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Consult your doctor if:

* Your symptoms last longer than 10 days
* You have a severe headache, and over-the-counter pain medicine doesn’t help
* You have a fever greater than 100.5 F (38 C)

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Sinusitis can affect anyone. You may be more likely to develop chronic sinusitis if you have:

* Asthma
* Nasal growths (polyps)
* Allergies to dust, mold or pollen
* A weak immune system
* A condition that affects the way mucus moves within your respiratory system, such as cystic fibrosis.

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Sinusitis can be caused by colds, allergies, bacterial or fungal infections, an impaired immune system, or structural problems in the nasal cavity. The resulting pressure changes in the sinuses can trigger headaches.

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Sinus headache symptoms may include:

* Pain, pressure, and fullness in your cheeks, brow or forehead
* Pain may worsen when you bend forward or lie down
* Yellow-green or blood-tinged nasal discharge
* Sore throat
* Fever
* Cough
* Fatigue

So what’s the confusion with migraines? The signs and symptoms of the two types of headaches often overlap. Migraine pain often gets worse when you bend forward, and migraines can be accompanied by various nasal signs and symptoms — including congestion, facial pressure and a clear, watery nasal discharge.

Sinus headaches, however, usually aren’t associated with nausea or vomiting, or aggravated by noise or bright light — all common features of migraines.

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You’re congested. You feel pressure around your eyes, cheeks and forehead. And your head is throbbing. It feels like a sinus headache — but don’t jump to conclusions.

Headaches often accompany sinusitis, a condition in which the membranes lining the sinuses become swollen and inflamed. But many people who assume they have sinus headaches actually have migraines or tension headaches.

When headaches caused by sinusitis do occur, proper diagnosis and treatment are the keys to relief.

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Any type of sexual activity that leads to orgasm — including masturbation, oral sex and intercourse — can trigger sex headaches.

The types of sex headaches that build up for several minutes before orgasm might be caused by tightening the head and neck muscles during sexual activity. The variety of sex headaches that occur abruptly at orgasm may be a response to increased blood pressure that causes the cerebral blood vessels to dilate.

The abrupt variety of sex headache may also be caused by a stroke or bleeding into or around the brain.

Other factors that have been associated with sexual headaches include:

* Birth control pills
* Smoking marijuana
* Glaucoma
* Anemia
* Sinus infection
* Low blood sugar

Risk factors

Sex headaches can affect anyone. But they’re more common in men and in people who are prone to migraines.

When to seek medical advice

Sex headaches aren’t usually a cause for concern. But you should consult your doctor if you experience headaches during sexual activity — especially if it’s your first headache of this type.

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Exercise headaches:

* Are usually described as throbbing
* Occur during or after strenuous exercise
* Affect both sides of the head in most cases

Secondary exercise headaches may also include:

* Vomiting
* Double vision
* Neck rigidity

Primary exercise headaches typically last between five minutes and 48 hours, while secondary exercise headaches usually last at least a day and sometimes linger for several days or longer.

Causes

The exact cause of primary exercise headaches is unknown. One theory is that strenuous exercise dilates blood vessels inside the skull.

Secondary exercise headaches are caused by an underlying problem, such as:

* Bleeding in the area between the brain and the thin membranes that cover the brain (subarachnoid hemorrhage)
* Abnormalities in a blood vessel leading to or within the brain
* Cancerous or noncancerous tumors
* Intermittent obstruction of cerebrospinal fluid flow
* Reduced blood flow in the arteries feeding the heart
* Sinus infection

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Q: I get sudden nausea and dizziness to the point where I feel like I will faint. During these “spells” I also seem to get very flushed and weak. It’s happened on/off for at least the last 1-2 year and I haven’t been able to pinpoint what precipitates this. I’m a 30 year old female with no known health problems–just got a physical in Sept. and labs didn’t show anything unusual. I eat very healthy and exercise 4-5x/wk.

A: There are other causes which would include a sudden drop in blood pressure but your description sounds to be the below condition. A more prominent problem with dizziness is called vertigo and this can be severe and recurring. It is often an inner ear infection or calcium buildup that is floating in the ear canal.

I would suggest to watch your situation and should this recur again then see your primary for any needed treatment. Most likely though this was caused by allergies or blocked sinus. You may have a condition known as Benign vestibular Vertigo orparoxysmal positional vertigo.

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A headache in the face, cheeks, forehead, or around the eyes that comes on during a “cold,” or when the nose is congested and runny or filled with mucus, is probably a “sinus headache”: one caused by sinus infection. Another kind of sinus headache is the one that occurs in the sinus areas during descent (landing) in an airplane, especially if you have a cold or active allergy (this is called a vacuum headache).

Unfortunately there are many other causes of headaches that can be confused with sinusitis. For example, migraine and other forms of vascular or “tension” headaches also give pain in the forehead and around the eyes, and they may even cause a slight stuffy-runny nose. But they are more likely to come and go away in a day or so without a physician’s treatment, whereas sinusitis usually gives a headache that lasts for days or weeks until it is treated with antibiotics. Furthermore, intermittent headaches that cause nausea and vomiting are more typical of a migraine-type headache than sinusitis. Severe, frequent, or prolonged headaches deserve a visit to a physician for diagnosis and treatment.

What will a doctor do for my sinuses?

Your physician will ask you questions about your breathing, the nature of your nasal mucus, and the circumstances (time of day or seasons) that give you symptoms. Be prepared to explain your headaches: When and how often they occur, how long they last, and if they are associated with nausea, vomiting, vision changes, or nasal congestion. An otolaryngologist-head and neck surgeon is the kind of physician who will especially examine your ears, nose, mouth, teeth, and throat with particular attention to the appearance of your nasal membranes and secretions. He/she will check for deformities of your nose that impair breathing and for tenderness over your sinuses. X-rays of your sinuses might be needed.

Treatment will depend on the diagnosis that your physician establishes, Infections may require either antibiotics or surgery or sometimes both. Acute sinusitis most likely will improve on medication, but chronic sinusitis more often requires surgery. If your symptoms are due to allergy, migraine, or some other disease that mimics sinusitis, your doctor will have alternative treatment plans.

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