Q. I have pain in the left side of the head due to symptoms of forced menopause. Why?

Answered by
Dr. Hitesh Kumar
and medically reviewed by Dr. Chithranjali Ravichandran
This is a premium question & answer published on Apr 09, 2021

Hello doctor,

I have pain in the left side of the head. It starts when I sleep because of hot flashes and palpitation due to forced menopausal (hysterectomy).



Welcome to icliniq.com.

I would like to know some further details about headache:

1. Since when you started to have these headaches? How many years or months? And since when you had menopause?

2. In which part of the head you feel headaches? (You can attach your photo, clicked from a little distance, with the hand kept over part of the head, where you feel headache. Can attach 2 to 3 photos from front sides if headache area is large).

3. What kind of headaches you feel - heaviness or bursting or squeezing or stretching or throbbing or some other kind?

4. Headache is episodic or persistent? If episodic, one episode of headache lasts for how long duration (without pain killer tablet)?

5. Do you feel any nausea or vomiting during a headache episode?

6. Is headache associated with any redness in the eyes or watering from eyes or nasal blockage?

7. Have you noticed any specific trigger factor or timing for this headache till now?

8. How frequent were these headaches nowadays? (how many times in a month/ week)

9. How is the intensity of headaches - mild or moderate or severe?

10. Do you take some medicine (SOS or regularly) for your headaches or post-menopausal symptoms? If yes, please tell the name of the medicines, dosage, and how many times you take them? Also, please tell me other medications which you are on?

11. How is your vision in routine time- for distant objects for near objects?

12. Has you undergone a CT scan or MRI for headaches or other tests? If yes, please send their reports as an attachment.

Other information:

1. How is your sleep routine? - Do you get sleepy soon after lying in bed? Or does it take a long time? - Once got sleepy, do you have frequent awakenings during sleep? - Do you feel fresh on awakening from sleep in the morning?

2. How is your usual mood in day-to-day activities? Happy or toward the sad side (thinking about past events) or the worried side (thinking about future things or irritable or something else)?

3. How is your appetite?

Regarding follow up:

Revert with above mentioned information for better understanding and further judgement.

Hi doctor,

The pain started two days from now. I got my hysterectomy operation. I have attached the picture. It is a throbbing headache. It is persistent but not so painful. Episodic pain comes when I move my head. I do not feel any nausea and vomiting. No redness in my eyes, not watery, and no nasal blockage. There is a lack of sleep that causes headaches. I also cannot sleep because of my hot flashes and palpitation once in a while. It is not frequent, and headache only occurred when I cannot sleep. It is moderate to severe, moderate if I did not move my head. I took only B complex for this pain Pharex B1, B6, B12. Yesterday, until now, my vision looked normal, with near-sightedness. I did not go to any laboratory. Sometimes it took me a long time to sleep. Mostly I woke up two times to go to the comfort room. Sometimes I woke up with chest pain. I am happy in my day-to-day activities, and I do not think about any worries. My appetite is good. I eat well.

Thank you.



Welcome back to icliniq.com.

As per your description, this is a new onset acute headache for two days (without any past history of headaches). The described hot flushes are associated with palpitations and sleep disturbance with a history of chest pain in the morning, which may point toward the possibility of anxiety and panic attack too. The headache may be related to lack of sleep, but being a new-onset headache must rule out some other organic causes.

Investigations to be done:

MRI Brain with MR angiogram and MR venogram with contrast.
Ophthalmologist consultation to look for refraction, IOP (intraocular pressure), Fundus.
ECG (electrocardiogram).
2D Echocardiography or Stress echocardiography.
Holter Monitoring.
Serum Vitamin B12.
FT3 (free triiodothyronine), FT4 (free thyroxine), TSH (thyroid stimulating hormone).
Trop I (troponin test).
CPK- MB (creatine phosphokinase-MB).
Cardiology consultation for palpitation and chest pain.

Treatment plan:

For time being you can try some pain killers medications (Tablet Naproxen 500 mg BD for three days) for symptomatic relief.
Side by side need detailed evaluation or investigations to try to find cause for headache or chest pain and palpitations.

Regarding follow up:

Review SOS.

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