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Headaches are pretty common amongst people. Often they occur due to prolonged exposure to the screen (laptop or television screen) or due to lack of sleep. But have you ever heard of a headache which occurs during or after having sex?

Coital cephalalgia is a medical condition in which a person suffers from headaches related to sexual activity - that is, before, during or after an orgasm. This condition is mostly seen in men. 

Sex-related headaches can be very distressing - both for the person who gets them and their partner, as the affected person starts developing fear around sexual activity and orgasm. Some people may also develop patterns of decreased sexual arousal. In most of the cases, the condition is benign (non-cancerous and harmless) but in some people, it can be due to an underlying cause. 

Here in this article, we will tell you about the different types of sex headaches and what can be done to deal with them.

  1. Types of sex headaches
  2. Symptoms of sex headaches
  3. Causes of sex headaches
  4. Diagnosis of sex headaches
  5. Treatment of sex headaches
  6. Doctors for Sex headache

The International Headache Society has divided sex-related headaches into two major categories:

  1. Primary headache associated with sexual activity: This is further divided into:
    • Pre-orgasmic headache: This type of headache sets in before the orgasm. It can start during sexual activity and increase in intensity as sexual excitement rises. Symptoms include a dull ache in the head and neck, along with awareness of contraction in the muscles of the neck and/or jaw. This type of headache cannot be attributed to another disorder or underlying condition.
    • Orgasmic headache: Sudden severe (“explosive”) headache which occurs at the time of orgasming. This type of headache, too, cannot be attributed to another disorder.
  2. Secondary headache disorder: This type of headache is connected to spontaneous (or idiopathic) low CSF pressure. CSF or cerebrospinal fluid provides cushioning to the brain and spinal cord. When CSF pressure decreases, the brain can sag slightly, stretching the tissues and membranes that generally keep the brain in place. This stretching causes a headache.
    Low CSF pressure can be a serious condition that should be investigated by a medico as soon as possible.

The symptoms of sex-related headaches can vary:

  • Some people may complain of a dull ache in the head and neck that increases as sexual excitement increases.
  • Some people may complain of sudden, sharp, throbbing headache that happens just before or at the moment of orgasm.
  • Some people can experience both headaches before and during orgasm.

These headaches can either last for several minutes or can stay for hours or even two to three days. It is also seen that most of the patients with sex-related headaches also suffer from migraine.

If the person presents with the following neurological symptoms, they may require immediate medical assistance:

There is no certain cause of sex-related headaches. The majority of sex headaches, especially those which have an abrupt onset and slowly increase with time, have a benign origin and do not have any underlying condition. They are sometimes associated with migraines. 

However, the headaches which last for a longer period of time and are associated with a stiff neck, nausea and sometimes loss of consciousness may be caused by an underlying condition. Some of the underlying reasons for sex headaches could be:

The doctor may ask for a detailed history of the frequency and intensity of headaches. The doctor may prescribe you the following tests if they suspect any underlying condition:

  • Computed tomography scan of head:CT scan is done to check for any abnormalities in the skull, paranasal sinuses or brain.
  • MRI: A head MRI scan is done to find out the details of any injury or damage to the brain.
  • Lumbar puncture: Lumbar puncture is also known as spinal tap and it is done to find out any abnormalities in the cerebrospinal fluid.
  • Cerebral angiography: This test helps in finding any abnormalities and/or blockages in the blood vessels of the brain.
  • Urinary catecholamine: Catecholamines are released in excessive amounts in the body when there is any physical or emotional stress. Catecholamines in urine can also suggest a tumour in the body.

The treatment of sex-related headaches is done with the help of medications and self-management.

  1. Drug therapy for sex headaches
  2. Self-management for sex headaches

Drug therapy for sex headaches

Your doctor may prescribe certain drugs to prevent headaches related to sex:

  • Propranolol hydrochloride is one of the drugs which is has been effective in the prophylaxis (prevention) of sex headaches. 
  • Naratriptan is another drug which has been effective if taken 60 minutes prior to sexual activity.
  • Indomethacin is a drug which proves effective if taken 30-60 minutes prior to sexual activity. However, it can have serious gastrointestinal side-effects and has been intolerable to many people.
  • For those who have an intolerance to indomethacin, doctors may prescribe other triptans, ergots and benzodiazepines which can reduce the orgasmic headaches if taken 30 minutes before sexual activity. 
  • Painkillers such as ibuprofen, diclofenac, paracetamol and acetylsalicylic acid are of limited value after the onset of the headaches.
  • Some patients may require medications for a longer period of time. These patients are given indomethacin three times a day and propranolol, metoprolol and diltiazem once daily.

Self-management for sex headaches

People suffering from sex headaches can reduce the frequency of their headaches by making some modifications in their sex life.

  • People suffering from sex headaches must talk about their sexual fears with their partners to reduce their stress a little bit. If your partner doesn't know about your condition, it may lead to disappointment, resentment and more distress. So it is important to discuss your condition with your partner as soon as possible. (Read more: Tips for a healthy relationship)
  • If the person suffering from sex headaches has tension in their neck and jaw, they must keep the muscles of the neck and shoulders relaxed during sexual intercourse. (Read more: How to talk to your partner about sex
  • The person should do some relaxation exercises regularly which should concentrate on relieving neck and shoulder tension. These exercises can also be done before anticipating any sexual activity.
  • Your doctor may tell you and your partner about different sex positions that can help reduce the tension from your neck and shoulder during intercourse. 
  • Some people can tell early on if they are going to get a sex headache - before it begins. If they stop right then and do not pursue an orgasm at that point, they might not get the headache.
  • Doctors may also advise you to engage in intercourse more frequently but less strenuously to reduce the frequency of headaches. 
  • Some doctors advise that people with sex headaches should become sexually passive for a while. This might seem harsh but by stopping the sexual activity for a while or suppressing orgasm, you may be able to get rid of the headaches.
Dr. Virendra Kumar Verma

Dr. Virendra Kumar Verma

यौन चिकित्सा और वैवाहिक चिकित्सा

Dr. S.R. Raveendan

Dr. S.R. Raveendan

यौन चिकित्सा और वैवाहिक चिकित्सा

Dr. Maini Kailash

Dr. Maini Kailash

यौन चिकित्सा और वैवाहिक चिकित्सा

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References

  1. Margaret J Redelman. What if the ‘sexual headache’ is not a joke?. British Journal of Medical Practitioners. 2010;3(1):304
  2. Utku U. Primary headache associated with sexual activity: case report. Med Princ Pract. 2013;22(6):588-9.
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