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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