Sex headaches

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“When I was in college I would experience an intense headache – like a migraine intense headache – during sex, usually after orgasm. I looked it up when I was a kid, but sort of lost track of that thought. Fifteen years later, I’ve experienced it again, and it’s made me realize that I never looked into it since, and I’m concerned. I experienced a lot of headaches as a child, and I wonder if that has anything to do with it or if this is an underlying medical issue. I can’t over-articulate the intensity of the pain, it is a debilitating headache in the back of neck, my forehead, my jaw. It’s one of the more painful things I’ve experienced. Is this normal? Should I be concerned?”

Youch! That sounds awful! Sure, pain mixed with pleasure can be delightful, but only when it’s intentional and can be halted. This seems like an absolute vibe killer.

I’ve personally never experienced or even read about headaches brought on by sex before, so I did some digging. I asked Twitter to see if others share your experience and quickly received multiple replies.

“This happened to me once when I was 20. As soon as I came, the back of my neck/head felt an intense pain I had never felt before or since. I even cried out. It persisted to happen for a few more weeks, though getting less and less painful each time until I didn’t feel it anymore.”

“Infrequently, but god, it’s the worst!”

“Rarely but occasionally, knocks out my vision and triggers a full migraine”

“Definitely. Rare but the feeling is incredibly painful after orgasm. Usually due to extreme stress. First time I experienced one was after my girlfriend proposed to me in Paris. Then I would experience them if I was having sex with someone I didn’t want to.”

“It’s the worst. I always hope for relief but usually end up with a pounding headache for days after”

So, for what it’s worth, you’re not the only one. According to the British Journal of Medical Practitioners, headaches caused by sexual activity are rare – only around 1% of people will experience them. But it’s also very likely that they are underreported: sufferers may be embarrassed to talk about sexual situations with their doctors or simply not seek help for them, as it sounds like you have not.

Men are 3 to 4 more times more likely to affected by sex headaches and the condition often peaks specifically around the ages of 20 and 40.

Men are 3 to 4 more times more likely to affected by sex headaches and the condition often peaks specifically around the ages of 20 and 40, which tracks with your 15 years of relative relief in between bouts. A history of migraines greatly increases your risk of getting headaches from sex, another factor which you mentioned. These headaches can strike during any kind of sexual activity, whether partnered or solo.

Most sex headaches fall into one of two categories, according to the American Migraine Foundation. Pre-orgasmic headaches are exactly what they sound like, usually starting as a dull ache in the back of the skull and neck and increasing along with arousal. Orgasmic headaches come on more suddenly and explosively, right before or during climax. People can experience either or both, but the orgasmic ones, also known as a thunderclap headache, happen much more often. The pain is often bilateral (on both sides of the head) and occipital (in the back of the head) and can last anywhere from a minute to days. Sex headaches may also recur in clusters for months or just happen once and never again.

Should you be alarmed? Not necessarily. According to the Mayo Clinic, most sex headaches – while very painful – aren’t a cause for concern. They eventually run their course and go away. However, there’s a possibility that the pain is a result of a serious underlying condition, like hemorrhage, stroke or brain aneurism and for that reason, I highly recommend talking to your doctor, especially if it’s your first sex headache. You should quickly seek treatment if the pain is accompanied by vomiting, light sensitivity, or any other neurological issues.

According to the Mayo Clinic, most sex headaches – while very painful – aren’t a cause for concern. They eventually run their course and go away

Assuming there’s no serious condition responsible, you can take some steps to reduce the odds you’ll be hit while hitting it. Some drugs make a sex headache more likely: amiodarone (for cardiac dysrhythmias), hormonal birth control bills, pseudoephedrine, cannabis, and – ironically – drugs that are used to assist with erections. Working out, getting enough sleep, staying hydrated, maintaining a healthy body weight, and seeking help for tension and anxiety are associated with reduced risk of these attacks.

Taking a more laidback or passive approach to sex can help, and opting for positions with less neck tension is a great idea. There are also prescription drugs to preempt sex headaches, some that are for daily prophylaxis and others that can be taken a half an hour before you anticipate getting it on.

Aside from physical concerns, being struck by such horrendous agony during sex can significantly impact your sex life and relationships. It’s frightening, distressing and potentially traumatic to both you and your partners, so it’s important to talk openly about these experiences and share your concerns. Good luck!

Have a question for Dr. Timaree? Send an email to asktimaree@philadelphiaweekly.com.

    • Timaree Schmit Headshot

      Timaree Schmit is basically an episode of Adam Ruins Everything, but in the shape of a person. She has a PhD in Human Sexuality Education and years of experience in community organizing, performance art, and finding the extra weird pockets of Philly.

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