What is sex headache?

Sex headache, known as coital cephalgia, is a rare type of severe headache that occurs at the before orgasm during sexual activity, as well as masturbation. It may come like a dull ache in the head and neck that builds up as sexual excitement increases. Or, more commonly, it may come as a sudden, severe headache just before or during orgasm.

Most sex headaches are nothing to worry about. But some can be a sign of something serious, such as problems with the blood vessels that feed your brain.

How common is sex headache?

It is most common for men to experience these headaches for the first time in their early 20s, or between the ages of 35-44; the reason for this is unclear.

Sex headache is more common in men than women, by a ratio of approximately 3:1; these headaches appear in roughly 1% of the population. However, it is suggested that the rate of occurrence may be higher due to the awkwardness of speaking with a health care provider about the disorder, especially in situations where the problem seem to resolve on its own after a few days.

Up to 10% of patients taking medication for erectile dysfunction may experience these headaches. It is important to see a doctor if you have such symptoms in order to rule out the presence of more serious problems like brain aneurysm, or tumors.

Symptoms

There are two types of sex headaches.

The most common variety:

• Gives no warning and occurs within a few seconds of an orgasm
• Is often described as throbbing or stabbing

The other variety of sex headache:

• Often begins as a dull ache on both sides of the head
• May cause tightening of the neck and jaw muscles
• Builds gradually over a matter of minutes before an orgasm
• Intensifies as sexual excitement increases

Most sex headaches last at least several minutes. Others may linger for a few hours. Many people who have sex headaches will experience them in clusters over a few months and then go for a year or more without having any sex headaches.

Causes

Any type of sexual activity that leads to orgasm can prompt sex headaches.

Abrupt-onset and slow-to-build sex headaches can be primary headache disorders not associated with any underlying condition.

Sex headaches that come on suddenly are more likely to be associated with:

• A widening or bubble in the wall of an artery inside your head (intracranial aneurysm)
• An abnormal connection between arteries and veins in the brain (arteriovenous malformation) that bleeds into the spinal fluid-filled space in and around the brain
• Bleeding into the wall of an artery leading to the brain (dissection)
• Stroke
• Coronary artery disease
• Use of some medications, such as birth control pills
• Inflammation from certain infections

Sex headaches associated with loss of consciousness, vomiting, stiff neck, other neurologic symptoms and severe pain lasting more than 24 hours are more likely to be due to an underlying cause.

Risk factors

Sex headaches can affect anyone. But risk factors for these headaches include:

·  Being a man

·  Being prone to migraine headaches

Tests and diagnosis

Diagnosis may involve undertaking the following test:

.   Brain imaging

This might be recommended by your health care provider

·  Magnetic resonance imaging (MRI). An MRI of the brain can help detect any underlying causes for your headache. During the MRI exam, a magnetic field and radio waves are used to create cross-sectional images of the structures within your brain.

·  Computerized tomography (CT). In some cases, especially if your headache occurred less than 48 hours beforehand, a CT scan of your brain may be done. CT uses an X-ray unit that rotates around your body and a computer to create cross-sectional images of your brain and head.

.  Angiograms

Your doctor may also order a cerebral angiogram, a test that can show the neck and brain arteries.

.  Spinal tap

Sometimes a spinal tap (lumbar puncture) is needed as well — especially if the headache started abruptly and very recently and brain imaging is normal. With this procedure, the doctor removes a small amount of the fluid that surrounds your brain and spinal cord. The fluid sample can show if there's bleeding or infection.

Treatments and drugs

In some cases, your first sex headache may also be your only one. Some sex headaches improve rapidly, so the pain is gone before any pain reliever can work. Because of reports that engaging in sex soon after experiencing a sex headache can cause even worse pain, you may be advised to refrain from sexual activity until your last headache has completely resolved.

Preventive medications

For individuals who have history of sex headache with no obvious cause, some medication can be recommended. These may include:

·  Daily medications. Beta blockers, for example, propranolol. These are used to treat high blood pressure, coronary artery disease and migraines and may be taken daily to prevent sex headaches. They're recommended only if you have frequent or prolonged attacks.

·  Occasional medications. An anti-inflammatory drug such as indomethacin can be taken an hour before sex to ward off headaches.

Prevention

Sometimes sex headaches can be prevented by stopping sexual activity before orgasm. Taking a more passive role during sex also may help

Outcome

The outcome of sex headache is encouraging if well managed.