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There are two types of sex headaches. The most common variety:

• Gives no warning and occurs within a few seconds of an orgasm
• Is often described as throbbing or stabbing

The other variety of sex headache:

• Often begins as a dull ache on both sides of the head
• May cause tightening of the neck and jaw muscles
• Builds gradually over a matter of minutes before an orgasm
• Intensifies as sexual excitement increases

Most sex headaches last about 30 minutes. Others may linger for a few hours. Many people who have sex headaches will experience them in clusters lasting a few months, and then go for a year or more without any sex headaches.

When to see a doctor
Sex headaches aren't usually a cause for concern. But consult your doctor right away if you experience a headache during sexual activity — especially if it begins abruptly or it's your first headache of this type.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

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

Slow-to-build sex headaches
A tightening of the head and neck muscles during sexual activity may cause the types of sex headaches that build up for several minutes before orgasm.

Abrupt sex headaches
The variety of sex headaches that occur abruptly at orgasm may be caused by:

• A response to increased blood pressure and heart rate during orgasm.
• Bleeding into or around the brain (subarachnoid hemorrhage).

Other causes that have been associated with sex headaches include:

• Bleeding into the wall (dissection) of an artery leading to the brain

• Stroke
• Use of some medications, such as birth control pills
• Sinus infection
• Coronary artery disease
• Pheochromocytoma
• Glaucoma

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

Sex headaches can affect anyone. But risk factors for these headaches include:

• Being a man
• Being prone to migraines

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

You're likely to start by first seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to a neurologist. Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restricting your diet.
• Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including past illnesses and operations, major stresses or recent life changes and any medical problems that run in your family.
• Make a list of all medications, as well as any vitamins and supplements, that you're taking.
• Take a family member or friend along, if possible. Sometimes it can be difficult to soak up all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For headaches associated with sexual activity, some basic questions to ask your doctor include:

• What is likely causing my symptoms or condition?
• Are there other possible causes for my symptoms or condition?
• What kinds of tests do I need?
• Is my condition likely temporary or chronic?
• What is the best course of action?
• What are the alternatives to the primary approach that you're suggesting?
• I have these other health conditions. How can I best manage them together?
• Are there any restrictions that I need to follow?
• Should I see a specialist?
• Is there a generic alternative to the medicine you're prescribing me?
• Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment whenever you don't understand something.

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:

• When did you first experience your headache?
• How quickly did your headache begin?
• Have your headaches been continuous or intermittent?
• Were there any symptoms besides pain?
• Have you had other types of headaches? If so, what were they like?
• Has anyone in your immediate family experienced migraines or headaches associated with sexual activity?
• What, if anything, seems to improve your headaches?
• What, if anything, makes your headaches worse?

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

Brain imaging
Your doctor will likely recommend brain imaging.

• Magnetic resonance imaging (MRI). An MRI of the brain can help detect any underlying causes for your headache. During the MRI exam, a magnetic field and radio waves are used to create cross-sectional images of the structures within your brain.
• Computerized tomography (CT). In some cases, especially if your headache occurred less than 48 hours beforehand, a CT scan of your brain may be done. CT uses an X-ray unit that rotates around your body and a computer to create cross-sectional images of your brain and head.

Angiograms
Your doctor may also order a cerebral angiogram, a test that can visualize the neck and brain arteries. It involves threading a thin, flexible tube through a blood vessel, usually starting in the groin, to an artery in your neck. Contrast material is injected into the tube to allow an X-ray machine to visualize the arteries in your neck and brain.

A less invasive version of this test uses MRI or CT, instead of threading a catheter through your blood vessels.

Spinal tap
Sometimes a spinal tap (lumbar puncture) is needed as well — especially if the headache started abruptly and very recently and brain imaging is normal. 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 evidence of bleeding or infection.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

In some cases, your first sex headache may also be your last one. And many sex headaches last for such a short period of time, the pain is gone before any pill you take can work. Because of reports that engaging in sex soon after experiencing a sex headache can cause even worse pain, you may be advised to refrain from sexual activity until your last headache has completely resolved.

Preventive medications
If you have a history of sex headaches and there's no underlying cause, your doctor may recommend that you take preventive medications on a regular basis. These may include:

• Daily medications. Beta blockers, which are used to treat high blood pressure, glaucoma and migraines, may be taken daily to prevent sex headaches. They're only recommended if you have frequent or prolonged attacks.
• Occasional medications. Indomethacin, an anti-inflammatory, or triptans, a class of anti-migraine medication, can be taken an hour or so before sex to ward off headaches.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

Sometimes sex headaches can be prevented by stopping sexual activity before orgasm. Taking a more passive role during sex also may help.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.