Sexual Headaches: From Ecstasy to Agony
For years, partners have used headache as an excuse to avoid lovemaking. For some people, lovemaking causes the headache!
Forty-year-old Jack was making love to his wife when the pain exploded in his head. I felt as if someone had plunged an ice pick into the back of my skull, he reported to his doctor later. The pain lingered for about an hour, with no other symptoms, so Jack dismissed the episode as a fluke.
When the pain returned a few days later, once again as Jack was approaching orgasm, he could no longer ignore it. Was he about to die from an aneurysm? Was his sex life in danger of dying, too? The pain he'd experienced, though short-lived, was enough to make Jack fearful of making love again.
Though reluctant to discuss his sex life with his doctor, Jack made an appointment and described his symptoms. To his relief, the doctor was able to rule out a hemorrhage and other life-threatening conditions. He diagnosed Jack's pain as benign sexual headache, a lesser-known type of headache triggered by orgasm.
Physical and Psychological Effects
People suffering from benign sexual headache—also known as benign coital headache, orgasmic headache, or orgasmic cephalgia describe sudden, intense pain near or at the moment of orgasm. The pain remains intense for 5-15 minutes, though some people report pain lasting as long as several hours or two days. Pain can occur with intercourse or masturbation, and may happen infrequently, or every time a person approaches orgasm.
Benign sexual headaches can appear suddenly in persons who have never had them before, though persons with a history of migraines—particularly men over 40—seem more prone to them. Nevertheless, men and women of all ages have reported suffering from these peculiar headaches.
When the first headache strikes, the sufferer stops copulating or masturbating and rests quietly in agony, explains David C. Haas, MD, professor of neurology and headache specialist at State University of New York Health Science Center at Syracuse. Most are worried that they might have something seriously wrong in their heads, and many seek medical advice soon afterwards.
In addition to the pain of benign sexual headache, the experience can have a traumatic effect on your sex life. Imagine an invisible presence lurking in the bedroom, waiting to hit you in the head with a hammer at the moment of climax. Imagine how, if left untreated, benign sexual headaches can change one's quality of life.
Types of Benign Sexual Headaches
Benign sexual headaches can be classified according to their causes or according to what the sufferer experiences.
According to the National Headache Foundation, the cause can be either:
- Muscular—Muscle contraction in the head and neck associated with sexual excitement
- Vascular—Increased blood pressure in the blood vessels in the head during intercourse
Sufferers experience three types of benign sexual headaches:
- Dull—The dull type of headache starts as a dull ache that intensifies with increased sexual excitement and gradually subsides once sexual activity ceases. People with this type of headache may not even make the connection between their pain and sex, and are less likely to seek medical help.
- Explosive—The explosive type of benign sexual headache is characterized by sudden, intense pain just before or at the moment of orgasm. This is the type most often seen by doctors.
- Postural—This type is rare. Like explosive sexual headaches, postural headaches begin with intense pain at orgasm. The pain then subsides, but reoccurs when the patient stands up.
Determining a Cause
Doctors haven't determined the exact cause of benign sexual headaches, though they are classified with other headaches brought on by exertion, such as the exercise-induced headaches sometimes experienced by joggers and weightlifters. In fact, one study of 30 patients with benign sexual headache found that 43% of them also experienced other exertional headaches.
Because migraine sufferers are more prone to sexual headaches, some doctors believe sexual headaches may be related to vascular changes brought on by physical activity, such as exercise and sex. Other researchers believe stress and fatigue may contribute to or trigger the onset of benign sexual headache.
No Immediate Treatment
While you are experiencing benign sexual headache, there is little you can do to ease the pain. Analgesics such as ibuprofen or acetaminophen have little effect once the headache begins. Time and patience seem to be the best remedy. Dr. Haas advises the sufferer's partner to be patient and understanding. Being appropriately concerned for your partner's strange attack must be better for the sufferer's mental state than indifference or annoyance, says Dr. Haas.
Treating It Before It Starts
Fortunately, treatment to prevent a recurrence of benign sexual headaches is both simple and effective. Your doctor will first want to rule out other, more serious causes of head pain, such as hemorrhage of a blood vessel in the head. A physical exam will reveal symptoms of hemorrhage, such as stiff neck, change in pupil size, vomiting, or pain that persists for more than 24 hours. If any doubt exists as to whether or not a hemorrhage has occurred, your doctor may order a CT scan.
Options for prevention include:
- Abstaining from sex: Once your doctor has diagnosed benign sexual headache, he may prescribe a period of inactivity. Abstaining from sex for a period of two or three weeks often eliminates a patient's predisposition toward recurrence of benign sexual headaches.
- Medication before sex: Some people find that taking an over-the-counter nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, prior to sexual activity can prevent benign sexual headaches. If abstention or ibuprofen doesn't work, your physician may prescribe a short course of propranolol (Inderal). Twenty to forty milligrams of propranolol taken twice daily for 2-3 weeks usually puts an end to benign sexual headaches.
Though painful and sometimes frightening, benign sexual headache doesn't mean an end to a satisfying sex life. Understanding and proper treatment usually lead to a permanent cure.
American Headache Society
National Headache Foundation
Help for Headaches
Headaches associated with sexual activity and exercise. State University of New York--Upstate Medical University website. Available at: http://www.upstate.edu/neurology/haas/hpsxex.htm.
Milne R, More B, Goldberg B. An Alternative Medicine Definitive Guide to Headaches. Future Medicine Publishing; 1997.
Last reviewed January 2008 by Ryan Estévez, MD, PhD, MPH
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