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Hanky Panky Headaches Interfere with Romance

Sex headaches can be quite alarming. A checkup to make sure there is nothing more serious happening is essential; then, the headache may be prevented.

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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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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