it feels like Usually a throbbing pain on one side of your head that lasts anywhere from an afternoon to three days. The pain often worsens with activity and prevents you from going about your daily routine. "Many women assume they don't have migraines because they don't experience an 'aura,' or light flashes, but less than a third of sufferers actually do," explains Dr. Diamond.
How common is it? About 18 percent of American women get migraines, almost three times the rate among men.
What causes it? Migraines are due to changes in the brain nerves that cause blood vessels to expand, along with the release of pain-causing chemicals.
And if one of your parents suffered migraines, you have a 50 percent chance of also developing them.
Get relief Triptans are a class of pain-relieving drugs specifically approved to treat migraines; you take them at the first sign of an attack. Treximet, which combines a triptan with the anti-inflammatory naproxen sodium, became available last year, and it appears to be more effective in relieving migraines than either medication on its own. If you get these headaches more than twice a month, you may also want to take a daily preventive drug like the beta-blocker atenolol or the antiseizure drug topiramate, both of which have been shown to reduce frequency and severity in 50 to 60 percent of attacks. If you have chronic migraines, occurring 15 or more days per month, ask your doctor about Botox. While not yet approved for headaches, "it has a firm foundation of scientific evidence supporting its role as preventive treatment," says Richard Lipton, M.D., director of the Montefiore Headache Center at The Albert Einstein College of Medicine, in the Bronx, New York.

Menstrual Migraine
What it feels like The same as a regular migraine, but it occurs just before or at the start of your period.
How common is it? About 60 to 70 percent of all women's migraines are related to menstruation, according to the American Headache Society.
What causes it? The drop in estrogen levels right before your period can excite your pain nerves and release pain-causing chemicals.
Get relief Your doctor may prescribe a triptan such as Frova for the days before your period as a preventive measure, says Stephen Silberstein, M.D., director of the Jefferson Headache Center at Thomas Jefferson University Hospital, in Philadelphia. If you're on the Pill, consider one of the newer continuous use brands, such as Seasonale or Lybrel, so you get your period four times a year or less. A study from Texas A&M College of Medicine in Temple found that women who used these had milder headaches than those on the traditional 28-day pill cycle. If you also get frequent migraines at other times, your doctor may suggest a daily preventive drug such as a beta-blocker or topiramate.

Tension Headache
What it feels like A dull, non-throbbing pain on both sides of the head. "Many people say it's like a tight band around their head," says Sheena Aurora, M.D., director of the Swedish Headache Center, in Seattle.
How common is it? Almost 80 percent of all adults experience a tension-type headache at some point.
What causes it? Doctors aren't quite sure, but they suspect that tension-type headaches result from imbalances of several neurochemicals that stimulate pain pathways, including serotonin, as well as muscle tightening in the back of the neck and scalp, which can get worse when you're anxious.
Get relief If you experience only one or two headaches a month, try an over-the-counter painkiller like ibuprofen or acetaminophen. But since these medicines can lead to rebound headaches (see opposite page) when you take them too often, see your doctor or a headache specialist if you get headaches more frequently. Often, simple stress-management techniques such as exercise, getting enough sleep, and relaxation methods like biofeedback or talk therapy help, says Susan Broner, M.D., a neurologist at The Headache Institute at St. Luke's-Roosevelt Hospital Center, in New York City. If these don't work, the drug of choice is amitriptyline, an older tricyclic antidepressant that often provides pain relief: An Ohio University in Athens study found that patients who took a small daily dose along with stress-management therapy cut their headache frequency in half. (The antidepressant is thought to change neurochemistry in the brain, which helps blunt pain, although the exact mechanism isn't understood.)

Sinus Headache
What it feels like A gnawing, pounding pain in your forehead and nasal area coupled with facial pain and pressure, nausea, and often a decreased sense of smell and a fever How common is it? Not very—in fact, almost 90 percent of patients who report having sinus headaches actually have migraines, according to the American Headache Society. What causes it A sinus infection (sinusitis), a cold, or allergies Get relief See your primary-care doctor, who can often diagnose the problem by looking up your nose. If you do have sinusitis, it's usually treated with a seven- to ten-day course of antibiotics, decongestants, and steroid nasal sprays. A CT scan of your sinuses can also spot anatomical abnormalities, like a deviated septum, that are blocking your sinuses and in rare cases may require surgery.

Rebound Headache
What it feels like A daily headache that can be either dull or throbbing
How common is it? About 2 percent of women experience rebound headaches (also called medication overuse headaches).
What causes it? Ironically, rebound headaches can be the result of taking OTC or prescription pain relievers more than twice a week, which can lower levels of serotonin. "A woman often starts taking a pain pill a few times a week to treat her frequent tension type headaches or migraines—and before long, she needs to take pills a few times a day to treat what's become daily head pain," says Alan Rapoport, M.D., a neurologist at UCLA School of Medicine.
Get relief The only way to resolve a rebound headache is to stop taking acute-care headache meds too frequently, but it can be painful, so don't try it on your own. "Consult your primary-care physician or a headache specialist," says Dr. Diamond. "I usually put a patient on a weaning schedule; so if she's taking ten pain relievers a day, I take her down to eight the next week, then six, and so on." During this time you may also need prescription medication like steroids, which have an anti-inflammatory effect that can quickly help relieve pain.

Cluster Headache
What it feels like A sudden, intense burning pain on one side of the head, usually behind your eye and extending to your forehead, nose, or cheek. Attacks usually last anywhere from a few minutes to a few hours and may recur up to four times a day.
How common is it? Less than 1 percent of the population gets them; men outnumber women five to one.
What causes it? Blood-vessel swelling in the head
Get relief The pain can be so severe that you end up in the emergency room, where you may be given injectable triptans or oxygen therapy that you inhale through a mask for 15 minutes. If you experience a cluster headache, it's important to see a headache specialist who can recommend preventive drugs like calcium channel blockers, which help regulate the chemicals that carry impulses in the brain.