[26F] Experiencing nausea, fatigue, and new onset severe headaches

Patient Description

A 26-year-old female is reporting new onset headaches that are intermittent and exacerbated by light and noise. The headaches are located at the front and back top of the head and can last a few hours if Tylenol is not taken. Accompanying symptoms include nausea, fatigue, sluggishness, muscle aches, acne, and oily skin. The patient is not currently pregnant and has not experienced these types of headaches in the past.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Migraine: This is a type of headache characterized by throbbing pain, typically on one side of the head, and can be accompanied by nausea and sensitivity to light and sound.

    • Treatment typically involves over-the-counter or prescription medications to relieve symptoms and prevent future attacks.
  • Tension headache: This is the most common type of headache, often described as a constant band-like pain around the head. It can be associated with muscle tension and stress.

    • Treatment usually involves pain relievers, stress management, and sometimes antidepressants.
  • Hormonal changes: Given your age and sex, hormonal changes related to your menstrual cycle could be causing your symptoms. Hormonal changes can cause a variety of symptoms including headaches, nausea, and changes in the skin.

    • Treatment can involve hormonal contraceptives or other medications to manage symptoms.

Please note that these are only possibilities and not a definitive diagnosis. You should consult with a healthcare professional for an accurate diagnosis and treatment.

What you can do

Here are some general suggestions that might help:

  1. Over-the-counter pain relievers: Non-prescription medications such as ibuprofen or acetaminophen can help relieve headache pain.
  2. Rest and relaxation: Try to rest in a dark, quiet room. This can often help with migraines and tension headaches.
  3. Hydration: Make sure you're drinking enough water. Dehydration can contribute to headaches.
  4. Avoid triggers: If certain activities or situations seem to trigger your headaches, try to avoid them if possible.

What you should look out for

You should seek immediate medical attention if:

  • Your headache is severe and sudden (like a "thunderclap")
  • You have a headache accompanied by a high fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or difficulty speaking
  • You have a headache after a head injury
  • Your headache is getting progressively worse over days or weeks
  • Your headache is unlike any you've had before

Remember, this advice is intended to be general in nature, and specific causes may not apply to your personal circumstances. Always consult with a healthcare professional for accurate information.

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11 mo ago

People Also Ask


What are the common symptoms of a migraine?

Common symptoms of a migraine include throbbing or pulsing pain, usually on one side of the head, sensitivity to light and sound, nausea, and sometimes vomiting. Some people also experience visual disturbances known as auras.


How can hormonal changes affect headaches?

Hormonal changes, particularly those related to the menstrual cycle, can lead to headaches due to fluctuations in estrogen levels. These changes can also cause other symptoms like nausea, fatigue, and changes in skin condition.


What are some effective treatments for tension headaches?

Effective treatments for tension headaches include over-the-counter pain relievers like ibuprofen or acetaminophen, stress management techniques, regular physical activity, and sometimes prescription medications such as antidepressants if headaches are frequent.


When should I seek medical attention for a headache?

You should seek medical attention for a headache if it is severe and sudden, accompanied by symptoms like a high fever, stiff neck, confusion, seizures, or if it follows a head injury. Also, if the headache is progressively worsening or unlike any you've had before, it's important to consult a healthcare professional.


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