What Causes Headache After Orgasm?

Do you get a headache after orgasm or during intercourse? Could this be causing you to worry and probably affecting your sex life? If yes, you are not alone. Severe headache during sex happens to a lot of people. It occurs more in men than women, although headaches in general are more common in women than men. Several studies indicate that sex headaches are more likely to occur in people who suffer from migraines.

Why Do I Get a Headache After Orgasm?

In general, sudden headaches during or after sex may be associated with the following:

  • Medications including some birth control pills
  • Intracranial aneurysm: dilation or bubble within an artery in the head
  • Inflammation due to some infections
  • Arteriovenous malformation: abnormal connections of arteries and veins in the brain leading to bleeding into the spinal fluid-filled space surrounding the brain
  • Dissection: bleeding in the wall of one or more arteries leading to the brain
  • Stroke
  • Coronary artery disease

In some cases, sex headaches are accompanied by a stiff neck, vomiting, loss of consciousness and some neurological symptoms. There may also be severe pain that lasts for more than 24 hours. Such headaches may have underlying causes.

Types of Headache After Orgasm

Sex headache can be categorized mainly into the following types:

1. Early Coital Cephalgia

This is a moderate headache with a short duration. The pain is dull with a cramping feeling. It has a bilateral occurrence within the cervical/occipital area, and worsens as sexual excitement intensifies. Early coital cephalgia is accompanied by contraction of neck and jaw muscles. It is thought to result from excessive contractions in the head and neck just before orgasm.

2. Orgasmic Coital Cephalgia

This is the most common orgasmic headache. The severe headache has an abrupt onset, coinciding with orgasm and lasting for up to 20 minutes. It is normally localized within the area behind the eyes, but may affect the head generally. When it occurs for the first time, it is advisable to seek professional help to rule out other serious causes such as arterial dissection and subarachnoid hemorrhage.

3. Late Coital Cephalgia

This is a secondary headache that may occur after sexual intercourse, especially once you get on your feet. Late coital cephalgia can last for several hours or even days. It is thought to be the result of decreased pressure of the cerebrospinal fluid (CSF) due to a dural tear arising from physiological stress associated with sexual excitement.

How to Manage Headache After Orgasm

You can deal with the headache by sex abstinence until the pain subsides. In cases where you can associate the pain with a specific act or position during intercourse, you can keep the pain away by avoiding such acts or sex position.

In general, sex headaches are non-recurrent. However, if the ache is severe or takes too long to subside, you can consider medication. Common medicines for orgasmic headaches include propranolol and indomethacin. But besides these, the following have been successfully used:

  • Calcium-channel blockers such as nimodipine and diltiazem 60 mg. These are helpful especially for patients with suspected cerebral vasoconstriction.
  • Topiramate, 50 mg daily, especially when propranolol and indomethacin are contra-indicated.
  • Triptans–this has been recommended for treatment of the acute phase and in prevention of sex headaches.

Other People's Experiences of Headache After Orgasm

"Whenever I have an orgasm, I suddenly get a severe headache. Sometimes this happens even when I get aroused. I consult my doctor who says this is common for men. But I am a woman. The doctor prescribes Topomax 25 mg once daily for two weeks, after which he increases the dosage to twice daily. This hasn't stopped the headache but has stopped the pain from a pinched nerve in the back. Two months later, my doctor increases my Topomax dose to 50 mg at night and 25 mg in the morning for a further month. My current dosage is 50 mg twice daily, but I am still getting the headaches, though they are less severe and less frequent. Still, I am worried and unable to relax completely."

"My first headache after orgasm happened three days ago when my wife and I were having vigorous sex. We were doing it doggy style and just as I hit orgasm, an extremely painful headache set in suddenly and with such intensity that I couldn't see. I felt so weak that I fell on my back. I later had another episode but this time the headache wasn't so bad. I fear it could be related to my breathing and blood pressure. In the past one year, I have put on thirty pounds and I am worried about my blood pressure. For this reason, I recently bought a blood pressure machine so that I can monitor my BP. My average for the last two days is 139/89 which means I am just at the borderline."

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