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What if sex could both trigger and relieve a migraine?
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Welcome to Migraine Heroes. For anyone living with migraine and wondering why nothing has fully
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worked yet, I'm Diane Ducarme. In seven years of working with people with migraine, I've learned
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that no two migraine stories are the same and none of them are simple. But your migraine has
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its own patterns. Here we look at them from different angles so you can start recognizing
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them for yourself. A quick note, this is educational. For diagnosis or medication,
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please keep working with your doctor. Now take a deep breath and let's dive in.
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In this episode, you will learn why sex can sometimes relieve a migraine, but other times
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trigger an attack, how migraine affects your sexual desire and pleasure, and how traditional
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Chinese medicine explains migraine during sex and how it interprets what might be going on
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in the body more holistically. Stay with me till the end because I will share with you one
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hack on desire I learned from my little sister that is quite unexpected and you can try this
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week. Now it's not something we talk about often, is it? And I'm myself surprised. I'm doing an
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episode on this topic. It's a touchy topic and one I don't discuss much with people I work with.
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If I'm completely honest, this is not a topic that I've addressed that many times so explicitly.
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But so I decided to dedicate an episode to it because people online also mention
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they'd rather not talk to their neurologist about it. So let's dive in. Imagine you had a long day
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and you're finally having a nice evening and in bed with someone you love and you want to feel
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close and you want to relax. You want to enjoy the moment, but somewhere in the back of your mind,
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there's a question. Oh my god, what if I get a migraine? And maybe you've turned down sex
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because of that fear and maybe you felt guilty afterwards and maybe you've worried that your
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partner would interpret your pain as rejection. Or perhaps you've experienced something completely
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unexpected. You had a migraine, you were intimate and somehow your headache actually got better.
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How can that be? And how can the same activity make migraine better for one person and worse
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for another? And what might that tell us about your migraine patterns? Because the relationship
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between sex and migraine is much more interesting than you might imagine. So first, to get us into
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the topic with real people and real stuff that you can actually maybe relate to. A few people
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on Reddit and what they say about sex and migraine. The first person says, for me during it, everything
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goes away. All of my pain, it has always happened to me. My brain shuts off once I get turned on.
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I can't focus on multiple things. But after, it hits me like a train. I get horrible migraines
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after. That's the first person. The second person says, if it's during the onset, it helps a lot.
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If I'm already in a full migraine mode, it is unthinkable. So here we have a different
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vision. The time, is it happening during the prodrome or during the migraine attack itself?
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The third person says, my migraine goes away when I'm doing the deed but comes back to collect with
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interest when I'm done. So here we're talking about the feeling or what happens smoother during,
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but then it's a lot worse after, which is something I've read a lot. Then someone says the exact
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opposite, hurts more during but way better after, is what the person says. And then another one,
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really interesting, sex makes it better but self-pleasure makes me want to die. It feels like
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my brain is going to explode. I need to explain this to my urologists, but I'm kind of embarrassed.
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So I thought, you know, let's save that person the embarrassment and have a conversation here.
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So can sex actually relieve migraine? And so we're going to start with the surprising part,
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and it is a big yes. Yes for some people, sexual activity appears to relieve migraine pain,
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because we always want to refer to some science over here. In 2013, so a while ago,
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a study published in Cephalalgia, a leading, as you know, scientific journal dedicated to
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headache disorders, found something very fascinating. Among people with migraine who
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had experienced sexual activity during an attack, 6 in 10 reported some improvement,
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but approximately 1 in 3 reported feeling worse. I want to insist in that study, because when I go
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on Reddit online, it looks like the trend should be reversed. Now it looks like the same activity
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with two completely different outcomes, and it does raise a fascinating question.
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Why would the migraine brain respond so differently to the same or actually similar experiences?
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And so one possible explanation from a Western science point of view, because here you're going
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to see East and West take very different stand on this, involves how brain processes pleasure
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and pain. You see, your brain isn't simply receiving pain signals. It's also constantly
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regulating how strongly those signals are experienced. And pleasure is part of that story.
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So during sexual activity, especially orgasm, the brain activates systems involved in excitement,
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in reward, and in pain regulation. And so researchers have suggested that natural pain
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regulating chemicals, including endorphins, might contribute to the relief in some people.
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So that's one Western explanation for that relief.
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Now there's another side to this. There's the fact that sex also involves physical
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exertion. So your heart is going to increase, your breathing changes, your muscles contract.
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And for some people, those changes may be uncomfortable, particularly if their head
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is already sensitive. And of what I read, for some people, discomfort can come during or after,
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depending on what puts them in or out of balance. So perhaps the question isn't simply whether sex
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is good or bad for migraine. Perhaps the most useful question is what is happening in your body
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on the days when intimacy feels good, compared with the days when it doesn't. And that is where
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your individual patterns become really interesting and really important to understand.
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Now, before we go further, there's an important distinction I want to make. Because sometimes
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sexual activity does not just coincide with a migraine attack. It can trigger a different
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kind of headache altogether. There's a recognized condition in Western science called primary
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headache associated with sexual activity. It's a type of primary headache disorder brought on by
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or occurring exclusively during sexual activity, including intercourse or masturbation,
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and the absence of any underlying brain or vascular disease. So this is called primary
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headache associated with sexual activity. If it helps you, this is a diagnosis. It does exist.
