What can cause recurring headaches?

DEAR DOCTOR K:

I’m a 47-year-old woman. Lately I’ve been getting headaches several times a week. Should I see a doctor?

DEAR READER:

I think anyone who is having frequent headaches can benefit from medical attention. That’s especially true if they’re interfering with your ability to function. I’m assuming that you have not been bothered by frequent headaches earlier in your life. In a person who’s 47 and is having frequent headaches for the first time, it is very important to get them evaluated.

Headaches are rarely signs of a serious disease, like a brain tumor. But once in a while they can be. These “red flag” signs should lead you to call your doctor sooner rather than later, if your headache:

  • is accompanied by neurological impairment, such as difficulty speaking, seeing or walking;
  • slowly but relentlessly gets worse over weeks or months;
  • is accompanied by constant, severe, throbbing pain in the temple region;
  • awakens you at night, is present on awakening, and improves when you get out of bed;
  •  feels like a blow to the head;
  •  is accompanied by fever and a stiff neck.

When you see your doctor, be prepared to describe your headaches in detail:

  • If you haven’t had headaches before, when did these recurring headaches start?
  • Where in your head do you feel them?
  • How often do they occur?
  • How long do they last?
  • How severe are they? (Are they so severe you can’t really function?)
  • What brings them on or makes them worse?
  • What relieves them; in particular, do any medicines help?
  • Are there major stresses in your life?
  • What other symptoms, if any, do you have along with the headaches?
  • Do other people in your family get headaches frequently?

Your answers to these questions can help your doctor determine what type of headaches you are having and how best to treat them.

Your physical exam should include a blood pressure check. Your doctor should look inside your eyes with an ophthalmoscope, which can detect signs of a brain tumor. Your doctor may also check for telltale signs of certain types of headaches, such as tender areas at the back of your head.

Since you’re over age 40, also see an ophthalmologist. Glaucoma can cause headache-like pain. So can squinting from eyestrain. Simply getting new glasses can help.

To exclude more serious causes, your doctor may perform imaging tests such as a computed tomography (CT) scan or a magnetic resonance imaging (MRI) scan.

We have more information on diagnosing and treating headaches in our Special Health Report, “Headaches.” You can learn more about this report here.