[34F] Experiencing daily headaches with fatigue

Patient Description

A 34-year-old female presents with daily headaches that have been occurring for 1.5 weeks. The headaches are described as a pressure-like sensation in the forehead and temples, with an intensity of 6 out of 10. The pain is worse in the morning and evening but persists throughout the day. Light sensitivity is noted, but there is no nausea, vomiting, or muscle tenderness. The headaches started gradually over 3 days and are somewhat alleviated by Advil, which she has been taking two to three times per day since the onset of symptoms. The patient also reports fatigue. She has a medical history of Type I Diabetes diagnosed in 2002, exercise-induced asthma diagnosed in 2010, and eczema diagnosed in 2020. Current medications include Humalog 100 units/ml daily, triamcinolone cream used every other day, and Vitamin D 5000 IUs daily. The patient recently had a Nexplanon implant. No known drug allergies or other medications reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Tension Headache: This is the most common type of headache and is often described as a constant pressure or tightness around the forehead or back of the head and neck. It can be associated with stress, lack of sleep, poor posture, or eye strain.

    • Treatment typically involves over-the-counter pain relievers like ibuprofen (Advil), which you've mentioned provides some relief. Other strategies include rest, relaxation techniques, and regular exercise.
  • Medication Overuse Headache: This type of headache can occur in people who frequently use medications to relieve headaches. Over time, the body adapts to the medication, and when the medication wears off, a headache occurs (a rebound effect).

    • Treatment involves reducing or stopping the overused medications under the supervision of a healthcare provider.
  • Hormonal changes due to Nexplanon: Nexplanon is a hormonal contraceptive implant that releases a type of progestin. Changes in hormone levels can sometimes trigger headaches and fatigue.

    • If this is the cause, the symptoms may improve as your body adjusts to the new hormone levels. However, you should discuss this with your healthcare provider.

What you can do

  1. Continue to monitor your symptoms. If your headaches persist or worsen, seek medical attention.
  2. Try to identify any potential triggers for your headaches, such as stress, lack of sleep, or certain foods or drinks. Avoiding these triggers may help reduce the frequency or severity of your headaches.
  3. Practice good posture, especially if you sit at a desk for long periods. Regular breaks and stretching can help prevent tension headaches.
  4. Stay hydrated and maintain a healthy diet. Dehydration and skipping meals can trigger headaches.
  5. Regular physical activity can help prevent headaches. Try to incorporate some form of exercise into your daily routine, such as walking, cycling, or yoga.

What you should look out for

Seek immediate medical attention if you experience:

  • A sudden, severe headache like a thunderclap
  • Headache with a fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or speaking difficulties
  • Headache after a head injury, especially if the headache worsens
  • A chronic headache that is worse after coughing, exertion, straining, or a sudden movement
  • New headache pain if you're over 50

Please remember that while I strive to provide accurate information, I'm an AI and not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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9 mo ago


People Also Ask


What are the common causes of tension headaches?

Tension headaches are often caused by stress, lack of sleep, poor posture, or eye strain. They are characterized by a constant pressure or tightness around the forehead or back of the head and neck.


Can taking Advil frequently lead to more headaches?

Yes, frequent use of pain relievers like Advil can lead to medication overuse headaches, where the body adapts to the medication, and headaches occur when the medication wears off.


How can hormonal changes from Nexplanon affect headaches?

Hormonal changes from Nexplanon, a hormonal contraceptive implant, can sometimes trigger headaches and fatigue as the body adjusts to new hormone levels. These symptoms may improve over time.


What lifestyle changes can help reduce the frequency of headaches?

Lifestyle changes such as maintaining good posture, staying hydrated, eating regular meals, managing stress, and incorporating regular physical activity like walking or yoga can help reduce the frequency of headaches.


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