THERE'S a reason why the cliched phrase, "Not tonight, dear, I have a headache", always appears in the speech bubble above a woman's head, instead of a man's.
It is not sexist to say that women suffer from headaches more often than men. It's simply a biological truth. Women's fluctuating hormone levels are the main reason for this, as the hormone levels can cause chemicals in the brain to rise and fall, leading to headaches during certain times.
This is not to say that all women constantly suffer headaches and men do not. Environmental and social factors like stress can contribute to headaches in both men and women.
Not all headaches are the same. Different types of headaches have different causative factors. If you know what type of headache you are prone to, you can learn how to prevent or treat them when they occur.
In this article, I will describe six common types of headaches.
#1. Tension headaches
This type of headache is the most common in both women and men. It results in a dull ache on both sides of your head, triggered by stress, fatigue, or hunger.
A tension headache is different from a migraine because it does not cause nausea or sensitivity to light, sound or smells, neither does it get worse with regular activities like walking.
The triggers of tension headaches are sometimes unavoidable, but fortunately, this type of headache can be treated with over-the-counter painkillers.
Women are believed to be more prone to migraines than men because hormonal changes are one of the triggers of migraines, which is why it can occur more frequently during menstruation.
The vast range of other triggers includes certain types of food and drink (e.g. aged cheeses, red wine, and coffee), nicotine and cigarette smoke, sudden changes in weather, over-sleeping, strong smells and, for some, even sex.
Like tension headaches, migraines can also be triggered by stress, lack of sleep, and emotional upsets. But the difference with migraines lies in the symptoms - the pain is sometimes only on one side of the head, it causes nausea and/or vomiting, and there is sensitivity to light, sounds, and motion.
Some people with migraines notice a warning "aura" before the migraine occurs, while others don't. The aura takes the form of flashing lights, or spots and lines floating in front of the eyes.
As the migraine triggers are very specific for each person, you can prevent them or reduce the severity by identifying the triggers and avoiding them. You can also see your doctor for specific pain-prevention medications.
#3. Sinus headaches
The sinuses are air-filled cavities in the skull that help insulate the skull. A sinus infection can cause a headache or pressure in the eyes, nose, cheek area, or on one side of the head.
Sinus headaches are treated with decongestants that contain painkillers. Sometimes, your doctor may prescribe antibiotics if there is an infection present.
Sometimes, sinus headaches can be mistaken for migraines, and vice versa. One way to distinguish it is to see whether the headache is accompanied by a fever and thick greenish or yellow mucous. This distinction is important because if you take decongestants for what is actually a migraine, you could make your headache worse.
#4. Cluster headaches
This type of headache is actually more common in men than in women. It is called a cluster headache because it occurs in cluster periods, such as for several days, weeks, or months at a time, followed by a remission where the attacks stop completely.
Cluster headaches cause a sharp, penetrating or burning pain, generally located in or around the eye, that may radiate to other areas of the face, head, neck and shoulders, and is usually one-sided.
Unlike migraines, cluster headaches lead to restlessness, because the person may feel that lying down makes the pain worse.
Unfortunately, over-the-counter painkillers often do not work for cluster headaches. You should see a doctor for prescription medications, such as triptans, or other specific medications.
#5. Rebound headaches
Ironically, popping too many painkillers can set you up for a never-ending cycle of headaches. These are called rebound or medication-overuse headaches.
You may be getting rebound headaches if you're taking over-the-counter painkillers or sinus headache formulas with a decongestant at least 15 days a month, or prescription painkillers at least 10 days a month.
What happens is that your threshold for pain is lowered as your body's pain receptors become overly sensitive when the dose of painkiller wears off.
It won't be easy to wean yourself off the pain medications. But you have to, because the vicious cycle could go on and on, with no relief. Ask for your doctor for help, and explore other remedies for relieving pain, such as acupuncture, yoga, or medication.
Most importantly, do not self-medicate rebound headaches by trying other medications on your own.
#6. Exercise headaches
Some women suffer from headaches right after physical activity, particularly strenuous exercise. These are actually called exertional headaches, which are a group of headaches associated with some form of physical strain, such as exercise or even sex.
This type of headache is closely related to migraines, as it often occurs in those who have inherited a tendency for migraines. Most exercise or exertion headaches are harmless and can be treated with simple painkillers.
However, if it's a new, severe headache that occurs after exercise, especially if you're not prone to migraines, it could be a sign of something more serious, such as abnormalities in the brain or other diseases. It is better to be safe by seeing your doctor immediately.
This is no reason to stop exercising completely. Exercise reduces stress, helps you sleep, and increases endorphins (chemicals in your brain that act as natural painkillers).
What you can do is avoid activities that make your head bob up and down, such as jogging, and switch to cycling or swimming instead. Drink plenty of water before, during, and after your workout, warm up gradually, and exercise in a cool environment.
Headaches are no joking matter. They can make you want to curl up in bed and avoid the rest of the world. Learning to recognise the different types and their causes can help you to be in control of the pain.
Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician & gynaecologist (FRCOG, UK). The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader's own medical care.