Q. I am a chronic migraine headache sufferer since the age of 15. I was assured that once I went through menopause it would all go away. I have now reached that age, and while they have reduced, I still have at least one migraine per week. However, I now experience another type of headache on a daily basis. This type of headache does not respond to drugs. The pressure I feel on my head when lying down for more than a few hours, no matter what type of pillow or mattress, gives me a headache. This has led to restless sleep and reduced performance at work and even the need to call in sick.

Have you ever heard of this? Is this normal for headache sufferers?

A. The development of “new” or “different” headaches in a post-menopausal woman or older gentleman provides a measure of concern for those of us who specialize in headaches. The absence of a response to medication also is a bit disquieting. This presentation is not particularly compatible for a post-menopausal migraine variant and should trigger further testing to determine the root cause.

Although these headaches may be merely secondary to some mechanical compression of nerves in your upper neck or skull base from degenerative disease—arthritis, for example—a brain scan and other testing are necessary to exclude more ominous options. I would advise you contact your physician with these complaints as soon as possible.

Robert Kaniecki, MD
Director of The Headache Center and Chief of Headache Division, Assistant Professor of Neurology at the University of Pittsburgh

To locate a headache specialist in your area, check out the NHF’s Physician Finder on our Web site, www.headaches.org. The NHF also has free lists of physician members for most states. Call 1-888-NHF-5552 to get a copy.

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