Epitomized by the oft-quoted cliché "Not tonight dear. I have a headache", females with migraine have been culturally stigmatized as being hyposexual and inclined to use headache as a means of avoiding sexual intimacy.
At the American Headache Society's annual scientific meeting held in June of this year in San Francisco, Dr. Lee Peterlin of the Lancaster General Health Headache Center and Dr. John Rothrock from the George Washington University School of Medicine presented their results of clinical research involving the levels of libido, sexual activity and sexual performance in females with migraine compared to an otherwise comparable population of females without any history of migraine. Some may regard their findings as surprising, but those findings are not entirely without precedent.
Remarked Peterlin, “Investigators before us have found that both males and females with migraine may have a higher libido than individuals with tension type headache. All we did was extend their research by examining a control population free of any primary headache disorder.”
In their study, Peterlin and Rothrock asked a consecutive series of almost 200 sexually active heterosexual female migraine patients between the ages of 25 and 55 to anonymously complete a survey assessing their sexual histories and the Female Sexual Function Index (FSFI), a validated instrument which provides an objective assessment of female sexuality. They compared their responses to those of 100 sexually active heterosexual females matched for age, marital status, educational background and socioeconomic status but free of any migraine or other significant headache history.
When patients with chronic migraine were excluded, the migraine group reported a higher monthly frequency of intercourse and a higher likelihood of intercourse resulting in orgasm. The FSFI scores in this group were similarly higher than those recorded in the migraine-free controls. In contrast, those with a heavier headache burden - the chronic migraine patients -reported lower libido, lower frequency of intercourse and lower likelihood of intercourse-associated orgasm than either the control group or patients with episodic migraine.
Commented Rothrock, “These data would appear to contradict the proposition that something about migraine itself predisposes to hyposexuality. Just the opposite, the patients we studied who were experiencing migraine on only an episodic basis demonstrated levels of libido and sexual performance exceeding that of controls. Interestingly, many of those patients also reported using intercourse as a means to potentially terminate a migraine attack."
Will effective treatment of chronic migraine lead to an increase in libido and sexual performance? An interesting hypothesis, both Peter line and Rothrock agreed, but as yet the data to support a definite answer are lacking.
In the female migraine patient population, libido, frequency of intercourse and likelihood of intercourse-associated orgasm appear to correlate with headache burden. Patients with LFEM and MFEM may report a level of libido, frequency of intercourse and likelihood of orgasm-associated intercourse that exceeds what is reported by age-matched controls free of migraine. Many patients with LFEM, MFEM and HFEM appear to utilize intercourse/orgasm as a means to potentially terminate an acute migraine attack.