PAIN MANAGEMENT Headache • Migraine headache • Tension headache • Cluster headache • Rebound headaches • Primary cough headaches • Ice cream headaches • Exercise headaches • External compression headaches • Spinal headaches • Thunderclap headaches • Sex headaches • Chronic daily headaches • Sinus headaches

Note: All links within content go to MayoClinic.com

Jokes about sex and headaches abound. But the pain is no laughing matter.

Sexual activity — especially orgasm — can trigger a headache. You may notice a dull ache in your head and neck that builds up as sexual excitement increases and peaks during orgasm. Or you may experience a sudden, severe headache during orgasm.

Most sex headaches are nothing to worry about. But proper diagnosis is important. Sometimes sex headaches are a sign of something serious, such as bleeding in the brain or stroke.

Sex headaches often start as a dull ache on both sides of the head. The pain may intensify as sexual excitement increases.

In other cases, sex headaches appear suddenly during orgasm. You may feel severe pain around or behind your eyes. Some people describe the pain as pulsing, throbbing or a sudden blow to the head. The pain may get worse when you move.

Most sex headaches last a few minutes. Others may linger for a few hours.

Any type of sexual activity that leads to orgasm — including masturbation, oral sex and intercourse — can trigger sex headaches.

Dull, achy sex headaches are thought to be caused by tightening the head and neck muscles during sexual activity. Sex headaches associated with orgasm may be a response to increased blood pressure that causes the cerebral blood vessels to dilate.

In other cases, medications such as birth control pills and pseudoephedrine (a common decongestant in many over-the-counter cold remedies) have been linked to sex headaches.

Sex headaches aren't usually related to the amount of physical exertion associated with sexual activity.

Sex headaches can affect anyone. But they're more common in men and people who are prone to migraines. Sex headaches may be more likely if you're tired, stressed or have sex multiple times in rapid succession.

Sex headaches aren't usually a cause for concern. But it's a good idea to consult your doctor if you experience headaches during sexual activity — especially if it's your first headache of this type. Sex headaches may indicate a serious underlying problem, such as bleeding in the brain or stroke.

Your doctor may recommend a magnetic resonance imaging (MRI) exam to detect any underlying causes for your headache. During the exam, a magnetic field and radio waves are used to create cross-sectional images of the structures within your brain.

In other cases, a computed tomography (CT) scan of your brain may be done. Computerized tomography uses an X-ray unit that rotates around your body and a computer to create cross-sectional images (like slices) of your brain and head.

Sometimes a spinal tap (lumbar puncture) is needed as well — especially if the headache appeared suddenly. With this procedure, the doctor removes a small amount of the fluid that surrounds your brain and spinal cord. The fluid sample can be tested for protein, white blood cells and other substances.

Sex headaches aren't associated with any physical complications. But fear of recurrent headaches may turn into a fear of having sex, which can affect intimate relationships and how you feel about sex.

Sex headaches often disappear on their own. Nonsteroidal anti-inflammatory drugs such as aspirin or ibuprofen may help ease the pain of a lingering headache.

If you have a history of sex headaches, your doctor may recommend preventive therapy before sex. Sometimes aspirin or ibuprofen is enough. In other cases, medications such as propranolol (Inderal, others) or indomethacin (Indocin, others) may be an option.

Sometimes sex headaches can be prevented by stopping sexual activity before orgasm. Slowing down the pace and relaxing neck and jaw muscles during sexual activity may help, too.