Headache During Sex?

A headache during sex is embarrassing to say the least, but if this is something that has happened to you before then maybe you should read on.

Sex headaches are pounding, sometimes severe pain that occurs during sex or more specifically, during the orgasm. Sometimes they will start just at the beginning of relations. They might even be mild headaches. If so this is known as benign coital headache or orgasmic cephalgia. These headaches occur more often in men than women. Aside from being disruptive (!) they are not dangerous headaches and are easily treated. The current theory is that they are caused by muscle contraction and/or vascular dilation of the head and neck during sex.

What is a little more concerning is if this is a headache you have never had before or "is the most severe headache of your life". This could be an emergency headache, and you should be seen by your provider. This rare, second type of sex headache could be the herald of a more serious condition such as a bleed in the brain. A brain hemorrhage can be due to either an aneurysm or an arteriovenous malformation (AVM). An aneurysm is an out-pouching in an artery due to a weakened area of the artery wall..like a bulge in a tire.

An AVM is a tangle of arteries and veins that share connections and also have thin walls making them susceptible to a bleed. What happens during sex is that the weakened areas of these walls begin to give way, they leak blood and the massive headache results. This type of headache is called a thunderclap headache and requires a CT or MRI of the brain soon. Since blood pressure rises and falls during sex, this is what eventually causes the rupture of the blood vessels.

Most people do not even know if they have these conditions. If you have a family history of aneurysm, you should be screened with an imaging study as this condition can be hereditary.