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What Is a Sex Headache?


HeadachePhoto credit: A headache via photopin (license)

Pauline Ryeland – Intimacy Whisperer and Somatic Sexological Body Worker

Well it’s true sex headaches exist and it’s not the old saying of “honey, not tonight, I’ve got a headache.”

Sex headaches can be completely debilitating and there are two types of sex headaches. The first can start as a dull ache in the head and neck which can intensify as sexual excitement increases. The second can be a sudden severe throbbing headache that occurs just before or at orgasm. Unfortunately, sometimes both types can occur at once. These headaches can last anywhere from a few minutes to a few hours and, in extreme cases, several days;  being enough to put anyone off having sex.


If you’re experiencing a sex headache, then the first thing to do is to see a doctor. A doctor can run tests to ensure that there is no bleeding from the brain or any other problems with the vessels in the brain.

  • Contributing causes of a sex headache can be glaucoma, strokes, coronary arterial dysfunction and sinus infections.
  • Side effects of a sex headache can be vomiting, visual and sensory loss and motor disturbances.
  • Some of the risk factors can be obesity, stress, migraine history, history of arterial disease, marijuana, amyl nitrate and some other drugs can contribute as well as obesity.

How can you treat these awful sex headaches?  Well, conventional medicine will give you a range of medications which may or may not help.

When I’ve been presented with this problem, I look at the person’s history; when the headaches began; any history of surgeries, injuries or falls; and the condition of the neck and tail bone.  There could potentially be internal adhesions which can travel from the site of injury through layers of muscle and tissues and can attach to ligaments, joints, fascia and tendons. These can create all sorts of issues within the body and could be a contributing factor.

I would also want to know the sexual and orgasmic history of a headache suffer.  Most people, when they orgasm, clench their jaw, hold their breath and tighten their body.  I would look at teaching a person who reacted this way to connect more with their sexual energy by using breath and movement to allow the body to open more. I would recommend ways that avoided contraction, which will allow the blood to flow through the body as well as allowing the sexual energy to flow more.

When you learn to connect with your body more, you become more present and aware which can help you to see how you are blocking the flow of energy. Connection with your body will reduce the “sex headaches” and can alleviate them all together.



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There is an old joke about the man who is sick of his wife always using a headache as an excuse to avoid sex.

So he decides to trick her. He asks her,”Sweetie, would you like an Aspirin?”

She answers, “No dear. I don’t have a headache.” He says, with a smile on his face, “Good.”

On a more serious note, however, a sex headache can be a warning of something much more sinister going on. Any sexual activity can trigger sex headaches. The exact prevalence in not known, although it is more common in women than in men.


There are two types of sex headaches – the pre-orgasmic and the orgasmic headache.  Neuroimaging is needed to distinguish primary, benign causes of a sexual headache from secondary, potentially life-threatening causes.


Abrupt-onset and slow-to-build sex headaches can be primary headache disorders not associated with any underlying condition. However, sex headaches associated with loss of consciousness, vomiting, stiff neck, other neurological symptoms and severe pain lasting more than 24 hours are more likely to be due to an underlying cause including:

  • A widening or bubble in the wall of an artery inside your head (intracranial aneurysm).
  • An abnormal connection between arteries and veins in the brain (arteriovenous malformation) that bleeds into the spinal fluid-filled space in and around the brain.
  • Bleeding into the wall of an artery leading to the brain (dissection).
  • Stroke.
  • Coronary artery disease.
  • Use of some medications, such as birth control pills.
  • Inflammation from certain infections.

Several theories have been put forth to explain the underlying mechanism of a primary sexual headache. The leading explanation involves exertion leading to a sudden increase in intracranial pressure or an inappropriate reaction in the cerebral vasculature. Neural hypersensitivity, similar to a migraine, may also play a role.


There are two subtypes of primary sexual headache:

  • Early sexual activity: usually of short duration and moderately severe. It is a tight, cramping, dull pain, often intensifying as sexual excitement increases. It is thought to relate to excessive contraction of the head and neck musculature that occurs before orgasm.
  • Orgasmic: which is severe, comes on abruptly and occurs at the point of orgasm. Postponing orgasm can prevent a sex headache. It is the most common type of headache associated with sexual activity.

Primary sexual headache is not usually recurrent:

  • It may appear suddenly, last for many months or years and stop abruptly.
  • It may occasionally occur on a regular basis for several months or, rarely, years.
  • Attacks may be intermittent and mild, or so severe as to scare the sufferer from attempting sex.

There appears to be a high comorbidity with a migraine, benign exertional headache and tension-type headache. The occurrence is not dependent on particular sexual habits. It most often occurs during sexual activity with the usual partner but also occurs during masturbation.

Risk factors include obesity, kneeling position during intercourse, the degree of sexual excitement, stress, history of a migraine and an exertion headache and a family history of a headache and arterial occlusive disease.

Pharmacological triggers may include marijuana, amyl nitrite, amfetamines, sildenafil and some anxiolytics.

Sensible actions to implement to avoid sex headaches include weight reduction, an increase in exercise, taking the passive role in intercourse and avoidance of drugs which act as trigger factors are all thought to be helpful.


As a psychologist in private practice, Dr Jan specializes in relationship therapy, particularlysex therapy. She is also the author of eight books on family and relationship issues including, “Sex-Wise Teens” and “Sex-life Solutions”.






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