Contrary to the popular cliché, "Not tonight, I have a headache," new research suggests that not all headache sufferers avoid sexual activity. In fact, migraine sufferers reported higher levels of sexual desire than those with other types of headaches, according to researchers from Wake Forest University School of Medicine and colleagues.

"Our study suggests that sexual desire and migraine headaches may be influenced by the same brain chemical," said Timothy Houle, Ph.D., lead author and research assistant professor of anesthesiology. "The results support the idea that migraine, as a syndrome, is associated with other common phenomena. Understanding of this link will help us to better understand the nature of migraine and perhaps lead to improved treatment."

The research, involving 68 young adults from Chicago, will appear in an upcoming issue of Headache, published by the American Headache Society, and already is available on line.

The objective of the study was to examine the relationship between migraine headache and self-reported sexual desire. There is evidence of a complex relationship between sexual activity and headache. Both sexual desire and migraine headache have been linked to levels of serotonin, a brain chemical that also plays a role in depression. An excess of serotonin may be associated with decreased libido, and migraine sufferers are reported to have low system levels of the brain chemical. Serotonin has also been found to play a role in migraine attacks.

"Considering the circumstantial evidence linking both migraine and sexual desire to serotonin, we wanted to explore whether the two phenomena are actually related," said Houle.

The researchers hypothesized that abnormalities in the serotonin systems of migraine sufferers may influence their sexual desire. Because high levels of serotonin are associated with low sexual desire, and migraine sufferers have low levels of the chemical, it was predicted that they would report higher levels of sex drive.

The study involved 68 participants who reported having at least 10 headaches a year. Their mean age was 24 years. Participants underwent interviews to diagnose their headache type -- either migraine or tension -- and filled out a 14-item questionnaire to measure sexual desire.

Males reported levels of sexual desire that were 24 percent higher than females. Migraine sufferers reported levels of sexual desire that were 20 percent higher than those suffering from tension headaches. Females with migraines had levels of sexual desire similar to males who had tension headaches.

"The study demonstrated that migraine patients in general may experience higher levels of sexual desire than others," said Houle. "They appeared to be aware of this, rating their sex drive as being higher than others their age and gender."

He said the results suggest that a serotonin link may be implicated in both migraine headaches and sexual desire.

"This opens the door to consider other phenomena that have a similar neurochemical basis," he said. For example, there is an increased prevalence of depression in people with migraine, which is also theorized to be modulated by serotonin.

Houle said future research should focus on whether a cluster of migraine characteristics or symptoms can serve as markers of an altered serotonin system. Although the current study was not able to address whether the link may apply to middle-age or older adults with migraines, Houle said the finding appears to be quite general and is likely to be found in older patients as well.

Co-researchers were Lara K. Dhingra, Ph.D., from Memorial Sloan-Kettering Cancer Center, Thomas A. Remble, M.A., from Rush University Medical Center, Lori A. Rokicki, Ph.D., in private practice in Toledo, Ohio, and Donald B. Penzien, Ph.D., from the University of Mississippi Medical Center.

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