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And so according, again, to Western science, this is happening. Now, traditional Chinese medicine
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would have other explanations and other naming for this. I hope it can give a pathway for some
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of you. Now, what if sex isn't always the whole story? What if you were already exhausted? What
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if your neck was already dense? And we know that migraine can begin changing how you feel before
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the headache itself starts. And sometimes what looks like a trigger may actually be happening
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during the early stages of an attack. It doesn't mean sexual activity cannot trigger a headache.
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It can, but it means the timing and the surrounding circumstances deserve attention. And this is what
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we heard in the Reddit testimonials where people report they're in a prodrome phase or in an acute
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attack phase. Now, there's another side of the conversation that I think deserves so much
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attention. And that is what migraine does to your intimate life. Not just physically,
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but emotionally. Because imagine living with a brain that can become overwhelmed by light, sound,
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smell, touch, or physical activity. Imagine never being quite sure when your next attack would
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arrive. Now, imagine bringing all of that uncertainty into your relationship. Because
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migraine doesn't just interrupt your plans. Sometimes it changes how comfortable you feel
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in your own body. You may love your partner. You may want intimacy. But after a day of nausea,
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of sensory overload, of exhaustion, even a gentle touch might feel just like too much.
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And sometimes the anticipation of pain becomes a burden of its own. So you might be avoiding
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intimacy because you're afraid of triggering an attack. Your partner might misunderstand,
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and you might feel guilty. And little by little, something that should bring pleasure and
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connection becomes another source of worry. There's something I really want you to hear.
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You can love your partner and desire your partner and still not have the physical capacity for
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intimacy on a particular day. Those things can be true all at the same time. And understanding
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that distinction can make an enormous difference. Now, as I mentioned to you at the beginning,
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my little sister once gave me an advice. So here's the context. She decided, as she was
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well into work and relationships, that she wanted to study sexuality. So she took a course,
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a research course, at university for a year. And when she was finishing it, I said, hey,
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anything interesting? Like, you know, is there any hack or any, I don't know, surprising fact?
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And here's what she shared. She says, well, a man is usually excited by a woman visually. I mean,
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it's a sexual relationship, of course. And the woman is excited by herself. And I thought it
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was really, really puzzling. Just take a little bit of time to think about what I'm saying as
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I'm saying it. So the man is excited by the woman. OK, clear, nice, sharp, understandable.
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And then the woman is excited by the idea of herself. And once you know that little hack,
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you know how to be turned on, you actually need not to think of your partner, but to think of
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yourself. I'm just going to leave it at that and leave your imagination go. And maybe once your
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partner wants intimacy and you don't have a migraine and you're not afraid of having one,
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but you're also not in the mood, you know, this is a little hack to change your mood and to
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gain some intimacy for the days when you don't feel like having some. I'm just going to leave
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it out there. Now, let's look at things from a completely different angle, from an Eastern
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perspective, from traditional Chinese perspective, because traditional Chinese medicine has a rather
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interesting and very different way of looking at headaches, particularly when they appear during
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sexual activity. And I want to introduce you to two concepts that we haven't really explored in
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this podcast before and in this way before, meridians and blood stasis. So we're going to
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start with meridians. So in traditional Chinese medicine, many of you will know meridians are
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pathways through which things circulate. So what this is called the Qi, the energy and the blood.
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And they're not the same thing as blood vessels or nerves, but they can be in part. And practitioners
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are going to use these pathways as a kind of a map connecting different areas of the body and
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looking at where symptoms appear together. And when we are talking about sex and headache, one
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pathway, for example, very interesting is the liver meridian. So traditionally, the liver meridian
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begins at the big toe and is going to travel up all the way inside the leg, which can be a very
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arousing part of the female body. And then it passes through the groin and around the external
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genital region before entering the lower abdomen. And I'm sorry, I'm going to have to confess today,
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I have a little cold and my voice is not as normal as it should be. And it's a Sunday,
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I've decided to record the podcast in spite of my little runny nose. And I apologize because
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I really feel a runny nose does not add to the topic. So bear with me. I'm a mom of two and
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my son came back with a little bug. This bug is just going through me. So we're back. So we have
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the big toe all the way to the entering the leg, lower abdomen. And from there,
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it's traditional pathway is going to continue upward through the body and it's going to pass
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through the throat. It's going to connect with the eyes, with the eyebrows, reach the forehead,
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and ultimately the top of the head is going to meet the governing vessel. We're going to
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add that in a minute. So within the traditional transmission model, there's actually one continuous
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pathway is connecting the genital region, the lower abdomen, the liver, the eyes, and the head.
