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.
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.