"Big O" cause or stop headaches and Migraine?
We've all heard the old
joke, "Not tonight, dear. I have a headache." Right? Surprisingly enough,
for some people, there definitely is a correlation between sexual activity
and headache or Migraine that can be good!
The Bad News
For some people, sexual activity can cause headaches and trigger Migraine
attacks called coital cephalgia (headache), exertional headache,
or exertionally-triggered Migraine. Such headaches may be benign
exertional headaches that can also be brought on by other strenuous
activities. They may also be directly linked to orgasm or sexual excitement.
Coital headaches may have
a duration of up to 24 hours, and are more common among men than women at a
ratio of 4:1. Although such episodes are usually benign, it is
important that they be correctly diagnosed to rule out organic causes.
Tests used to confirm the diagnosis include CT scan, MRI, and MRA.
Headaches or Migraine
attacks induced by sexual activity may strike prior to, at the time of, or
Such attacks have also
been documented after masturbation. There are three patterns of occurrence
for coital headache:1
- Sudden onset:
This pattern applies in 70% of coital headaches, and begins just before,
during, or immediately after orgasm. The headache is severe, usually
throbbing, and may build over minutes or be explosive. Average duration
is several hours.
crescendo headache: This pattern applies in approximately 25%
of cases. The onset is much earlier than orgasm, with intensity
increasing until the time of orgasm. Frequently in the back of the head,
the pain is dull and aching. Rarely, nausea and vomiting may occur.
headache: This is the least common of coital headaches. The
pain occurs in the lower back of the head and is greatly increased then
the patient stands. This form is more likely to be accompanied by nausea
A Brighter Side
To the Bad News
Once coital headaches are diagnosed benign, medications can be taken one to
two hours before anticipated sexual activity to hopefully avoid coital
headaches. Some medications that may be used are Indomethacin, DHE
(dihydroergotamine,) triptans —Imitrex, Zomig, Maxalt, Amerge, Relpax,
Frova, and Axert —, Midrin, propranolol (Inderal), and common analgesics. If
the problem persists, daily preventive medications may be in order. Care
should be taken not to use the triptans, Indomethacin, DHE, or analgesics
more than two or three days a week in order to avoid
headache, aka rebound.
The Good News
In a journal article by Randolph W. Evans, M.D. and James R. Couch, M.D., Ph.D.,
the authors open by saying,
"Occasionally, orgasm can trigger a Migraine but, in others, can relieve a
Migraine. Dr. Couch's data suggests that some women who decline, 'Not tonight, I
have a headache,' may be avoiding an effective treatment."2
Study of Migraine relief with
sexual intercourse in women was undertaken at the Headache Clinic at Southern
Illinois University. For those who obtained relief through orgasm, the level of
relief varied, but it is interesting to note that of those who obtained any
relief, the largest subset is those who obtained complete relief. Of study
- 47.4% had complete
- 48.5% had no relief, and
- for 4.1%, orgasm made
their Migraine worse.2
In comparing the efficacy of
orgasm to that of Migraine abortive medications, orgasm is significantly less
effective than triptans or DHE, but when it is effective, the onset of relief is
faster than with medications.
Dr. Evans and Dr. Couch conclude their journal article with this statement,
"The issue of suppression of headache by orgasm does bring up the possibility of
suppression of one multi-faceted, presumably neural origin syndrome (Migraine)
by another neural event (perception of sexual orgasm). Perhaps there are other
situations in which an indigenous neural process might be used to suppress
Migraine. Certainly there are some interesting theoretical possibilities here."
indeed! Although this study did not include men, Dr. Evans and Dr. Couch report
there is anecdotal information suggesting that relief with sexual orgasm may
occur in men, including men suffering cluster headaches.
As with so many issues with
headaches and Migraine, we find that there wasn't a single answer to our initial
question, "Does the "Big O" cause or cure headaches and Migraine?" In searching
for answers to the question, both good news and bad news are found, but even for
those for whom orgasm sometimes causes headaches or triggers Migraines, there
are avenues of prevention to be explored. Don't give up or be embarrassed to
approach your doctor with the problem. The answer might be simpler than you
1 Saper, Joel R.,
Silberstein, Stephen, Gordon, C. David, Hamel, Robert L., Swidan, Sahar.
Headache Management: A Practical Guide to Diagnosis and Treatment of Head, Neck,
and Facial Pain, Second Edition. Lippincott Williams & Wilkins, 1999,
2 Evans, Randolph
W. & Couch, R. (2001). "Orgasm and Migraine." Headache: The Journal of Head
and Face Pain 111 (6), 512-514.
Medical review by
John Claude Krusz, PhD, MD
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© Teri Robert, 2006 - Present. Last updated
December 8, 2010.