The term sex headache encompasses headaches occurring either just before or during orgasm. They can also occur during masturbation.

Sex headaches occuring just before orgasm (pre-orgasmic) are often described as a dull ache in the head and neck.  Sometimes the patient notices tension in the jaw and facial muscles.  It occurs during sexual activity, can be severe but often improves when the patient stops the activity.

Headaches occurring at the moment of orgasm are often more sudden and explosive.

Who gets these headaches?

Both males and females of any age.

Investigations

Sex headache can mimic other life-threatening neurological disorders, especially brain haemorrhage, therefore often needs to be investigated with a scan and other tests the first time it occurs. In some situations even a second or third sex headache may need urgent investigation.

Dangerous causes for headache are a bit more likely if the headache has occurred at the moment of orgasm.

When sex headache occurs on a more frequent or predictable basis, there is no need for further investigation and it is entirely harmless.

The vast majority of sex headaches are of this harmless (or benign) type.

Treatment:

Whilst sex headache is nearly always benign, they can cause significant physical and psychological stress.  If the headaches last longer than half an hour, the patient may benefit from a tablet.  Indometacin is the most common medication used.  If the headaches are happening very frequently, the patient may benefit from a tablet to prevent them.  Beta-blockers, for example Propanolol, are sometimes used for this purpose.

These headaches usually go away spontaneously after weeks or months, but may recur years later.