Sex headaches are caused by sexual activity and feel like a dull ache in your head and neck that builds up as sexual excitement increases; they are mostly harmless.
What is a sex headache?
Sex headaches are headaches that are brought on by sexual activity. Sex headaches can be due to a more serious underlying cause or could be a "primary headache" disorder which has no other underlying cause.
Symptoms with no underlying cause include a headache during sexual activity either prior to or during an orgasm. If there is an underlying cause, symptoms may also include a loss of consciousness, nausea or vomiting, neck pain or stiffness, double vision, or numbness and weakness.
Treatments include medication to alleviate headache symptoms as well as procedures for any underlying causes.
Your headache can be treated with over-the-counter pain relievers like ibuprofen or acetaminophen. If the symptoms happen or have happened more than once, you should be evaluated by a your health care provider.
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Symptoms of a sex headache
The headache will usually be the only symptom of a primary sex headache. Having other symptoms in addition to a headache suggests a potentially more serious cause.
Symptoms of primary sex headache
There are two main types of primary sex headaches that differ in terms of the timing and nature of the headache. The symptoms of the two main types of primary sex headaches are :
- Headache during sexual activity leading up to orgasm ("preorgasmic headache"): In this type of sex headache, the person may experience a dull headache in the back of the head on both sides that steadily gets worse with increasing sexual excitement. This type of sex headache is seen in about one-third of cases. These types of headaches will typically last around 30 minutes but can last up to three hours.
- Headache during orgasm ("orgasmic headache"): In an orgasmic headache, the person will experience a sudden explosive headache that occurs right before or at the time of orgasm. This type of headache will cause a severe throbbing head pain that may spread to the entire head. This type of headache occurs in about two-thirds of cases. These types of headaches will typically last minutes to hours but can last up to three days.
Symptoms due to an underlying cause
People who experience headaches during sex due to an underlying cause (secondary) may experience additional symptoms and represent much illnesses that may be life-threatening. These may include:
- Loss of consciousness: If the headache is caused by an underlying cause such as bleeding in the brain, narrowing of the blood vessels in the brain, a blood clot, or a tear in the wall of a blood vessel in the brain, a loss of consciousness may occur.
- Nausea or vomiting: A sex headache that is caused by bleeding in the brain can be associated with nausea or vomiting. This may be due to the increased pressure in the head caused by the bleeding.
- Neck pain or stiffness: A sex headache that is caused by bleeding in the brain or a tear in the wall of a blood vessel in the brain or neck may be associated with neck pain or stiffness (meningismus). You may feel it is difficult to bend the neck.
- Double vision: Some causes of sex headaches such as a blood clot in the brain or a tear in the wall of a blood vessel in the brain or neck may cause double vision (diplopia). This may occur due to damage to the nerves important for moving the muscles that control eye movements.
- Numbness or weakness: Some causes of sex headaches may result in numbness or weakness of a part of the face or body. For example, narrowing of the blood vessels in the brain can cause a stroke by decreasing blood flow to part of the brain.
What causes a sex headache
Sex headaches tend to occur more commonly in males, middle-aged individuals, and in people with other headache disorders such as migraines, exertional headache, or tension headaches. Specific causes of sex headaches, from primary to more severe, include the following.
Primary sex headache
Primary sex headaches are sex headaches that do not have another underlying cause. The reason that primary sex headaches occur is not known. Some researchers believe that primary sex headaches occur because of excessive contraction of neck and jaw muscles during sexual activity. Others believe primary sex headaches may occur due to changes in blood flow to the brain that occur during sexual activity.
Bleeding in the brain
Sometimes, sex headaches can be a sign of something more serious, such as bleeding in the brain (subarachnoid hemorrhage). This usually occurs when a bulge in a blood vessel in the brain ruptures during sexual activity. This will cause a sudden-onset severe headache, as well as other symptoms that are typically not seen in primary sex headaches.
Narrowing of the blood vessels in the brain
Some sex headaches can be caused by a group of conditions that involve recurrent, reversible narrowing of the blood vessels in the brain. These conditions will cause recurrent episodes of sudden severe headaches that may occur during sexual activity.
A blood clot in a blood vessel in the brain
Some sex headaches can be caused by a blood clot in a blood vessel in the brain. This can cause a headache that usually starts gradually but may get worse with straining, and thus may manifest during sexual activity.
A tear in part of the wall of a blood vessel in the brain or neck
Some sex headaches can be caused by a tear in part of the wall of a blood vessel in the brain or neck. This is called a "dissection," and may cause blood to collect in the wall of the blood vessel, blocking off blood flow to the brain. This can occur with minor trauma to or bending of the neck, which can occur during sexual activity. This will usually cause a gradual onset headache or neck pain on one side as well as other symptoms.
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Treatment options and prevention for sex headache
- Triptan medications to treat headache symptoms: Triptans are medications typically used for migraine headaches that help by narrowing blood vessels in the brain that may be causing the pain and decreasing the release of inflammatory substances. Specific examples include sumatriptan (Alsuma) and zolmitriptan (Zomig).
- Medications to prevent sex headaches: For people who consistently experience headaches during sex, your physician may recommend taking a medication prior to having sex to prevent the sex headache. Medications commonly recommended for this purpose include indomethacin and propranolol (Inderal).
- Treatments of underlying causes: Treatments will vary depending on the specific cause. These may include medications to lower blood pressure and prevent seizures, medications to break up blood clots, or surgical procedures to fix abnormal blood vessels.
When to seek further consultation for sex headache
If you are experiencing symptoms of a sex headache you should consider going to your physician.
If you experience sudden severe headache, lose consciousness, or have other symptoms
You should go to the emergency room or call an ambulance right away if you experience a sudden severe headache or any other symptoms such as a loss of consciousness, neck pain or stiffness, double vision, or numbness or weakness. These symptoms may be due to a serious underlying cause that requires prompt diagnosis and treatment.
Questions your doctor may ask to determine sex headache
- Any fever today or during the last week?
- How long has your current headache been going on?
- Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
- Are you sick enough to consider going to the emergency room right now?
- Have you experienced any nausea?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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- Sex headaches. Mayo Clinic. Published May 4, 2018. Mayo Clinic Link
- Frese A, Gantenbein A, Marziniak M, Husstedt IW, Goadsby PJ, Evers S. Triptans in orgasmic headache. Cephalalgia. 2016;26(12):1458-1461. NCBI Link
- Teague S. Blood clots. RadiologyInfo.org. Updated on August 15, 2018. RadiologyInfo.org Link
- Brain AVM (arteriovenous malformation). Mayo Clinic. Published June 9, 2018. Mayo Clinic Link