In rare instances, headaches can be brought on by sexual activity — especially with orgasm. You may notice a dull ache in the 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.
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 the brain.
There are two types of sex headaches:
In some people, both types of headaches are combined.
Most sex headaches last at least several minutes. Others may linger for hours or even 2 to 3 days.
Many people who have sex headaches will experience them in clusters over a few months, and then they may go for a year or more without having any. Up to half of all people with sex headaches experience them over the course of about six months. Some people may only have one attack during their lives.
Sex headaches aren't usually a cause for concern. But consult your health care provider right away if you experience a headache during sexual activity — especially if it begins abruptly or it's your first headache of this type.
Any type of sexual activity that leads to orgasm can trigger 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:
Sex headaches associated with loss of consciousness, vomiting, stiff neck, other neurological symptoms and severe pain lasting more than 24 hours are more likely to be due to an underlying cause.
Sex headaches can affect anyone. But risk factors for these headaches include:
Sometimes sex headaches can be prevented by stopping sexual activity before orgasm. Taking a more passive role during sex also may help.
Your provider will likely recommend brain imaging.
Computerized tomography (CT). In some cases, especially if your headache occurred less than 48 to 72 hours beforehand, a CT scan of the brain may be done.
CT uses an X-ray unit that rotates around the body and a computer to create cross-sectional images of the brain and head.
Your provider may also order a cerebral angiogram, a test that can show the neck and brain arteries.
This procedure involves threading a thin, flexible tube through a blood vessel, usually starting in the groin, to an artery in the neck. Contrast material is injected into the tube to allow an X-ray machine to create an image of the arteries in the neck and brain.
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 provider removes a small amount of the fluid that surrounds the brain and spinal cord. The fluid sample can show if there's bleeding or an infection.
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.
If you have a history of sex headaches and there's no underlying cause, your doctor may recommend that you take preventive medications regularly. These may include:
You're likely to start by seeing your provider. However, you may be referred to a neurologist. Here's some information to help you get ready for your appointment and to know what to expect from your provider.
Preparing a list of questions can help you make the most of your time with your provider. For headaches associated with sexual activity, some questions to ask your provider include:
Don't hesitate to ask other questions that may come up during your appointment.
Your provider is likely to ask you questions, such as: