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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31326
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Lately I've been have insomnia head aches and along with

Customer Question

Hi lately I've been have insomnia head aches and along with that hot flashes
JA: Is the headache episodic or daily? Any nausea along with the headache?
Customer: I do suffer from migraines and yes feeling nausea
JA: Please give me a bit more information, so the Doctor can help you best.
Customer: I'm currently 27 my boyfriend and I have been ttc for the past 2 months I've been feeling nauseous lately I took a pregnancy test this morning it came out negative
JA: Is there anything else the Doctor should be aware of?
Customer: No
JA: OK. Got it. I'm sending you to a secure page on JustAnswer so you can place the $5 fully-refundable deposit now. While you're filling out that form, I'll tell the Doctor about your situation and then connect you two.
Submitted: 4 months ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 4 months ago.

I am Dr. Arun and will be helping you today.

Do you have fever, body-ache, loss of appetite, weight loss?

Are these headache different than the migraine headaches?

Any significant past medical history or family history?

Were any investigations done for your present symptoms?

Customer: replied 4 months ago.
No I haven't had fever. I some times don't feel like eating. I have been sleepy lately I rather sleep than do anything else I have noticed I can easily sleep 12-15 hours. I've had worse migraines my whole family suffers from migraine and I was detected I suffer from migraines since the age of 10. I am currently trying to conceive to have a child this is our third month trying. I did notice my menstrual period only lasted 2 days this month I took a pregnancy test this morning which came out negative. If my pregnancy test is correct of me being negative I am currently beginning my fertile window going into ovulation.
Expert:  Dr. Arun Phophalia replied 4 months ago.

Thanks for the further information.

Following is the impression by the information you have provided;

1) You have migraine which seems to have aggravated.

2) Sleep issues

3) Fertility

4) Stress, anxiety related to above all and may be some other issues too.

I would take the fertility or trying for conception issue first. Please do not stress over it. It is a natural phenomenon and would happen spontaneoulsy. Any stress or anxiety can change the hormone subtly and in act may delay it. So counsel is to enjoy and let the nature takes its own course.

Now coming to migraine. You may not be taking any medicine for it because of your pregnancy. I understand medicine can harm the baby so none of them be entirely safe. But if these headaches are affecting your quality of life seriously, you may consider some of the medicine.

There are two types of medications used for the treatment of migraine;

1) To abort the attack


Dopamine antagonists



2) To prevent the headache


Valproic acid, gabapentin

Calcium channel blockers

Beta-blockers, tricyclic antidepressants

There are dietary triggers known which should be avoided. Common triggers are

a) chocolate,

b) aged cheeses and meats,

c) wine and beer

d) citrus fruits.

Preventive medicines for migraine may be safe so you can talk to your doctor about it.

A physical illness is uncommon with the sleep issue. An off and on sleeplessness need to dig the cause for underlying anxiety, depression or other related issue. A thorough evaluation by the history is done to reach to a conclusion. Accordingly the medical treatment is commenced. The precipitating factors can be;

1) depression,

2) anxiety,

3) sleep-wake schedule changes,

4) medications,

5) other sleep disorders,

6) medical conditions

7) work-related issues

8) family problem,

9) health events.

All these in isolation or in combination play problems in sleep issues. Good sleep cycle, handling the specific problem, counseling, cognitive-behavioral therapy, medications are employed for the treatment.

Following measures are helpful;

1) Avoid if you do;

a) caffeine or alcohol use,

b) environmental noise,

c) inappropriate room temperature,

d) watching TV in bed.

e) avoid large meals in dinner.

2) Relaxation techniques

3) Acupressure and acupuncture.

Anxiety and stress can be treated by following;

Anxiety can be treated by the following measures by yourself;

1) Cognitive-behavioral therapy (CBT) and operant-behavioral therapy (OBT); done by a psychologist.

2) Relaxation training and biofeedback.

3) Hypnosis

4) Acupuncture and acupressure

5) Yoga

6) Meditation

7) Group sporting activities

8) St. John's wort

9) Melatonin
10) Valerian root.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Expert:  Dr. Arun Phophalia replied 4 months ago.

I am not sure, if your hormonal evaluation is done or not. Hormonal problems can cause all of your symptoms, including hot flashes. So following work up would be advised;

1) FSH

2) LH

3) Estradiol

4) T3, T4, TSH

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.

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Thank you.

Wishing you all the very best in life.

Expert:  Dr. Arun Phophalia replied 4 months ago.

Thank you for the opportunity to answer completely your Question. Please make sure to rate me because that is how I am credited and paid for my work.

Now, I will provide an Additional Service offer so that you have this option available on your question list to get a hold of me directly in the future.

This additional service offer can be used for

- if you would like to schedule a new, private email session or to ask me directly a new question. It's up to you.

Thank you.