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ORGASMIC HEADACHE
Please , could you refer me to studies or give me any advice , other than propranolol and naproxen , about orgasm migraines ? It ’ s so bad I can ’ t get up for a whole day and it doesn ’ t go away for days . It ’ s ruining my marriage .
Orgasmic or pre-orgasmic headaches are usually short in duration , but severe pain can last as long as 24 hours . It is important to exclude secondary causes of the headache after the first episode , such as subarachnoid hemorrhage or arterial dissection , with appropriate imaging studies . The headache usually occurs on both sides of the head and can start as dull at the beginning of sexual activity and then become intense with orgasm . The first line of treatment is usually the antiinflammatory , indomethacin , ( used for gout ), which can be titrated up to higher doses depending on a patient ’ s tolerance to the gastrointestinal side effects ( i . e . ulcers , stomach , and esophageal irritation , etc .). This can be used with or without a beta blocker such as propranolol . Other forms of acute treatment such as ergotamines do not have any substantial evidence to support the use in orgasmic headache . Most current clinical studies involve acute and prophylactic treatment for migraine or cluster headache , and there are no current national studies for exertional or orgasmic headaches .
George R . Nissan , DO Baylor Headache Center
Dallas , TX
IMPORTANT SAFETY INFORMATION ( Continued )
Do not take BOTOX ® ( onabotulinumtoxinA ) if you : are allergic to any of the ingredients in BOTOX ® ( see Medication Guide for ingredients ); had an allergic reaction to any other botulinum toxin product such as Myobloc ® ( rimabotulinumtoxinB ), Dysport ® ( abobotulinumtoxinA ), or Xeomin ® ( incobotulinumtoxinA ); have a skin infection at the planned injection site .
The dose of BOTOX ® is not the same as , or comparable to , another botulinum toxin product .
Serious and / or immediate allergic reactions have been reported . These reactions include itching , rash , red itchy welts , wheezing , asthma symptoms , or dizziness or feeling faint . Tell your doctor or get medical help right away if you experience any such symptoms ; further injection of BOTOX ® should be discontinued .
Tell your doctor about all your muscle or nerve conditions such as amyotrophic lateral sclerosis ( ALS or Lou Gehrig ’ s disease ), myasthenia gravis , or Lambert-Eaton syndrome , as you may be at increased risk of serious side effects including severe dysphagia ( difficulty swallowing ) and respiratory compromise ( difficulty breathing ) from typical doses of BOTOX ® .
Tell your doctor about all your medical conditions , including if you : have or have had bleeding problems ; have plans to have surgery ; had surgery on your face ; weakness of forehead muscles , such as trouble raising your eyebrows ; drooping eyelids ; any other abnormal facial change ; are pregnant or plan to become pregnant ( it is not known if BOTOX ® can harm your unborn baby ); are breastfeeding or plan to breastfeed ( it is not known if BOTOX ® passes into breast milk ).
Tell your doctor about all the medicines you take , including prescription and non-prescription medicines , vitamins , and herbal products . Using BOTOX ® with certain other medicines may cause serious side effects . Do not start any new medicines until you have told your doctor that you have received BOTOX ® in the past .
Especially tell your doctor if you : have received any other botulinum toxin product in the last 4 months ; have received injections of botulinum toxin such as Myobloc ® , Dysport ® , or Xeomin ® in the past ( be sure your doctor knows exactly which product you received ); have recently received an antibiotic by injection ; take muscle relaxants ; take an allergy or cold medicine ; take a sleep medicine ; take anti-platelets ( aspirin-like products ) or anti-coagulants ( blood thinners ).
Other side effects of BOTOX ® include : dry mouth , discomfort or pain at the injection site , tiredness , headache , neck pain , and eye problems : double vision , blurred vision , decreased eyesight , drooping eyelids , swelling of your eyelids , and dry eyes .
For more information refer to the Medication Guide or talk with your doctor .
You are encouraged to report negative side effects of prescription drugs to the FDA . Visit www . fda . gov / medwatch or call 1-800-FDA-1088 .
Please refer to full Medication Guide including Boxed Warning on the following pages .
12 HeadWise ® | Volume 5 , Issue 1 • 2015 injection