Jul 8, 2013 Everyday Health
Last year a patient mentioned to me that every time she had an orgasm she experienced a terrible headache. I advised her to see her internist, or maybe a neurologist. Quite frankly, I thought she was someone who suffered from migraines and the correlation with her orgasm was simply a coincidence.
Wrong! Now I know there is a specific entity known as orgasmic headache. I want to be clear- headache associated with sexual activity is not the same as headache before sexual activity, as in “Not tonight honey, I’ve got a headache.”
This is not a common problem, only affecting about 1% of the population, but even if only one in a hundred women experience a headache during sexual activity, that’s significant. Fortunately, 75% of the time this is a one-time event, so more likely than not if you only experienced it once, you will not again.
I learned more about sexual headache when I heard a lecture by Dr. Robert Cowan, the director of The Headache Program at Stanford University. He emphasized that there are two very distinct categories of sexual headaches.
Pre-orgasmic headaches occur during arousal and usually start as a mild dull ache in the head and neck. Many women describe a throbbing, pressure like sensation in the head accompanied by a muscle contraction in the neck or jaw. Pre-orgasmic headaches get worse with increased sexual excitement and can last up to 3 hours.
While a real romance killer, these sexual headaches are generally not an indication of anything serious. Take some indomethacin , an anti-inflammatory medication, 30 minutes prior to sexual activity (I know, it’s not like you have a schedule for intercourse) and if that doesn’t work, see your doctor for further evaluation and a prescription remedy.
A true orgasmic headache is a sudden explosive headache that is simultaneous with orgasm. It starts in one spot and quickly spreads.
This is the important part. A true orgasmic headache has a very high correlation with a more serious problem, such as stroke or brain hemorrhage. In fact, 4-12% of patients with a sub-arachnoid hemorrhage report that their first indication that something was wrong was when they experienced an excruciating headache during sex.
The bottom line is, if you have a severe explosive headache simultaneous with orgasm, put on your clothes and get yourself to an emergency room. A head CT or MRI will determine if there is something serious going on. In many cases it will turn out to be nothing. But if you have a ruptured aneurysm, your orgasm will have literally saved your life.