Sexual headache
Sexual headache | |
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Other names: Coital cephalalgia | |
Specialty | Neurology |
Sexual headache is a type of headache that occurs during sexual activity, including masturbation or orgasm.[1]
They are typically not serious, but occasionally are the result of intracranial bleeding or cerebral infarction, especially if the pain is sudden and severe.[2] They may be caused by general exertion, sexual excitement, or contraction of the neck and facial muscles.[2]
Most cases can be successfully treated with medication.[2]
Signs and symptoms
According to the third edition of the International Classification of Headache Disorders (ICHD), which terms this condition primary headache associated with sexual activity, it normally begins as a dull headache that increases with sexual excitement, and becomes intense at orgasm,[3] which is called sexual benign headache. For some patients, the headache begins suddenly, often at orgasm,[2] which is called orgasm headache. In two thirds of cases, it is bilateral, and unilateral in the rest.[3] The pain lasts from one minute to 24 hours with severe intensity, or as long as 72 hours with mild intensity.[3] Its occurrence is unpredictable, and may not follow every sexual act.[2]
Previous editions of the ICHD divided the condition into two subforms: preorgasmic headache and orgasmic headache. These subforms were merged into one entity with varying presentation because clinical studies could not distinguish them.[3] Post-orgasmic headaches associated with posture may be better attributed to a spontaneous cerebrospinal fluid leak.[3] Sudden, severe headaches during sexual activity may also be caused by intracerebral hemorrhage, subarachnoid hemorrhage, or cerebral infarction, which require immediate medical attention.[2][4]
Causes
For some patients, the headaches may be related to general exertion. About 40% of patients with sexual headaches in one study also experienced headaches from non-sexual exertion.[2] A pressor response to exercise has been suggested as a mechanism.[5] For other patients, the pain appears to be specifically activated by sexual excitement and contraction of facial and neck muscles.[2]
Sporadic case studies have linked sexual headaches to the use of certain drugs, including amiodarone, pseudoephedrine, birth control pills, and cannabis.[2] It may be secondary to another condition, such as reversible cerebral vasoconstriction syndrome.[2] It is associated with migraines.[2]
Treatment
A physician may recommend engaging in sexual activity less strenuously.[2] Case series have found indomethacin and beta blockers to be successful in treating these headaches.[2][6] Propranolol, Bellergal, and triptans have also been used with success.[2] Anecdotal and indirect evidence suggests a trial of magnesium supplementation may improve symptoms (in subjects with known or suspected low Mg levels).[7]
Epidemiology
These headaches are estimated to appear in roughly 1% of the population.[2] They can occur with sexual activity at any age.[3] It is more common in men than women, with studies putting the gender ratio between 1.2:1 and 3:1.[3]
See also
References
- ↑ Garza, Ivan; Robertson, Carrie E.; Smith, Jonathan H.; Whealy, Mark E. (2022). "102. Headache and other craniofacial pain". In Jankovic, Joseph; Mazziotta, John C.; Pomeroy, Scott L. (eds.). Bradley and Daroff's Neurology in Clinical Practice. Vol. II. Neurological disorders and their management (8th ed.). Edinburgh: Elsevier. p. 1776. ISBN 978-0-323-64261-3. Archived from the original on 2023-07-02. Retrieved 2023-06-12.
- ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 Cutrer, F. M. & DeLange, J. (2014). "Cough, exercise, and sex headaches". Neurologic Clinics. 32 (2): 433–450. doi:10.1016/j.ncl.2013.11.012. PMID 24703538.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 Headache Classification Committee of the International Headache Society (IHS) (2013). "The International Classification of Headache Disorders, 3rd edition (beta version)" (PDF). Cephalalgia. 33 (9): 674–675. doi:10.1177/0333102413485658. PMID 23771276. S2CID 78846027. Archived from the original (PDF) on 2016-03-03. Retrieved 2015-04-15.
- ↑ Valença, M. M.; Valença, L. P.; Bordini, C. A.; Da Silva, W. F.; Leite, J. P.; Antunes‐Rodrigues, J. & Speciali, J. G. (2004). "Cerebral vasospasm and headache during sexual intercourse and masturbatory orgasms". Headache: The Journal of Head and Face Pain. 44 (3): 244–248. doi:10.1111/j.1526-4610.2004.04054.x. PMID 15012662. S2CID 37901372.
- ↑ Staunton, H P; Moore, J (1978). "Coital cephalgia and ischaemic muscular work of the lower limbs". Journal of Neurology, Neurosurgery & Psychiatry. 41 (10): 930–933. doi:10.1136/jnnp.41.10.930. PMC 493197. PMID 731244.
- ↑ Anand, K. S.; Dhikav, V. (2009). "Primary headache associated with sexual activity" (PDF). Singapore Medical Journal. 50 (5): e176–7. PMID 19495503. Archived (PDF) from the original on 2017-11-14. Retrieved 2023-06-10.
- ↑ Mauskop, A.; Altura, B. T.; Cracco, R. Q.; Altura, B. M. (1996). "Intravenous Magnesium Sulfate Rapidly Alleviates Headaches of Various Types". Headache: The Journal of Head and Face Pain. 36 (3): 154–160. doi:10.1046/j.1526-4610.1996.3603154.x. PMID 8984087. S2CID 31498913.
External links
Classification |
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- Medscape: Etiology of Coital Headaches Archived 2022-09-30 at the Wayback Machine
- Dexter, S. (2010). "Benign coital headache relieved by partner's pregnancies with implications for future treatment". BMJ Case Reports. 2010: bcr1020092359. doi:10.1136/bcr.10.2009.2359. PMC 3028282. PMID 22315637.
- Delasobera, BE; Osborn, SR; Davis, JE (2012). "Thunderclap headache with orgasm: A case of basilar artery dissection associated with sexual intercourse". The Journal of Emergency Medicine. 43 (1): e43–7. doi:10.1016/j.jemermed.2009.08.012. PMID 19818575.
- Uterga, JM; De Garay, MA; De Luna, IO; Uribarri, JB (2009). "Recurrent coital headache associated with an unruptured carotid saccular aneurysm". Headache. 49 (8): 1232–3. doi:10.1111/j.1526-4610.2009.01479.x. PMID 19549158. S2CID 205683288.
- Mauri, G; Vega, P; Murias, E; Vega, J; Ramón, C; Pascual, J (2012). "Fusiform aneurysms of the vertebral artery: A hidden cause of exertional headache?". Cephalalgia. 32 (9): 715–8. doi:10.1177/0333102412449928. PMID 22684099. S2CID 23496163.