Orgasmic and Sex Headaches


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Coital Headache Treatment

There are two types of sexually-associated headaches: pre-orgasmic headache, and orgasmic headache, or post-coital headaches. Other names sometimes used for sex headaches are orgasmic cephalgia, coital headache, or orgasmic migraine. (Not everyone with this type of headache has migraines.)

Orgasmic headaches have been thought to be a variant of exercise-induced headache, at least in some cases. However, any type of sexual activity that leads to orgasm, including oral sex and masturbation, has been associated with headaches.

Sex headaches occur in 3% to 4% of sexually active men, and a slightly lower number of women. A small survey (176 people) done by the National Headache Foundation found that 46% of those surveyed reported having had sex headaches, however over 1/3 had only had six such headaches. Having another type of headache (migraine, tension-type headache, and exertional headache) increases the risk of developing sex headaches. It should be noted that medications used to treat erectile dysfunction (Viagra®, Cialis®, and Levitra®) can also cause headache as a side-effect.  

Pre-orgasmic headaches are a dull ache in the head and neck, associated with awareness of tight neck and jaw muscles during sexual activity, that increases during increasing sexual excitement. This bilateral headache builds slowly and can become more intense a few minutes before orgasm.  

Post-coital headache is a sudden, severe, explosive headache occurring at orgasm. Understandably, this can be quite alarming the first time it occurs. Although it is probably not a sign of something serious, it is best to see your doctor to make certain. Occasionally, this type of headache does herald a potentially serious problem. About 78% of sex headaches are post-coital headaches—the abruptly occurring kind. The co-occurrence of migraine is more common with this type of sex headache. There are both episodic and chronic forms of sex headaches. About 75% are the episodic kind, and 25% are the chronic kind. Prognosis is best if you only have a few attacks.

Sex headaches—should I be worried?

What's going on with your head, anyway? In most cases, the pain is caused by blood pressure changes or changes in blood vessel diameter. In rare situations, though, this headache is caused by blood leaking out of a blood vessel and into your brain at the time of this headache. This can be due to weakness in the blood vessel wall. This is why anytime you experience the worst headache of your life, or if you have had the first sex headache or "thunderclap headache," you should be evaluated to rule out a serious condition.

Once you have seen a doctor to rule out a potentially serious problem, treatment may be offered. If orgasmic headache happens infrequently, it can often be prevented with prescription-strength nonsteroidal anti-inflammatories. If you are in an episode with frequent occurrences, or if you experience the chronic form of sex headache, preventive medications can reduce the severity of your symptoms. Beta blockers and calcium channel blockers have been found to be effective.

References:

2. Biehl K, Evers S, Frese A. Comorbidity of Migraine and Headache Associated With Sexual Activity. Cephalalgia, 2007:1271 -1273 vol. 27: Available at: http://cep.sagepub.com/cgi/content/abstract/27/11/1271
3. Cutrer FM, Boes CJ. Cough, exertional, and sex headaches. Neurol Clin. 2004;22(1):133-149. Available at: http://www.ncbi.nlm.nih.gov/pubmed/15062531
4. Pascual J, Iglesias F, Oterino A, Vazquez-Barquero A, Berciano J. Cough, exertional, and sexual headaches: An analysis of 72 benign and symptomatic cases. Neurology. 1996;46(6):1520-1524. Available at: http://www.neurology.org/cgi/content/abstract/46/6/1520
5. Frese A, Rahmann A, Gregor N, et al. Headache Associated With Sexual Activity: Prognosis and Treatment Options. Cephalalgia, 2007:1265 -1270 vol. 27: Available at: http://cep.sagepub.com/cgi/content/abstract/27/11/1265
6. Lance JW. Headaches related to sexual activity. Journal of Neurology, Neurosurgery & Psychiatry. 1976;39(12):1226-1230. Available at: http://jnnp.bmj.com/content/39/12/1226.abstract
7. Evans RW, Pascual J. Orgasmic Headaches: Clinical Features, Diagnosis, and Management. Headache. 2000;40(6):491-494. Available at: http://www3.interscience.wiley.com/cgi-bin/fulltext/119034583/main.html,ftx_abs
8. Redelman MJ. What if the ‘sexual headache’ is not a joke? British Journal of Medical Practitioners. 2010;3(1):304. Available at: http://bjmp.org/content/what-if-sexual-headache-not-joke
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