I don't have cramps the way everyone else does. I'm all right at the time of my period, and I only feel them slightly during ovulation. My main problems are, headaches and backaches every month. I get a headache during ovulation and then about three days before my period. It's such a severe pain that I sometimes wonder if it's a migraine. I feel like King Kong is crushing my head in his hands and my eyes are about to explode. As soon as I start to bleed the headache stops, but then a backache takes over.

For the first two days of my period I have an excruciating pain at the base of my spine. My X-rays show nothing. One doctor put me on Darvon, another suggested a partial hysterectomy, and another said I had pain because of the way I'm built. I'm thirty-three years old and I don't want a hysterectomy. What can I do? There are so few days in a month when I feel good.

—Y.N.

Tarzana, California

It is not uncommon for women to have headaches before their periods. Estrogen, the female hormone, increases before menstruation. Estrogen binds salt which, in turn, binds water. Water tension pulls on the brain membrane and causes swelling and migraine headaches. A woman who suffers from headaches should cut down on her salt intake before her period, drink plenty of fluids to wash out her system, and she might even try diuretics.

The headaches are coming from a hormonal imbalance, before her period and during her ovulation. Birth control pills would regulate her hormones, so she might take them as long as she doesn't smoke or have diabetes or high blood pressure, and if she has her blood pressure checked twice a year. Also, vitamin B6 has been known to offer some relief from premenstrual tension. I would suggest that she take at least 50 milligrams of vitamin B6 every day to help her cope with the stress of her headaches and backaches. And on her most stressful days, she might double the dosage.

Nerves from the uterine area enter into the spine and often cause spinal and back pain. If a woman has a tilted uterus there is a definite pull on the nerves during menstruation. Birth control pills prevent a heavy buildup of the uterine lining and decrease the pressure on the uterine nerves to the spine. Painkillers don't treat the cause. For a doctor to suggest a hysterectomy without first examining this woman for a tilted uterus or prescribing medication that would reduce uterine pressure and menstrual flow, is absurd. If birth control pills are ineffective, Danocrine (danazol), an antihormone, might end some of the pain and discomfort she is feeling. Danocrine must be taken every day and could be continued for months to curb the menstruation.

However, if this woman exercises and keeps her body in shape, she may find that she will naturally lessen her flow and the pull on her nerves. Physically active women are known to have fewer aches and more moderate periods.

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Women's Health