Sexual activity — especially an orgasm — can trigger a headache. You may notice a dull ache in your head and neck that builds up as sexual excitement increases. Or, more commonly, you may experience a sudden, severe headache just before or during orgasm.
About one in 100 people will experience a sex headache at some point during his or her lifetime. Men are at least three times more likely than women to have sex headaches.
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.
Any type of sexual activity that leads to orgasm — including masturbation, oral sex and intercourse — can trigger sex headaches.
The types of sex headaches that build up for several minutes before orgasm might be caused by tightening the head and neck muscles during sexual activity. The variety of sex headaches that occur abruptly at orgasm may be a response to increased blood pressure that causes the cerebral blood vessels to dilate.
The abrupt variety of sex headache may also be caused by a stroke or bleeding into or around the brain.
Other factors that have been associated with sexual headaches include:
- Birth control pills
- Smoking marijuana
- Sinus infection
- Low blood sugar
Your doctor may recommend an MRI exam of the brain to detect any underlying causes for your headache. During the exam, a magnetic field and radio waves are used to create cross-sectional images of the structures within your brain.
Your doctor may also order a cerebral angiogram, a test that can visualize the neck and brain arteries. It involves threading thin tubing through a blood vessel, usually starting in the leg, to an artery in your neck. Contrast material is injected into the tubing to allow an X-ray machine to visualize the arteries in your neck and brain.
A less invasive version of this test uses MRI or CT, instead of threading a catheter through your blood vessels.
Sometimes a spinal tap (lumbar puncture) is needed as well — especially if the headache appeared suddenly. With this procedure, the doctor removes a small amount of the fluid that surrounds your brain and spinal cord. The fluid sample can be tested for evidence of bleeding or infection.
There are two types of sex headaches. The most common variety gives no warning and occurs within a few seconds of an orgasm. Pain 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 and builds gradually over a matter of minutes before an orgasm, typically intensifying as sexual excitement increases.
Most sex headaches last a few minutes. Others may linger for a few hours. Many people who have sex headaches will experience them in clusters for a few months, and then go for more than a year without any sex headaches.
In many cases, your first sex headache may also be your last one. And many sex headaches last for such a short period of time, the pain is gone before any pill you take 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.
If you have a history of sex headaches and there’s no underlying cause, your doctor may recommend that you take preventive medicine, such as:
- Indomethacin, an anti-inflammatory
- Triptans, a class of anti-migraine medication
- Beta blockers, such as propranolol or metoprolol
Indomethacin and the triptans can be taken an hour before sex to ward off headaches. The beta blockers must be taken daily to prevent sex headaches and are only recommended in patients with frequent or prolonged attacks.
Sometimes sex headaches can be prevented by stopping sexual activity before orgasm. Taking a more passive role during sex also may help.
Sex headaches can affect anyone. But they’re more common in men and in people who are prone to migraines.