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This case report describes one case of an adolescent with an eating disorder and migraine headaches who reported masturbation as a relieving factor for her migraines. Sexual history poses as a challenging topic for adolescents overall. A therapeutic relationship and non-judgmental approach are important in gathering a thorough history to maximize care. It is imperative to ensure an appropriate sexual history is obtained and then re-evaluated when care management appears ineffective. Patients are more likely to offer more information when therapeutic, trusting and non-judgmental relationships are established.