Headache After Sex? Understanding Causes and Effective Treatments

Billions of people worldwide experience headache pain. If you’re having headaches after sex, it’s possible you’re just tired or feeling stressed. These headaches can happen during sex, when you’re feeling frisky, while you orgasm, or after finishing.

While coital cephalalgia (a sex headache) is usually harmless, it can sometimes be a sign of a serious medical condition. Below, we dig into the potential causes of headaches after sex, symptoms to watch out for, treatments, and when to see a doctor.

What Are Postcoital Headaches?

Can sex cause headaches? Sometimes.

Coital headaches are headaches that happen during sex, and postcoital headaches are those that occur after sex. Previously, sex headaches were known as benign vascular sexual headache, coital cephalalgia, and intercourse headache. Now, the medical community just calls them headaches associated with sexual arousal (HSA). These headaches affect about 1 to 1.6% of sexually active men and women. Research shows that HSA can happen at any sexually active age and is more common in men than women.

According to the International Classification of Headache Disorders (ICHD-3), primary HSA starts as a dull ache on both sides of the head during sexual excitement. The pain can suddenly become more intense at orgasm.

Here’s a rundown of the diagnostic criteria for HSA:

✅At least two episodes of head or neck pain that match up with the following:

1. The headache happens during and is triggered only by sexual activity

2. The headache pain gets worse with increasing sexual excitement AND/OR causes abrupt, explosive pain before orgasm

3. Severe pain lasting between 1 minute and 24 hours OR mild pain lasting for up to 72 hours

4. No other headache diagnosis fits

Sex-related headaches can happen before, during, or after orgasm.

The two main types of sex headaches include:

1. Pre-orgasmic headaches. These develop during sexual activity and involve a dull ache in the neck and back of the head that intensifies as sexual excitement increases.

2. Orgasmic headaches. These happen suddenly and typically involve sharp, explosive pain at the moment of climax. The pain may linger after orgasm.

These two subtypes, preorgasmic headache and orgasmic headache, were originally included in the International Classification of Headache Disorders, but have since been taken out. Clinical studies were not able to distinguish between these two types, and as a result, medical professionals now just call them “primary headache associated with sexual activity”, regardless of when they occur during or after sex.

Symptoms of Sex Headaches

Common symptoms of sex headache when reaching climax in males include:

Sudden And Severe Pain

The pain may feel intense and throbbing. People sometimes refer to it as a primary “thunderclap” headache. These types of headaches are either getting more intense as sexual excitement builds or they can be sudden and explosive in intensity right before or during orgasm.

One 2021 study, involving 245 people with HSA published found that most participants (85.3%) experienced sudden thunderclap-like onset of headaches.

However, in some people, HSA starts as a mild ache and builds up as sexual activity continues.

Location

You’ll typically feel this type of headache pain at the base of your skull, temples, or behind your eyes. It can also spread across your whole head.

Duration

Once they occur, sex headaches can last from a few minutes to several hours or, in rare cases, even days. Research has shown that up to 40% of primary headaches associated with sexual activity can come and go for over a year.

Associated symptoms

Some men who experience headaches after sex also report symptoms like:

• Nausea

• Vomiting

• Light sensitivity (photophobia)

• Sound sensitivity (phonophobia)

In a 2021 case study, researchers detailed the case of a 40-year-old man who was hospitalized who experienced sudden severe headaches after orgasm several times a month. He would also feel nauseated and vomit after.

Why Does My Head Hurt After Sex?

Headaches after sex can happen for several reasons, ranging from harmless and benign to serious. Understanding the cause is key to finding the right treatment.

Primary HSAs are called “primary” because they are not caused by another condition or disorder. These types of headaches are usually harmless, and medical researchers aren’t entirely sure what causes them.

In some cases, sex headaches can mimic other serious medical conditions.

In the previously mentioned study, researchers found that of 245 HSA cases:

• 15.5% were primary headaches

• 71% were associated with reversible cerebral vasoconstriction syndrome (RCVS)

• 2.9% were due to serious  causes like:

  • Subarachnoid hemorrhage

  • Right internal carotid disease

  • Moyamoya disease, a rare progressive disorder caused by blocked arteries at the base of the brain

Reversible cerebral vasoconstriction syndrome is a group of conditions involving a narrowing of the blood vessels that supply your brain. It often causes thunderclap headaches.

While the exact cause of reversible cerebral vasoconstriction syndrome isn’t always clear, there’s a link between RCVS and complications like stroke and subarachnoid hemorrhage.

Some of the potential causes of RCVS include:

• Pregnancy

• Recreational drug use

• Certain medications, including antidepressants

• Tumors

• Some autoimmune conditions (e.g., lupus)

• Head trauma

Subarachnoid hemorrhage is a medical emergency involving bleeding in the space between your brain and the surrounding membrane.

This is why people experiencing a new or unexplained headache during sexual activity should see a doctor for evaluation. Imaging of the brain and blood vessels may be needed to rule out the conditions mentioned above, like subarachnoid hemorrhage.

Other Potential Causes of Headaches After Sex

Here are a few other possible reasons you’re getting a headache after orgasm

Benign Exertional Headaches

Sexual activity, like exercise, can increase your blood pressure and heart rate, which can lead to an exertional headache. These types of headaches are typically harmless and happen because of increased blood flow to your brain.

