Sex, orgasms, and headaches

(1) Dear Alice,

Several years ago I remember seeing an article in the Reader's Digest about men getting headaches after an orgasm, but cannot locate the article now. I was hoping you could provide some information on the subject. My husband has been experiencing this problem lately. He does have high blood pressure. Thanks for your help!

(2) Dear Alice,

I am a fifty-year-old woman who has an active sex life with her fiancé. This past weekend and once before in my life — about ten years ago — I experienced excruciating pain in my head as I was climaxing — pain building as I reached orgasm but not dissipating as quickly. The pain is as intense as a migraine and stays with me for some time after, leaving me almost in tears. Please tell me what can be causing this and how I can correct it.

Dear Readers,

According to the National Headache Foundation, for some people, sex with orgasm can cause two kinds of headaches:

Coital cephalalgia: This exertional headache occurs during sex. It develops when the blood vessels of the brain dilate and the muscles of the head and neck contract as a result of building anticipation in preparation for orgasm. This headache is usually benign and rarely associated with a serious health problem. Taking a non-steroidal anti-inflammatory drug (NSAID), such as aspirin or ibuprofen, could help relieve the pain of an exertional headache. However, see a health care provider if you also experience any of the following symptoms along with this type of headache, or if this head pain occurs more often than once in a while, because it could indicate a serious problem that needs to be looked at right away:

  • Very stiff neck
  • Nausea
  • Vomiting
  • Unconsciousness
  • Lasts between 5 minutes and 24 hours

Orgasmic cephalalgia or orgasmic headache: A type of vascular headache that occurs right before orgasm, regardless of how vigorous sex is or not, this intense, severe headache has the following characteristics:

  • Can be caused by elevated blood pressure
  • Usually affects more men than women
  • Affects those who are particularly susceptible to migraines
  • Felt usually around or behind the eyes
  • Persistent pain lasting from a few minutes up to several hours

Remaining still while having this kind of headache could help limit the pain.

Another way of classifying sexual headaches is the method that J. Nick, Ph.D. and P. Bakouche, Ph.D. devised. They separated coital headaches into 3 individual categories, split according to time of appearance of pain during sex:

  1. Early headache, which is usually moderate and short lasting;
  2. Orgasmic headache, described by a sudden severe burst lasting 15 to 20 minutes;
  3. Late headache, lasting for hours or days. These sometimes follow orgasmic headaches.

If you experience any other unusual symptoms, such as a stiff neck, see a health care provider for a check-up to rule out more serious disorders. These ailments may manifest themselves as a stroke, brain tumor, or bleeding in or around the brain.

If your health care provider determines that your headache is just a headache, then you may want to take an anti-migraine medication or beta-blocker that constricts blood vessels. If prescribed such a medication, taking one before having sex could help to prevent sexual headaches.

For more information, you can visit the National Headache Foundation website.

Last updated May 14, 2015
Originally published Feb 05, 1999

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