Why You Get a Headache After Sex

When we talk about why you get a headache after sex, we’re talking about a condition that occurs as a result of sexual activity. It can appear moments before an orgasm or at the moment of orgasm and is characterized by a sudden and intense pain in the neck and head.

A headache during sexual activity, also known as an orgasmic headache, is usually not a cause for alarm, but sometimes it can be due to a cerebral vascular problem.

It is unknown what causes headaches during sexual activity, but some clinical studies point to a relationship with vascular changes caused by exercise, chronic fatigue, and stress as possible triggers.

Although headaches during sexual activity can affect anyone, they are more frequent in men than in women. However, a number of conditions can increase the risk of their occurrence, such as:

• Stroke
• Intracranial aneurysm
• History of migraines
• Use of certain medications
• Coronary artery disease
• Cerebral vasoconstriction syndrome
• Infection
• Arteriovenous malformation
• Cerebral artery dissection

However, any sexual activity that leads to an orgasm can cause a headache.

Types of Headaches

Headaches during sexual activity are usually divided into two main types:

• Pre-orgasmic headache: This manifests as a dull, growing pain in the head and neck that increases with sexual excitement.
• Orgasmic headache: This appears suddenly and explosively just before or at the moment of orgasm. It is a very intense pain that can be compared to a severe migraine or even a cerebral hemorrhage.

Although these sensations can be alarming, most of these headaches are benign. However, it’s important to differentiate them from other more serious causes of sudden headaches, such as a subarachnoid hemorrhage.

For this reason, after a first episode or if the pain is very intense, it is recommended to have a neurological evaluation to rule out possible complications.

Symptoms After Sex

The symptoms that appear will depend on the cause of why you get a headache after sex.

In general, these headaches are characterized by their appearance during sexual arousal or suddenly at the moment of orgasm.

The pain can range from a mild discomfort that grows in the back of the head or neck to an explosive, intense pain similar to a migraine. For some people, the pain can be so strong that it interrupts sexual activity, which in turn can lead to anxiety about future encounters.

The characteristic symptoms of a headache from having sex include:

• A squeezing pain in the back of the neck or head when arousal begins.
• Sudden, intense, and stabbing pain in the head at the moment of orgasm.
• A sensation of pressure or bursting in the skull.
• Pain that increases with sexual or physical exertion.
• In some cases, nausea.
• Sensitivity to light or sound.

This type of pain can last from a few minutes to several hours.

Diagnosis of Headaches After Sex

To diagnose why you get a headache after sex, a detailed clinical evaluation of the patient must be performed. With this, the doctor can learn more information about the onset, duration, location, and intensity of the pain, as well as its relationship to sexual activity.

It’s possible that some of these headaches are a symptom of more serious neurological conditions, such as cerebral hemorrhages or arterial dissection. For this reason, it is common to request imaging studies, including a CT scan, MRI, or cerebral angiography. After ruling out these risks, a diagnosis of a primary headache associated with sexual activity can be confirmed.

Treatment will depend on the characteristics of the headache. If the episodes are occasional and not severe, specific medication is not always necessary. In many cases, patients will improve by reducing the intensity of exertion during sex or by changing positions.

If the pain is frequent or severe, the doctor may prescribe preventive treatments that can be used before sexual activity. It’s important for the doctor to provide a treatment that is adjusted to each type of headache and the patient’s response.

In addition to pharmacological treatment, patient education is key. Knowing that the pain is benign can help reduce the anxiety that these episodes generate, which often worsens the symptoms.

If the pain persists or affects the patient’s sex life, psychological support or sex therapy may be recommended, especially if there is a component of anticipatory anxiety.

Follow-up with a neurologist is important to adjust treatment and monitor the condition’s progression.

At the Neurological Center at ABC Medical Center, we can provide you with specialized care. Contact us!