Up to 29% of people with HSA report experiencing benign exercise headaches.

Tension or Stress

Sexual activity can sometimes cause physical or emotional stress. Stress is a common trigger for tension headaches. These headaches often feel like a dull, vice-like pressure on both sides of your head.

Up to 45% of people with HSA report having tension headaches.

Orgasm Migraine

If you have a history of migraine headaches, you might be more likely to experience headaches after sex. Up to a quarter of men with HSA report having migraine attacks.

Sexual activity can sometimes be a trigger for migraine episodes, especially in people who are also:

• Dehydrated

• Sleep deprived

• Stressed

Cluster Headaches

Physical activity, including sexual activity, can trigger cluster headaches. These types of headaches cause intense, one-sided pain, runny nose, and watery eyes.

They’re also most common in men in their 30s or 40s.

Hypertension

Sexual activity naturally raises blood pressure. Men with uncontrolled high blood pressure may likely develop high blood pressure-related headaches.

Medication Side Effects

Headaches are also a potential side effect of some erectile dysfunction (ED) medications such as Viagra (sildenafil).

While coital and postcoital headaches can be harmless, it’s a good idea to seek medical attention if you experience:

• A sudden, severe headache that feels like the worst headache of your life

• Frequent headaches after sex

• Headaches with symptoms like vision changes, weakness, speech issues

• Nausea, vomiting, or loss of consciousness

Getting headaches after sex can feel distressing and even make you anxious about sexual activity. You might feel awkward bringing it up with your partner — or even your doctor.

But open communication with your healthcare provider or partner is important.

Diagnosis of Postcoital Headaches

Diagnosing postcoital or sex headaches typically involves a detailed review of your personal and family medical history as well as a physical examination. Your doctor may ask about:

HSA diagnosis typically involves getting a detailed medical history and performing a physical exam.

A healthcare professional may ask you about:

• The timing and intensity of your headaches

• Whether you have a history of migraines or tension headaches

• Any new medications or lifestyle changes

• Other symptoms like nausea or neurological changes

If your headaches are severe or come with other worrisome signs, your doctor may refer you to a neurology specialist who may recommend the following tests:

• Brain imaging. CT scans or MRIs can help rule out bleeding, aneurysms, or structural abnormalities in your brain.

• Lumbar puncture. If a healthcare professional suspects a subarachnoid hemorrhage, they may recommend a spinal tap to check for blood in your cerebrospinal fluid.

Treatment for headaches after sex depends on the underlying cause.

Common treatment approaches include:

• Pain relievers. Over-the-counter (OTC) drugs like ibuprofen or acetaminophen may help relieve mild to moderate headaches.

• Preventive medications. Beta-blockers, calcium channel blockers, or triptans may help prevent or manage symptoms of recurring headaches after sex. The most common preventative treatment is indomethacin and triptans 30–60 minutes before sexual activity.

• Lifestyle changes. Your doctor may recommend lifestyle changes like minimizing stress, drinking more fluids, and improving sleep hygiene.

If you repeatedly experience headaches after sex, it’s a good idea to see your doctor to get a proper diagnosis and rule out serious underlying causes.

Here are a few tips for preventing sex-related headaches with no clear root cause:

• Warm-up gradually. Gradually increasing your activity during sex may help reduce the risk of exertional headaches. A slower buildup to orgasm can help your body adjust to increased blood flow and heart rate.

• Relaxation techniques. Practicing relaxation techniques before sexual activity can alleviate tension. This is especially helpful for men who experience pre-orgasmic headaches linked to muscle tension.

• Pain relief beforehand. Take a pain reliever roughly 30–60 minutes before sexual activity to prevent headaches.

• Beta-blockers or calcium channel blockers. If you have long-lasting headaches or recurring attacks, your doctor may recommend a beta-blocker like propranolol or a calcium channel blocker.

• Regular exercise. Engaging in regular cardiovascular exercise can improve your vascular health, potentially reducing your risk of exertion-induced headaches.

• Monitor triggers. Keep a headache diary to help identify specific triggers, like certain positions, intensity levels, or external factors (alcohol or stress).

Headaches associated with sexual activity in men are usually nothing to worry about. You can often manage them with simple lifestyle changes or medication.

If they’re severe or keep coming back, don’t ignore them. They might signal an underlying issue that needs treatment.

It’s a good idea to talk with a doctor if you develop regular sex headaches.

Headaches after sex can mess with your sex life, but they’re usually harmless and easy to manage.

Let’s recap what we know:

• You can prevent certain types of sex-related headaches. Is your neck feeling stiff post-sex? It might be from straining or taking on a certain position. Try to change things up next time — or maybe even ask your partner for a massage.

• Headaches after sex might be a sign of an underlying issue. While a random headache during or post-sex that goes away after a day isn’t usually cause for concern, frequent orgasmic head pain could be serious.

• A healthcare professional can help pinpoint the root cause of your head pain. And thankfully, you have options to manage chronic headache pain.

If you’re getting headaches after sex, it’s a good idea to let a healthcare provider know. They can help determine what’s going on and recommend treatment options, so you can get back to enjoying sex, not worrying about head pain.