Sexual headache is a type of

headache Headache is the symptom of pain in the face, head, or neck. It can occur as a migraine, tension-type headache, or cluster headache. There is an increased risk of depression in those with severe headaches. Headaches can occur as a result ...

that occurs in the

skull The skull is a bone protective cavity for the brain. The skull is composed of four types of bone i.e., cranial bones, facial bones, ear ossicles and hyoid bone. However two parts are more prominent: the cranium and the mandible. In humans, the ...

and neck during

sexual activity Human sexual activity, human sexual practice or human sexual behaviour is the manner in which humans experience and express their sexuality. People engage in a variety of sexual acts, ranging from activities done alone (e.g., masturbation) ...

, including

masturbation Masturbation is the sexual stimulation of one's own genitals for sexual arousal or other sexual pleasure, usually to the point of orgasm. The stimulation may involve hands, fingers, everyday objects, sex toys such as vibrators, or combinatio ...

orgasm Orgasm (from Greek , ; "excitement, swelling") or sexual climax is the sudden discharge of accumulated sexual excitement during the sexual response cycle, resulting in rhythmic, involuntary muscular contractions in the pelvic region charac ...

. These headaches are usually benign, but occasionally are caused by

intracranial hemorrhage Intracranial hemorrhage (ICH), also known as intracranial bleed, is bleeding within the skull. Subtypes are intracerebral bleeds ( intraventricular bleeds and intraparenchymal bleeds), subarachnoid bleeds, epidural bleeds, and subdural bleeds. ...

and

cerebral infarction A cerebral infarction is the pathologic process that results in an area of necrotic tissue in the brain (cerebral infarct). It is caused by disrupted blood supply ( ischemia) and restricted oxygen supply ( hypoxia), most commonly due to thromboemb ...

, especially if the pain is sudden and severe. They may be caused by general exertion, sexual excitement, or muscle contraction, contraction of the neck and facial muscles. Most cases can be successfully treated with medication.

Signs and symptoms

According to the third edition of the International Classification of Headache Disorders (ICHD), which terms this condition ''primary headache associated with sexual activity'', it normally begins as a dull headache that increases with sexual excitement, and becomes intense at orgasm, which is called sexual benign headache. For some patients, the headache begins suddenly, often at orgasm, which is called orgasm headache. In two thirds of cases, it is bilateral, and unilateral in the rest. The pain lasts from one minute to 24 hours with severe intensity, or as long as 72 hours with mild intensity. Its occurrence is unpredictable, and may not follow every sexual act. Previous editions of the ICHD divided the condition into two subforms: ''preorgasmic headache'' and ''orgasmic headache''. These subforms were merged into one entity with varying presentation because clinical studies could not distinguish them. Post-orgasmic headaches associated with List of human positions, posture may be better attributed to a spontaneous cerebrospinal fluid leak. Sudden, severe headaches during sexual activity may also be caused by intracerebral hemorrhage, subarachnoid hemorrhage, or

, which require immediate medical attention.

Causes

For some patients, the headaches may be related to general exertion. About 40% of patients with sexual headaches in one study also experienced headaches from non-sexual exertion. A pressor response to exercise has been suggested as a mechanism. For other patients, the pain appears to be specifically activated by sexual excitement and Muscle contraction, contraction of facial and neck muscles. Sporadic case studies have linked sexual headaches to the use of certain drugs, including amiodarone, pseudoephedrine, birth control pills, and cannabis. It may be secondary to another condition, such as reversible cerebral vasoconstriction syndrome. It is associated with migraines.

Treatment

A physician may recommend engaging in sexual activity less strenuously. Case series have found indomethacin and beta blockers to be successful in treating these headaches. Propranolol, Bellergal, and triptans have also been used with success. Anecdotal and indirect evidence suggests a trial of magnesium supplementation may improve symptoms (in subjects with known or suspected low Magnesium, Mg levels).

Epidemiology

These headaches are estimated to appear in roughly 1% of the population. They can occur with sexual activity at any age. It is more common in men than women, with studies putting the gender ratio between 1.2:1 and 3:1.

References

External links