Overview

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.

Symptoms

There are two types of sex headaches:

  • A dull ache in the head and neck that intensifies as sexual excitement increases
  • A sudden, severe, throbbing headache that occurs just before or at the moment of orgasm

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.

When to see a doctor

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.

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Causes

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:

  • A widening or bubble in the wall of an artery inside your head (intracranial aneurysm)
  • An irregular connection between arteries and veins in the brain (arteriovenous malformation) that bleeds into the spinal fluid-filled space in and around the brain
  • Bleeding into the wall of an artery leading to the brain (dissection)
  • Narrowing of the arteries in the brain (reversible cerebral vasoconstriction syndrome)
  • Stroke
  • Coronary artery disease
  • Use of some medications, such as birth control pills
  • Inflammation from certain infections

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.

Risk factors

Sex headaches can affect anyone. But risk factors for these headaches include:

  • Being male. Men are more prone to having sex headaches.
  • History of migraines. Being prone to migraines increases your risk of sex headaches.

Prevention

Sometimes sex headaches can be prevented by stopping sexual activity before orgasm. Taking a more passive role during sex also may help.

May 13, 2022
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  3. Jameson JL, et al., eds. Migraine and other primary headache disorders. In: Harrison's Principles of Internal Medicine. 20th ed. McGraw-Hill; 2018. https://accessmedicine.mhmedical.com. Accessed Feb. 20, 2022.
  4. Cutrer FM. Primary headache associated with sexual activity. https://www.uptodate.com/contents/search. Accessed Feb. 13, 2022.
  5. Headache: Hope through research. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Headache-Hope-Through-Research. Accessed Feb. 13, 2022.
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  7. Makarevičius G, et al. Successful treatment of primary headache associated with sexual activity using erenumab: Case report. Cephelagia. 2022; doi:10.1177/03331024221075074.

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