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Not Tonight Dear, I Have a Migraine

“Not tonight dear, I have a headache.” The problem with this phrase is that reaffirms the dysfunctional, harmful, and widely-believed myth that people with migraines are faking pain to get out of undesired tasks. The truth is that 37 million people have migraines. The complex neurological condition is very real and causes debilitating pain and other challenging symptoms. And when it comes to sex and migraines, research shows the relationship is extraordinarily complicated1-8. From triggering, to exacerbating, to alleviating them, sex can have a major impact on migraines.

Triggering and exacerbating

There are many reasons that migraines can either be triggered or an existing migraine can worsen during sexual intimacy.

Get your motor running

For some, the same stress/excitability dynamic that can cause migraines to trigger in regular life can light up a migraine during sexual intimacy. If someone is prone to getting anxious, stressed, or overly excited, s/he may find these same activities in the context of sex can lead to migraine.

Let’s get physical

Much like the exertional trigger (in which exercise, due to the increase of heart rate and blood flow, triggers or worsens existing migraines), pre-orgasmic headaches build in intensity with the increase of sexual arousal. Additionally, orgasmic headaches are described as “explosive” and occur post-orgasm. Both are perhaps variants of migraine.

“Yes, please, tonight, dear, I have a headache”: alleviating migraines with sex

The statement “Not tonight dear, I have a headache” implies that the person is already in pain and that there is a fear that sex will make matters worse. Some research shows that this is not the case for everyone. Indeed, in a small, unpublished study, sexual activity was shown to relieve headaches. Researchers described that of the 82 women studied, 70% had sexual intercourse during at least 1 migraine attack, and of those, approximately one-half (47%) experienced at least some relief from the headache following sexual intercourse. Seventeen and a half percent reported complete relief from the headache. The same researchers discovered similar findings in a previous study with a smaller sample of only 34 women in which 21% of patients reported some relief after intercourse. In another study of 304 migraineurs, of the third who had experience with sex during migraine, 30% of those (roughly 27 out of 91) reported to finding sex as a reliable way to relieve headache pain. While about 54 (60%) reported total or at least considerable relief after sexual relations.

Another note of interest is that chronic pain can kill women’s sex drive but not men’s, researchers discovered. A study, published in the Journal of Neuroscience, revealed that pain can negatively and significantly decrease a woman’s sexual desire.

The contradictory results of these studies illustrate a few absolute findings. First, the relationship between migraines and sex is deeply complex and different for many. There are no easy answers here and more research is needed. For those of us who are living the reality, it’s always best to strive for open communication with your partner, and to get the support you need in the way of family, friends, and your migraine specialist.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Evans RW, Couch R. Orgasm and migraine. Headache. 2001; 41:512-514.
  2. Couch JR, Bearss C. Relief of migraine with sexual intercourse [abstract]. Headache. 1990; 30:19.
  3. Couch JR, Bearss CM. Relief of migraine headache with sexual orgasm [abstract]. Headache. 1987; 27:287.
  4. Frese A, Eikermann A, Frese K, et al. Headache associated with sexual activity: Demography, clinical features, and comorbidity. Neurology. 2003; 61:796-800.
  5. Paulson GW, Klawans HL Jr. Benign orgasmic cephalgia. Headache. 1974; 13:181-187.
  6. Lance JW. Headaches occurring during sexual intercourse. Proc Aust Assoc Neurol. 1974; 11:57-60.
  7. Martin EA. Headache during sexual intercourse (coital cephalalgia). A report on six cases. Ir J Med Sci. 1974; 143:342-345.
  8. Hambach A1, Evers S, Summ O, Husstedt IW, Frese A. The impact of sexual activity on idiopathic headaches: an observational study Cephalalgia. 2013 Apr;33(6):384-9. doi: 10.1177/0333102413476374. Epub 2013 Feb 19.


  • beautyinadversity
    3 years ago

    Anyone else having a horrible sex life due to their chronic migraines? I thought I had a physiological disorder and had labs done to show my testosterone levels – which came out normal….so, in my case anyway, it truly is a chronic pain issue and is so hard for my spouse to understand!

  • Joanna Bodner moderator
    3 years ago

    Hi there beautyinadversity, I am so sorry you are dealing with this, but know you are absolutely not alone. I thought you might find this article helpful as it discusses tips on helping your partner understand – We are always here to lend and ear and always feel free to reach out for support. Warmly, Joanna ( Team)

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