Through centuries in the medical and popular literature women have been associated with migraines and have borne a "neurotic" label. Although many men are affected with headaches clearly women are three times more often affected with migraines than man. This is clearly due to hormonal changes.

Many women have a definite "menstrual" or "catamenial" headaches and this is caused by falling levels of estrogen during the late phase of the normal menstrual cycle. In many women taking the combined oral contraceptive pill experience migraine during the pill-free week, when estrogen falls after 21 days of high levels. During pregnancy when estrogen levels gradually rise migraine can improve but can recur immediately post partum.

In addition to Estrogen other chemicals in the body such as the "Prostaglandins" are responsible of some of the symptoms during menstruation such as headaches, nausea, vomiting and mood changes. Menstrual migraine should be treated with medication, light food and sleep. For women who have regular periods and regular "menstrual" migraines should receive "prophylactic treatment" (to prevent the occurance of headaches), using nonsteroidal anti-inflammatory drugs (NSAIDs). In severe cases hormonal treatment is necessary.

Headache is also a common side effect of oral contraceptive use, in many cases migraine attacks relate to the pill-free week. Such attacks are usually resolved by altering the ratio of estrogen to progesterone, taking three packets without a break or using estrogen supplements during the pill-free week.

Tension Type eadache
Tension Type Headache (TTH) is much more common than Migraine and also affects women more than men. 80-90% of women will experience a common tension-type headache in their life. Only a minority will consult a Doctor and is usually relieved with over the counter analgesics and NSAI. Occasionally can be disabling, usually caused by tension, stress, poor sleep, depression and anxiety are common.

Carpal Tunnel Syndrome (CTS)
Another neurological condition in which woman are affected three times as often as man is denominated the carpal tunnel syndrome where a nerve (called the median nerve) is "pinched at the wrist" and causes pain, numbness and tingling in the hand or thumb. Many times patients wake up at night with the arm "numb" and have to shake it to relieve the symptoms. Driving, holding things or doing manual labor can bring on the symptoms during the day. Initially the symptoms are sporadic, but with time, the frequency increases.

The great majority of patients with CTS are associated with tenosynovitis (inflammation of the wrist ligaments) the diagnosis is usually confirmed by nerve conduction studies and the treatment usually is bracing the wrists every night and using non steroidal anti-inflammatory drugs (NSAIDs).

Chronic Fatigue Syndrome (?Fibromyalgia, Myofascial pain)
This is a very controversial problem characterised by diffuse muscle aches, pains, chronic sleeping problems and tender points. It affects mainly women and psychological factors may play an important role. The medical literature has not found a cause for this syndrome and other more serious causes of fatigue have to be excluded in order to make a definite diagnosis ("Diagnosis of exclusions"). It is generally treated with physiotherapy, sleep hygiene, anti-depressive medications, muscle relaxants, pain medications and non steroidal anti-inflammatory medications (NSAI).