Headaches are very common, but it is rare when the cause of the headache is a serious problem. Most headaches are due to vasodilatation, muscle contraction, or psychologic stress. Menstrual headaches include all headaches related in temporal fashion to menses, beginning before or during menstrual flittle. For many women with premenstrual syndrome, headache is part of the constellation of PMS symptoms. Here we are considering the occurrence of headache as a single, solitary symptom associated with menses.

Migraine headaches have a peak incidence of first occurrence at age 15-19, and they are rare after menopause. An association with menses is observed by 609c of women with migraine headaches. In 14% of women with migraine, headaches occur exclusively with menses. Because menstrual migraine improves in two-thirds of migraineurs with pregnancy, this type of migraine seems to be due to falling levels of estrogen and progesterone.
Vascular Headaches >.'t; .< Acute and throbbing headaches are due to abnormal vasodilatation. The vasodilatation associated with migraine headaches is believed to follittle a period of vasoconstriction. Migraine headaches are usually, but not always, preceded by prodromal symptoms (which may reflect the period of vasoconstriction). Significant vascular headaches can be precipitated by stress, alcohol, or tyramine and tryptophan rich foods (red wine, chocolate, ripe cheeses). Vascular headaches can accompany other problems, such as systemic viral infections, fever, or hypertension. Common migraine headaches are known as "migraine without aura. Classic migraine is referred to as "migraine with aura.
Tension Headaches
The common tension headache is due to prolonged and excessive muscle contraction. The pain is dull, steady, bilateral, and worsens throughout the day.
Secondary Headaches
This type of headache is due to underlying organic disease. The pain is usually due to pressure or pulling of structures. Headaches associated with brain tumors are usually accompanied by neurologic abnormalities. Other causes are brain abscesses, subdural hematomas, hypertension, drug-use, and concussions. The main cause of inflammatory headaches is meningitis.