FOXSexpert: Why Do I Get a Headache During Sex?

Not tonight, honey. I ... don't wanna GET a headache?!?!?

When it comes to sex, “pulsating” feelings are usually a very good thing. But when pleasure turns to pain, pulsating is anything but erotic.

Meet the sex headache.

You’ve heard how endorphins released during sex can make you feel better, but science has actually confirmed a link between sexual activity and headaches, as well as migraines.

It’s called coital cephalgia ... in layman's terms, a sex headache.

This painful reaction to sex can last up to 24 hours, bringing a new — not to mention alarming — meaning to the not-tonight-I-have-a-headache excuse.

So, is this pain-in-the-head sex ever a cause for concern? Usually, it's harmless.

About one in 100 people will develop a sex headache at some point in his or her life, according to the Mayo Clinic. Men are at least three times as likely to get them.

These headaches are due to climax or becoming sexually aroused, whether from solo sex or sex with a partner, oral sex or intercourse.

The headaches, caused by exertion, can happen prior to sexual activity, during sex, during the orgasm or following the orgasm. They can also be situational specific: For example, a colleague of mine is treating a woman who experienced headaches primarily when she was on top. Ouch!

According to the book “Headache Management” by Joel Saper, these reactions present themselves in three different ways:

1. In approximately 70 percent of cases, a severe, throbbing or stabbing headache hits the individual suddenly, sometimes building for several minutes. It can last for hours.

2. In about 25 percent of cases, the headache starts before an orgasm, building in intensity as sexual excitement builds. This type is known to start in the back or sides of the head and is more of a dull ache.

3. The headache sits primarily in the lower back of the head and gets worse when you stand. It may involve feeling nauseous, to the point where the individual literally becomes ill.

For those affected, it isn’t uncommon for benign sex headaches to occur on a regular basis. To date, the best explanation is that the pain is due to muscle contraction and/or blood vessel dilation in the head and neck during intimacy.

People who are already prone to headaches tend to grapple with sex headaches more than others.

So ... when should you be concerned?

If you have a new, severe headache during sex — often described as among the worst ever — it may require immediate attention.

These headaches are often due to the rupture of an abnormal blood vessel, for example, an aneurysm, causing an acute brain hemorrhage or other serious condition. Since the heart rate and blood pressure are elevated, walls of abnormally weak blood vessels may burst or leak during sex.

If you start experiencing sex headaches out of nowhere, you should be evaluated by a physician immediately. You need to rule out any brain bleeding, with procedures like an MRI, CT scan or spinal tap. While brain bleeds make up only a small fraction of all headaches, this should be handled as an emergency situation. If not treated, they can result in disability or death.

One colleague’s client discovered that her sex headache would come on after having a few glasses of white wine and eating a large meal within two hours of sex, which she had lying down.

Other factors to consider include:

— Alcohol intake

— Food or non-alcoholic beverages consumed in the six hours prior to sex

— The size of a pre-coital meal

— Low blood sugar

— Birth control pills

— Marijuana intake

— Possible sinus infection

— Timing of sex: Does is only happen at night, or only in the morning?

— Lack of sleep

— Glaucoma

— Anemia

To combat the onset of these headaches, some people prefer to take medicine before sex. But some situations can be altered without having to resort to pills. Changing sexual positions (standing up instead of lying down, for example) may help.

For some couples, it helps to abstain from sex for a few days. The person with the headache may also find relief in being the passive sexual partner. As with most health problems, bringing your overall stress level down can help, as well.

In any event, consult your doctor, especially if the sex headaches become progressively worse. Sometimes the problem goes away on its own; sometimes the headaches go away, only to come back months later.

Dr. Yvonne K. Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, "Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots."

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