What Is a Post-sex Headache, and Is It the Same as a Migraine?

Have you ever had a sudden, severe headache during sex? You're not alone. Post-sex headaches are a rare but treatable headache disorder. Often confused with migraines, your neurologist will be able to develop a treatment plan to address your headache disorder. You should see a doctor immediately for any sudden, severe head pain.

Key takeaways:

Post-sex headaches are harmless, but other conditions that cause severe head pain aren’t. Prompt medical attention can rule out any other conditions.

What are post-sex headaches?

Have you ever had a post-sex headache? The medical name for this is a primary headache with sexual activity, but it’s also known as a post-coital headache. A primary headache means that there isn’t an underlying condition causing your headache. You may also hear it referred to as coital cephalgia or benign orgasmic cephalgia.

These headaches are rare. About 1% of the population has experienced a post-sex headache. Post-sex headaches only occur during or after sexual activity.

Researchers are not sure exactly what causes post-sex headaches. There may be a link to your cardiovascular system. This body system encompasses your blood vessels, arteries, and heart.

Your trigeminal nerve may also play a role. The trigeminal runs along your temples and branches out to your eyes, forehead, and jaw. You have one for each side of your head. When it becomes irritated, it can cause headaches and facial discomfort.

Who may get a headache post-sex?

There are two age ranges where post-sex headaches tend to appear. You may start to experience headaches with sex if you're between the ages of 20–24 or 35–44 years old. It gets more common as you get older. Males are roughly twice as likely to experience post-sex headaches as females.

If you’re sedentary and in poor physical shape, you may be more at risk. People who have high blood pressure are also more likely to have post-sex headaches. Being overweight is another significant risk factor.

Hypnic headaches, exertional headaches, and migraines are also more common in this population. Exertional headaches appear at the onset of physical activity. Hypnic headaches are a rare headache disorder that only happens at night while you’re asleep.

There seems to be a genetic component to this type of headache disorder. If you have a family member who has sex-related headaches, you may be more at risk. Researchers need larger studies to confirm this theory.

Some medications that may cause post-sex headaches include:

  • Ginkgo biloba glycosides
  • Amiodarone
  • Marijuana

Post-sexual headaches are complex. It may not be possible to pinpoint the exact cause.

Types of post-sex headaches

There are two types of post-sex headaches:

  1. Pre-orgasmic headache
  2. Orgasmic headache

A pre-orgasmic headache begins at the onset of sexual activity. It may start as a dull pain located around the back of your head. The pain will increase with sexual arousal.

An orgasmic headache happens around the moment of orgasm. You may notice it right before, during, or right after. This sudden headache is more severe than pre-orgasmic headaches. It starts as an explosive, sudden head pain. The headache will continue to be severe and throbbing after the initial presentation.

Orgasmic headaches are shorter than pre-orgasmic headaches. They may go away on their own after 20 minutes of severe pain.

Symptoms of post-sex headaches

When you have a post-sex headache, you’ll most likely feel pain on both sides of your head. The back of your head is another area for the pain to congregate. The pain may feel like a dull pressure, or you may experience a sudden, throbbing head pain that’s more intense.

You may experience severe pain up until 24 hours after sexual activity. It can last up to 72 hours, but the pain will become duller after the 24-hour mark. There are no other symptoms associated with this type of headache condition.

Post-sex headache vs. migraine

A post-sex headache is different from a migraine caused by sexual activity. A migraine is a complex neurological disease. Having head pain can be a cardinal sign of a migraine, but it’s not the only sign.

With a migraine, you may notice:

  • Brain fog
  • Nausea
  • Sensitivity to light and noise
  • Fatigue and weakness

These symptoms won’t appear if you have a post-sex headache.

If you think you may have migraines, you should make an appointment with a neurologist. A neurologist is a doctor that specializes in nervous conditions, like migraines.

A neurologist will be able to provide you with a treatment plan. This may include a combination of medications to get rid of or prevent a migraine. Sometimes, they may recommend lifestyle changes.

If you notice that sex is an ongoing trigger to your migraines, let your healthcare provider know. During your appointment, mention the duration of the headache and the level of pain. If you noticed any other symptoms, tell your doctor. This will help them provide an accurate diagnosis of your headache condition.

When should you see a doctor?

You should see a doctor the first time you feel a sudden, severe headache. Primary sex headaches are benign. This means they aren’t harmful to you. But, you need to see a healthcare provider to rule out any other harmful conditions.

If you develop a sudden, severe headache you may be experiencing:

  • Stroke
  • Aneurysm
  • Hemorrhage
  • A dissected artery
  • A thunderclap headache
  • Spontaneous intracranial hypotension

Some of these conditions are life-threatening. You need to seek medical care immediately to rule out any other reasons for your headache.

If you notice a dull headache, it may be a sign of hypertension. Often called “the silent killer,” hypertension can cause long-term complications. You can’t be certain of the cause of your headache until you see a healthcare provider.

How to treat post-sex headaches

Sometimes, being less active during sexual activity is enough to reduce your post-sex headaches. Playing a more passive role in the bedroom reduces the cardiovascular stress on your body. It may take 3 months to see a lasting effect.

Your neurologist may recommend a preventative medication. You will take preventative medication regularly to stop the headache from developing. Topamax or propranolol are two types of preventative medications your neurologist may recommend. Topamax is an anti-seizure medication. Propranolol is a beta-blocker that lowers your blood pressure. Sometimes, calcium-channel blockers can be an alternative to beta-blockers.

You may have to take these medications for 3–6 months to see a lasting effect. After this timeframe, your post-sex headache may disappear on its own. Some medications aren’t effective. Benzodiazepines, ibuprofen, and acetaminophen aren’t recommended.

Have you ever experienced headaches during or after sex? Leave a comment below.

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