Is it a Migraine Headache or
a Bad Tension-Type Headache?

Compared with migraine, tension-type headache is generally less severe and rarely disabling. Compare your symptoms with those in this chart to see what type of headache you might be having.

Migraine vs. Bad Tension-Type Headache

Symptom	Tension	Migraine
Intensity and quality of pain
Mild-to-moderate	x	x
Moderate-to-severe		x
Intense pounding or throbbing and/or debilitating		x
Distracting, but not debilitating	x
Steady ache	x	x
Location of pain
One side of head		x
Both sides of head	x	x
Other symptoms
Nausea, vomiting		x
Sensitivity to light and/or sounds	rare	x
Aura before onset of headache		x

Note: Rebound headache may have features of tension and/or migraine headache

Although fatigue and stress can bring on both tension and migraine headaches, migraines can be triggered by certain foods, changes in the body’s hormone levels, and even changes in the weather.

There's differences in how types of headaches respond to treatment with medicines. Although some over-the-counter drugs used to treat tension-type headaches sometimes help migraine headaches, the drugs used to treat migraine attacks do not work for tension-type headaches for most people.

You can't tell the difference between a migraine and a tension-type headache by how often they occur. Both can occur at irregular intervals. Also, in rare cases, both can occur daily or almost daily.

How can I tell if I have a Migraine or a Sinus Headache?

Many people confuse a Sinus Headache with a migraine because pain and pressure in the sinuses, nasal congestion, and watery eyes often occur with migraine. To find out if your headache is sinus or migraine, ask yourself these questions:

In addition to my sinus symptoms, do I have:

• moderate-to-severe headache
• nausea
• sensitivity to light

If you answer “yes” to two or three of these questions, then most likely you have migraine with sinus symptoms. A true sinus headache is rare and usually occurs due to sinus infection. In a sinus infection, you would also likely have a fever and thick nasal secretions that are yellow, green, or blood-tinged. A sinus headache should go away with treatment of the sinus infection.

When should I see a Doctor for my Headaches?

Sometimes, headache can signal a more serious problem. You should talk to your doctor about your headaches if:

• you have several headaches per month and each lasts for several hours or days
• your headaches disrupt your home, work, or school life
• you have nausea, vomiting, vision, or other sensory problems (such as numbness or tingling)
• you have pain around the eye or ear
• you have a severe headache with a stiff neck
• you have a headache with confusion or loss of alertness
• you have a headache with convulsions
• you have a headache after a blow to the head
• you used to be headache-free, but now have headaches a lot

What tests are used to find out if I have Migraine Headaches?

If you think you get migraine headaches, talk with your doctor. Before your appointment, write down:

• how often you have headaches
• where the pain is
• how long the headaches last
• when the headaches happen, such as during your period
• other symptoms, such as nausea or blind spots
• any family history of migraine
• all medicines you are taking for your medical problems, even over-the-counter medicines ( bring medicines in their containers to the doctor)
• all the medicines you have taken in the past that you can recall and, if possible, the doses you took and any side effects you had

Your doctor may also do an exam and ask more questions about your health history. This could include past head injury and sinus or dental problems. Your doctor may be able to diagnose migraine just from the information you provide.

You may get a blood test or other tests, such as CT scan or MRI, if your doctor thinks that something else is causing your headaches. Work with your doctor to decide on the best tests for you.

Are Migraine Headaches more common in Women than Men?

Yes. About three out of four people who have migraines are women. Migraines are most common in women between the ages of 20 and 45. At this time of life women often have more job, family, and social duties. Women tend to report more painful and longer lasting headaches and more symptoms, such as nausea and vomiting. All these factors make it hard for a woman to fulfill her roles at work and at home when migraine strikes.

I get Migraines right before my period. Could they be related to my menstrual cycle?

More than half of migraines in women occur right before, during, or after a woman has her period. This often is called “menstrual migraine.” But, just a small fraction of women who have migraine around their period only have migraine at this time. Most have migraines at other times of the month as well.

How the menstrual cycle and migraine are linked is still unclear. We know that just before the cycle begins, levels of the female hormones, estrogen and progesterone, go down sharply. This drop in hormones may trigger a migraine, because estrogen controls chemicals in the brain that affect a woman’s pain sensation.

Talk with your doctor if you think you have menstrual migraine. You may find that medicines, making lifestyle changes, and home treatment methods can prevent or reduce the pain.

Can Migraine Headaches be worse during menopause?

If your migraine headaches are closely linked to your menstrual cycle, menopause may make them less severe. As you get older, the nausea and vomiting may decrease as well. About two-thirds of women with migraines report that their symptoms improve with menopause.

But for some women, menopause worsens migraine or triggers them to start. It is not clear why this happens. Menopausal hormone therapy, which is prescribed for some women during menopause, may be linked to migraines during this time. In general, though, the worsening of migraine symptoms goes away once menopause is complete.

Can using birth control pills make my Migraines worse?

In some women, birth control pills improve migraine. The pills may help reduce the number of attacks and their attacks may become less severe. But in other women, the pills may worsen their migraines. In still other women, taking birth control pills has no effect on their migraines.

The reason for these different responses is not well understood. For women whose migraines get worse when they take birth control pills, their attacks seem to occur during the last week of the cycle. This is because the last seven pills in most monthly pill packs don’t have hormones; they are there to keep you in the habit of taking your birth control daily. Without the hormones, your body’s estrogen levels drop sharply. This may trigger migraine in some women.

Talk with your doctor if you think birth control pills are making your migraines worse. Switching to a pill pack in which all the pills for the entire month contain hormones and using that for three months in a row can improve headaches. Lifestyle changes, such as getting on a regular sleep pattern and eating healthy foods, can help too.

Can Stress Cause Migraines?

Yes. Stress can trigger both migraine and tension-type headache. Events like getting married, moving to a new home, or having a baby can cause stress. But studies show that everyday stresses—not major life changes—cause most headaches. Juggling many roles, such as being a mother and wife, having a career, and financial pressures, can be daily stresses for women.

Making time for yourself and finding healthy ways to deal with stress are important. Some things you can do to help prevent or reduce stress include:

• eating healthy foods
• being active (at least 30 minutes most days of the week is best)
• doing relaxation exercises
• getting enough sleep

Try to figure out what causes you to feel stressed. You may be able to cut out some of these stressors. For example, if driving to work is stressful, try taking the bus or subway. You can take this time to read or listen to music, rather than deal with traffic. For stressors you can't avoid, keeping organized and doing as much as you can ahead of time will help you to feel in control.