This is a headache triggered by sexual activity. It is also called orgasmic headache.

What are the symptoms of headache with sexual activity?

Mainly, a headache as a person gets into sexual excitement or reaches an orgasm. It may develop slowly or quickly at orgasm. It is usually a whole head severe pain, but it can be mild to moderate. It may last for a few minutes to a day or two. In some ways, it is like exercise induced headache. It may not occur with every sexual experience and may disappear without any treatment.

 

What other conditions may cause a headache at orgasm?

At the time of orgasm, the blood pressure is high, and the arteries and veins of the brain are somewhat stretched or in spasm. In case of a brain aneurysm, it may cause a leak resulting in sudden severe headache, usually describes as the worst headache of life. In that case, the patient may also develop other symptoms, such as nausea, vomiting, or confusion. In some patients, arteries may excessively constrict or go into a spasm, which may cause brain ischemia. Cervical spinal stenosis, or Arnold-Chiari malformation may also cause this type of headache. The pain in these cases may be mostly in the back of head and neck.  

 

How is this headache diagnosed?

With its typical history, usually the diagnosis is easy to make. Depending upon the severity of headache and any associated symptoms, initially, every patient needs urgent evaluation to rule out any structural issues, especially an aneurysm. Usually, a brain scan is required. If an aneurysm is suspected and the scan is normal, a lumbar puncture may also be needed. If no structural cause is found, it is labeled as the primary headache with sexual activity or the orgasmic headache.

 

Is it dangerous to have sexual activity with this type of headache?

If there are no structural issues, especially an aneurysm, the risk is of getting a headache. Otherwise, it is not dangerous.

 

How is this headache treated?

In some cases, change in position during sexual act may be useful, e.g., assuming a more passive role. In many cases, it is a self-limiting condition, which means that it disappears on its own. If it does not, a medication can be considered. Indomethacin taken ½ an hour before the act may help. Alternatively, regular use of propranolol may also help.

 

Where may I get more information about orgasmic headache?

American Academy of Neurology

American Headache Society