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In some instances, sexual activity, particularly reaching orgasm, can cause headaches. As sexual excitement increases, you might feel a dull pain in your head and neck, or you might experience a sudden, severe headache just before or during orgasm. Although most headaches related to sexual activity are benign, some can signify more serious conditions, such as issues with the blood vessels that supply the brain.
Symptoms
Sex headaches come in two types:
- A dull painin the head and neck that escalates with heightened sexual arousal.
- An abrupt, severe, throbbingheadache that arises just before or during orgasm.
In some cases, individuals might experience both types of sex headaches together. These headaches usually last for several minutes, though some can linger for hours or even a few days. Many people who experience sex headaches do so in clusters, happening frequently over a few months, followed by long periods with no headaches. Approximately half of those affected by sex headaches experience them for about six months. Others might only have a single episode in their lifetime.
While sex headaches are generally not worrisome, it’s crucial to consult a healthcare provider if you encounter a headache during sexual activity, especially if it’s sudden or the first time you’ve experienced such a headache.
Causes
Sex headaches can be triggered by any sexual activity that leads to orgasm.
Headaches that emerge suddenly or develop gradually can be primary headache disorders, meaning they are not connected to any underlying health issue. However, sudden-onset headaches related to sexual activity are more likely to be associated with:
- An abnormal link between arteries and veins in the brain (arteriovenous malformation) that bleeds into the spinal fluid-filled region in and around the brain.
- An enlargement or bubble in the wall of an artery inside your head (intracranial aneurysm).
- Dissection, bleeding into the wall of an artery that supplies the brain
- The constriction of brain arteries, known as reversible cerebral vasoconstriction syndrome.
- Coronary Artery Disease (CAD)
- Stroke
- Inflammation caused by specific infections
- Certain drugs, like birth control pills
Sex headaches accompanied by loss of consciousness, vomiting, stiff neck, other neurological symptoms, or severe pain lasting more than 24 hours are more likely to be caused by an underlying condition.
Risk factors
Sex headaches can impact anyone, but certain risk factors include:
- Gender. Sex headaches are more common in men.
- Migraine history. Sex headaches are more likely to occur in those who are prone to migraines.
Diagnosis
It’s likely that your doctor may advise:
Brain imaging
- Magnetic Resonance Imaging (MRI). A magnetic field and radio waves are employed during the MRI test to provide cross-sectional images of the brain’s structure. A MRI can assist in identifying any underlying reasons why you are experiencing headaches.
- Computerized tomography (CT). CT creates cross-sectional images of the brain using an X-ray machine that revolves around the body. A CT scan of the brain may be performed in certain circumstances, particularly if your headache started fewer than 48 to 72 hours prior.
- Magnetic Resonance Angiography (MRA) and Computerized Tomography (CT) angiography. These examinations show the blood vessels inside the brain and neck as well as those going to them.
Angiograms
Your healthcare provider might suggest a cerebral angiogram, a diagnostic test that helps visualize the arteries in the neck and brain. In this procedure, a thin, flexible catheter is inserted into a blood vessel, usually starting from the groin area, and is guided up to an artery in the neck. A contrast agent is then administered through the catheter, enabling an X-ray device to produce precise images of the arteries in the neck and brain.
Spinal tap
In some cases, particularly if the headache started suddenly and brain imaging shows no abnormalities, a spinal tap (lumbar puncture) might be required. During this procedure, a healthcare provider removes a small sample of cerebrospinal fluid—the fluid that surrounds the brain and spinal cord. Analyzing this fluid can help identify any signs of bleeding or infection.
Treatment
In some instances, your first sex headache may also be your last. Some sex headaches improve rapidly, with the pain subsiding before any pain reliever can take effect.
Preventive medications
If you have a history of sex headaches and there’s no underlying condition, your doctor might suggest that you regularly take preventive medications. Options could include:
- Daily prevention medications. Medications like beta blockers such as propranolol or metoprolol are recommended, especially for those experiencing frequent or prolonged attacks. These medications, commonly used for high blood pressure, coronary artery disease, and migraines, may help. Calcium channel blockers like verapamil hydrochloride, also used for high blood pressure, could be considered as well, particularly for individuals with a history of migraine. Other migraine preventive medications may also be used in such cases.
- Occasional prevention medications. Indomethacin, an anti-inflammatory drug, or a triptan, which is used for migraine relief, can be taken about an hour before sexual activity to help prevent headaches.
