Love, Intimacy, and Migraine: How to Stay Connected When You Live With Migraine

Migraine affects far more than head pain. It impacts energy, mood, confidence, schedules, and relationships — including love, intimacy, and dating. Yet this is one of the least talked-about aspects of living with migraine.

In a recent live interview, I sat down with Dr. Dawn Buse, PhD, a licensed psychologist, migraine researcher, and clinical professor of neurology, to have an honest conversation about how migraine affects intimacy, partnerships, and dating — and how people with migraine can stay connected without guilt or pressure.

Below, I’ve woven Dr. Buse’s insights and quotes directly from our conversation into an educational, compassionate guide for anyone navigating love and migraine.

How Migraine Impacts Love and Intimacy

Migraine is a neurological disease with episodic attacks — and those attacks don’t just last for a few hours.

As Dr. Buse explains:

“The whole migraine attack is much longer than people may think about… There’s the prodrome before the pain, the headache phase, and the postdrome after. People can feel tired, irritable, washed out, and not themselves for days.”

During migraine attacks, intimacy often feels impossible. Sensitivity to light, sound, smell, touch, and movement can make even gentle stimulation overwhelming.

“That’s not going to be a time when someone wants to think about being intimate, unless it’s something very gentle — like kindness, sitting together, or a touch on the arm.”

Even between attacks, migraine can still affect desire, energy, and confidence.

“Some people feel entirely back to normal between attacks, while others still have lingering symptoms like light sensitivity, cognitive fog, or skin pain.”

This unpredictability alone can strain relationships — especially when guilt enters the picture.

Migraine Guilt and Relationship Strain

Many people with migraine feel guilty about canceling plans, needing rest, or not being as emotionally or physically available as they want to be.

Dr. Buse is clear:

“Migraine is not your fault. You didn’t choose it. You didn’t sign up for this. It’s a neurologic disease with a genetic predisposition that strikes when it wants to.”

That guilt can quietly push intimacy to the bottom of the priority list.

“People come out of a migraine attack and think, ‘I’ve missed work, chores, family time — I need to catch up.’ Intimacy is not usually forefront of mind.”

But relationships thrive on connection — not perfection.

Redefining Intimacy When You Live With Migraine

One of the most important mindset shifts Dr. Buse encourages is broadening the definition of intimacy.

“We put a very high bar on what we think of as intimacy, but there’s a whole range — from holding hands, kind words, sitting together, all the way to sexual activity.”

Intimacy doesn’t have to mean intercourse or even sexual arousal.

Small, consistent moments matter:

• Hugs and hand-holding

• Sitting quietly together

• Affectionate texts

• Acts of care

• Emotional closeness

“Those little daily moments are intimacy too.”

This lower-pressure approach helps people with migraine stay connected even during high-symptom periods.

Migraine, Libido, and Fear of Triggering Pain

A common concern is whether sexual activity can worsen migraine.

“Some people worry that movement or exertion — including sex — might bring on head pain or make it worse.”

This fear even has a name:

“We call it ‘cephalophobia’ — fear of doing something that might trigger a headache.”

The key is flexibility and choice.

“You and your partner can modify what you do in any way. Intimacy exists on a wide spectrum.”

There is no single “right” way to be intimate with migraine — only what feels safe and supportive for you.

Communication Is the Foundation

Whether you’re in a long-term relationship or newly dating, communication matters more than pushing through symptoms.

For committed partners:

“A lot of partners are actually happy to hear this topic brought up. You can say, ‘I miss feeling close. How can we modify things so we still connect within my physical limits?’”

This opens collaboration instead of blame.

“Talking about it is the first step — and often the hardest one.”

Scheduling Intimacy (Yes, Really)

Many people with migraine struggle with bedtime intimacy because sleep schedules are non-negotiable.

Dr. Buse reframes the idea of planning:

“Intimacy doesn’t have to happen at bedtime. It can happen anytime.”

While scheduling may sound unromantic, it can be supportive.

“Making time and space is actually something both people can look forward to — even if plans sometimes have to change.”

The same goes for non-sexual connection:

“Planning fun, silly, or enjoyable activities together is just as important.”

Dating With Migraine: When and How to Share

Dating with migraine comes with unique fears — especially around canceling plans or being misunderstood.

Dr. Buse recommends a simple, honest explanation early on:

“Practice a one-minute explanation of migraine that feels comfortable. Explain it’s a disease, it comes with many symptoms, and sometimes plans need to change.”

This helps set expectations — and boundaries.

“If someone shuts down immediately, that’s probably not a good partner for someone living with migraine.”

Sharing migraine early isn’t a burden — it’s self-respect.

“You are not less than because you have migraine. You are a full person who also has migraine.”

Migraine-Friendly Dating and Activities

Rather than focusing on what you can’t do, Dr. Buse suggests leading with what does feel good.

“Offer activities you enjoy instead of just listing sensitivities. Take the lead.”

Low-key, migraine-friendly options might include:

• Walks

• Quiet cafes

• Museums at off-peak hours

• Cooking together

• Time at home

This approach builds connection without unnecessary symptom flares.

A Love Prescription for People With Migraine

Dr. Buse offers a powerful reframe:

“I’d like to write you a prescription for your relationship: intimate time is as important as getting your chores done.”

Connection supports emotional health — and migraine management.

“What brings you joy, pleasure, and relaxation should be a priority too.”

Living with migraine already requires strength, adaptability, and resilience.

“Be gentle with yourself. You are holding a lot together while living with a chronic, unpredictable disease.”

Finding Support Beyond the Migraine Attack

Living with migraine often means spending so much energy just trying to get through the day that relationships, pleasure, and connection quietly slip to the bottom of the list. That doesn’t mean they aren’t important — and it doesn’t mean you’re failing.

As Dr. Buse reminds us throughout this conversation, migraine is not your fault. It’s a neurological disease, not a personal shortcoming. And while migraine may change how intimacy looks, it does not take away your need — or your right — to love, closeness, and meaningful connection.

When intimacy is approached with flexibility, communication, and self-compassion, it can become another form of support rather than another source of pressure. Sometimes that means redefining what closeness looks like. Sometimes it means talking openly with a partner or practicing honesty early in dating. And sometimes it means getting help so you don’t have to navigate all of this alone.

A Gentle Invitation: Beyond Migraine Coaching

If migraine is impacting your relationships, your sense of self, or your ability to enjoy your life fully, Beyond Migraine Coaching was created for you.

Beyond Migraine is a mind-body coaching program that integrates:

• Nervous system regulation

• Pain reprocessing therapy principles

• Yoga and somatic practices designed specifically for migraine

• Emotional support for the real-life impacts of migraine — including relationships, identity, and burnout

This work isn’t about pushing through pain or forcing positivity. It’s about helping your migraine brain feel safer, supported, and less on high alert — so you can reclaim more ease, connection, and confidence in your life.

If you’re ready to explore a more compassionate, whole-person approach to migraine, you’re warmly invited to learn more about Beyond Migraine Coaching.

This article is based on a live interview with Dr. Dawn Buse, PhD, clinical professor of neurology and migraine researcher, and Adriane Dellorco, founder of Yoga for Migraine.  You can watch the full interview here on YouTube.