sexually frustrated couple, lasting sexual problems

If you have ever had an intimate moment interrupted by pain, you will be able to appreciate the difficult situation one reader encountered. What can be done for sex headaches?

 How Benign Are Sex Headaches?

Q. I have a problem my doctor and neurologist can’t help me with. I am hoping you can give me a hint as to what to do.

Whenever I strain in heavy lifting or in hanky panky (don’t laugh), I get severe pounding headaches lasting 5 to 15 minutes. I am incapacitated by them. My neurologist says they are “benign sex headaches” caused by my blood pressure going high, but I’m on Accupril for hypertension. Do you have any ideas? I would like a normal life back.

A. You are not alone in your distress.

Here is a story from another person with this problem:

“Thank you for your article about sex headaches. My doctor thought I was nuts when I complained of a similar problem. It happens only when I’m on top. This position gives me the most pleasure, but I have been avoiding it for fear of a stroke. The only other time I had such a headache was after going down a steep water slide. My kids and husband were terrified I was dying.

“I am a 49-year-old woman with high-normal (130/80) blood pressure. I take naproxen for arthritis and Zyrtec for allergies. The headache is explosive and excruciating. At least your article vindicates me and assures me I am not alone!”

Treating Sex Headaches:

Have a specialist evaluate your headaches. If they are “benign sex headaches” similar to those suffered by the reader who wrote to us previously, there are a number of treatments. For example, the naproxen you use for arthritis may prevent such headaches if taken before lovemaking. The older NSAID indomethacin is reported to be helpful for sex headaches as well as for headaches triggered by cough or exercise (Cutrer & DeLange, Neurologic Clinics, May 2014).

It is extremely important to rule out other potential causes of severe headaches.

One woman responded to the same letter:

“I read with great concern your column about the man who asked for help with headaches that occurred with exertion or sexual activity.

“When my husband was 25, he had a very similar headache while having sex. The doctors told him it was viral. After a week of bed rest and Tylenol he felt better and went back to work. The next week while having a bowel movement it recurred, but this time the headache was fatal. He had a ruptured aneurysm in his brain. Please tell your readers to rule out all possibilities of problems with blood vessels.”

Two Kinds of Sex Headaches:

Two kinds of headache are associated with sexual activity and exertion. One develops gradually with a dull, throbbing ache at the back of the head. The other type is explosive and excruciating, starting just before or during orgasm and lasting 5 to 15 minutes.

Neurologists often prescribe NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin IB), naproxen (Aleve) or indomethacin (Indocin) to be taken prior to love-making. An alternate approach is the blood pressure pill propranolol (Inderal) as a preventive measure. You might want to consult a headache specialist and ask if such treatment would be appropriate in your case. But please make sure to rule out anything serious that might require more aggressive treatment.

For those who would like to learn more about headaches and migraines, we offer our Guide on this topic. If you have ever experienced a sex headache like those reported here, please add your story in the comment section and let us know what has helped you.

Revised 9/21/2017

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  1. HN

    I have seen this in people who have trigger points in the muscles and tendons at the back of their neck, especially along the ridge of the skull. An easy self-test that can be done at any time is to put pressure along that ridge with a finger–if the pain level shoots up to a 6 or 8 with pressure (on the pain scale of 1 to 10, with 10 being excruciating pain), then that is a trigger point. Trigger points are notorious for triggering pain up into the head when strained (e.g., during sex, heavy lifting, water slides).

    After ruling out any more serious issues that could be causing it, find a licensed massage therapist who has experience specializing in releasing trigger points. Before scheduling an appointment, tell the therapist that you only want trigger point therapy for your neck. During the session, do not let them apply pressure above an 8 on the pain scale on any trigger point to avoid making the problem worse.

  2. JD
    United States

    I was taking Allegra and Flonase to control my allergies but decided to cut out the Allegra. For awhile my allergies were gone and eventually I discovered my sex headaches were gone too.

    My allergies returned with a vengeance this February so I decided to try Zyrtec and the sex headaches immediately returned. So I’m pretty sure Allegra and Zyrtec are the cause of my headaches. I’m guessing they are chemically related. I just stopped taking Zyrtec a couple days ago and am hoping the headaches will go away eventually.

    • SJ

      I would try something herbal to help with your allergies instead of taking the Zyrtec, etc. I had great results with Stinging Nettle thirty years ago. I was close to being asthmatic, using an inhaler when needed. I took stinging nettle for three months (2 X 2 daily). I also got on a good vitamin/mineral regiment and my allergies completely stopped. I am still allergy free thirty three years later.

  3. MT

    I used to have very brief severe headaches too…only when I was upright (on top). Not every time.

  4. Virtualguy

    Get healthy the natural way. Exercise.

  5. CS

    I also experienced headaches during sexual activity. I started going to a chiropractor and have not had one since. That has been over 20 years now.

  6. A L

    This is to Hanky Panky Headaches. Check with your neurologist about a condition (birth defect) called Chiari (sp) Malformation. It can only be detected by a MRI. Many people have this condition and it can cause severe headaches when laughing or coughing hard and they are treated for other conditions. It can cause paralysis (stroke symptoms) as our family experienced. It is where the Cerebellium presses on the spinal cord. Surgery is a choice of corrections. To People’s Pharmacy please do an article on this condition.
    PEOPLE’S PHARMACY RESPONSE: If someone suspects this, it should be checked out. It is pretty rare, though.

  7. Richard

    Those who suffer from this type of headache can benefit from Traditional Chinese Medicine. As someone who was beset with these truly incapacitating headaches I can attest to the effectiveness of acupuncture and Chinese herbal therapy.

  8. RHC

    I do not have headaches but I have a ringing in my one ear and head only every third day. the ENT Dr. Says it is tininutis but I have never heard of it being so exact. Should I see a Neurologist?

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