Primary Headache Associated with Sexual Activity

This headache disorder is rare. It is previously known as pre-orgasmic (appears during sex and increases during mounting excitement) or orgasmic headache (sudden explosive headache followed by severe throbbing immediately before at the point of orgasm). It is considered a primary headache because there is no other underlying cause.

This headache is usually bilateral and often located to occipital areas. Severe headache due to sexual activity can lasts anywhere from 1 minute to 24 hours. Milder headache can last up to 3 days. This headache may have migrainous features and should be differentiated from a migraine triggered by sexual activity. Can occur in anyone who is sexually activity regardless of age. More common among men than women.

People with new onset headache associated with sexual activity or if never evaluated for this headache should consider seeing a doctor to r/o underlying causes. Imaging studies may be ordered to rule out serious conditions such as subarachnoid hemorrhage, arterial dissection and reversible cerebral vasoconstriction syndrome.

Medications are available for headache associated with sexual activity, and should usually be prescribed after all imaging studies are completed.

American Migraine Foundation (2019)

Tanesha Reynolds, DNP, FNP-BC, Certified in Headache Medicine