About 1 out of every 100 people sometimes have painful headaches when sexually aroused. Sex headaches with severe pain may last from 1 minute to 1 day. Mild headaches may last up to 3 days.1
All jokes aside, this painful condition can be unpredictable because it rarely happens every time someone is aroused. It also contrasts with those with migraine or cluster headaches, who find sex helps reduce their head pain. In 4 out of 10 people, the pain stops when the sexual activity stops.1-3
Men are 3 to 4 times more likely to get sex headaches than women. Older names for this condition include orgasmic or pre-orgasmic headache. Sex headaches are in the same family as thunderclap, cough, and exercise headaches.3-5
What causes sex headaches?
Doctors do not fully understand what causes sex headaches. One idea is that sexual activity is similar to mild to moderate exercise. Many believe that exercise triggers the release of brain chemicals that are involved in sleepiness, fatigue, energy metabolism, or pain response. These brain chemicals include:6
- Hypocretin
- Calcitonin gene-related peptide (CGRP)
- Beta-endorphin
- Endocannabinoid ligand anandamide
- Brain-derived neurotrophic factor
If the headache begins after sex, gets worse when standing, and then better when laying back down, the cause may be leaking spinal fluid. This is technically not a “sex headache” but a different type of headache called a “low-pressure headache.”4
How is it diagnosed?
The International Headache Society defines a headache linked to sexual activity as:1
- At least 2 episodes of head and/or neck pain during or after sex
- Brought on by and only happens during sexual activity
- Pain increases as arousal increases
- Pain explodes just before or with orgasm, also called a thunderclap headache
Sexual activity includes sexual intercourse, masturbation, and watching pornography. The pain can be mild to severe, a dull ache, throbbing, or explosive and is felt on both sides of the head. It is most often felt in the back of the head or the top of the neck.5
It is important to see a doctor the first time a sex-related headache appears. Most sex headaches are not a sign of serious illness. However, your doctor will want to rule out conditions such as brain hemorrhage or a tear in the arteries in the head or neck.3
How are they treated?
Sex headaches can be treated in a number of ways. Drugs used to prevent these headaches include:3,4
- Indomethacin (Tivorbex)
- Triptans
- Certain beta-blockers
While sex headaches can be distressing or alarming, the good news is that many people have only 1 or 2 attacks and then go several years before another attack. It rarely becomes a chronic, or long-term, problem.2,4,7