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And so that makes it particularly interesting when we're thinking about symptoms that appear
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during sexual activity. And so within the traditional transmission framework,
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symptoms appearing simultaneously in the genital region and the head would not necessarily be
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considered unrelated events. In traditional transmission, things are rarely hurting in
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isolation and it's a myriad of indications that health points in the direction of the
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root cause of the problem and therefore explain the pattern. Now, there's another path worth
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mentioning here called the dumai or the governing vessel. And traditionally, parts of this pathway
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begins in the lower abdomen and perineal region and then travel all along the spine. So on the back
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of the body and it continues through the back of the neck, enters the head, around the occipital
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region, travels toward the vertex or top of the head. And suddenly, this becomes quite interesting
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for someone describing a sexual headache that begins with increasing pelvic and muscular
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activation and then appears in the back or top of the head. Again, it's a traditional map, not a
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description of modern anatomy, but it gives us a much more coherent way of thinking about the
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relationship between the pelvis and the head. And there's another important traditional
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transmedicine concept, the concept of blood stasis. So in traditional transmedicine, blood stasis
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describes a pattern in which movement of the blood is considered obstructed or insufficiently
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smooth. Now, it does not mean that an artery is blocked or that someone has a blood clot,
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not necessarily. It can be much lower stakes than that. But traditionally, blood stasis tends to be
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associated with pain that is particularly fixed, is particularly intense, or sometimes described
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as stabbing. And sex is interesting in this context because sexual arousal is a moment of
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significant physiological activation. The heart rate rises, the blood pressure changes, the blood
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flow to the genital tissue increases, and muscles through the pelvis, the abdomen, the neck, and
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other parts of the body contract. And around orgasm, these changes can become particularly
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intense. And so traditional transmedicine was paying attention to where the symptoms occurred,
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which regions seem to become involved together, whether pain was fixed or moving, and what was
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happening in the body when the pain appeared. And in the particular case of headache during
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sexual activity, the traditional liver and governing vessel pathways give us a much more
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relevant example of that way of thinking than simply looking at the location of the headache
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alone. So rather than looking at the moment when the headache appears, it encourages us to consider
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the broader pattern that preceded it. Now, in traditional transmedicine, sexual activity is
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part of health, not as more is better, but just finding balance and having a bit of a frequency
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because a lot of these pathways need to be activated, they need to be unblocked, they need
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to be smooth and flow. And so my invitation is to tinker with that and think about intimacy and
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movement in that zone as something that is healthy and good for the body, good for the mind, but in
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a way that needs to feel comfortable. And so an invitation with creativity to find your space of
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happiness in that territory. Because intimacy doesn't always have to lead to sex, and sex
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doesn't always have to lead to orgasm. You can have connection without all of that. And when
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you're living with Margaret, understanding your body's patterns, it can help you make those
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choices with just greater confidence. It's really the path of the middle. You know, I used to be
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such a perfectionist. I mean, not a perfectionist, I don't know, a type A. And I realized sometimes
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as a type A, you can send yourself through the wall. And sometimes by tinkering and you're in
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the middle lane, it's not that you're going slower, it's actually you're steadier. Because
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you're steadier, you don't make progress super fast, but you also don't send yourself into the
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wall. And so over time, you go further, you go longer, you build endurance, and you build a
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system that can build on itself. And by having a few positive experiences that are sexually or
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intimacy related, restoring pleasure, restoring comfort, restoring safety. Safety is so important.
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Experiencing an intimate relationship with safety, and that makes it more pleasurable. And therefore,
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things can be built on top of that, if that makes sense. Because I want to finish on something very
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personal. When you do live with margarine, so much of your life can become around avoiding pain.
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You plan around it, you negotiate with your body, you cancel things that you were looking forward to,
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and sometimes without even realizing it, you begin avoiding the few experiences that bring you joy,
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and that include intimacy, and that can include intimacy. But you deserve more than a life
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organized around your next margarine attack. You deserve affection, you deserve pleasure,
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you deserve tenderness, laughter, and connection. And if your intimate life has changed because of
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margarine, I want you to know that it matters. It's not superficial, it's not embarrassing,
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it's part of your health through your relationships and your quality of life.
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You don't have to force your body to behave the way it did before margarine, and you don't have
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to force yourself to meet someone else's expectations. You can begin by listening,
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by noticing what feels comfortable, what doesn't, what changes from one day to another,
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and perhaps little by little, replacing some of that fear with curiosity. Because your body may
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need different things on different days, and understanding those differences can help you
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make choices that feel right for you. The goal isn't simply to have fewer margarines,
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the goal is to have more of your life back. Now, one thing I have observed over the years
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is that partners often end up loving what we do. At the beginning, they can be a bit skeptical,
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like margarine hero's method, it sounds almost too good to be true, because it's simple,
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we just add fruits. And I think some of the partners initially think, well, okay,
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one more thing to try, that seems way too simple. If you want to discover what we do,
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you can go on margarinehero.com. But then something changes, fundamentally,
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their partners start to feel better. She has more energy, she's less afraid of the next margarine,
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she feels more like herself again. And suddenly, they become some of our biggest supporters,
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and I was never asking questions about sex, so I can't tell you whether that was part of it,
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but perhaps there's something in the old saying we used all the time in New Zealand,
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happy wife, happy life. That's all for today,
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I hope this episode helped you notice some new things. If you'd like to keep exploring
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your patterns, you can find us on margarineheroes.com. Your body has a story to tell,
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let's keep listening. I will be back with you soon.
