Presentation
[…] of presenting headaches. [patient.info]
OBJECTIVE: We describe a case of RCVS presenting as coital thunderclap headache with initial imaging demonstrating intraparenchymal hemorrhage and sulcal subarachnoid blood CASE: A 49-year-old Caucasian woman presented to her PCP with a three-day history [n.neurology.org]
OBJECTIVE: To present a case of orgasmic headache caused by a basilar artery dissection and to present a literature-based guide to the diagnosis and management of patients presenting with headaches related to sexual activity. [read.qxmd.com]
It is intense, holocranial, throbbing and accompanied by a stiff neck (as you can see the clinical presentation may resemble that of a post coital headache). [braindiseases.blog]
When patients first present with coital or orgasmic headache, it is mandatory to exclude serious underlying condition like ruptured aneurysm and bleeding in the brain. [nbharwani.com]
Respiratoric
- Cough
Headaches can be triggered by coughing, exertion, and sexual activity. [1,2,3] The lifetime prevalence of benign cough headache, benign exertional headache, and headache associated with sexual activity is 1% for each. [4] All 3 headache types occur more [medscape.com]
Primary cough headache, primary exertional headache and primary headache associated with sexual activity. Handb Clin Neurol 2010;97:459-68. 10. Pascual J, González-Mandly A, Martín R, Oterino A. [smjonline.org]
Headaches were not precipitated by physical activity, even if vigorous, except when having intercourse, and were not precipitated by coughing, sneezing, or involuntary Valsalva, for example, when straining for any reason. [webmedcentral.com]
Cough, exertional, and other miscellaneous headaches. Med Clin North Am. 1991; 75 :733–747. [ PubMed ] [ Google Scholar ] [ncbi.nlm.nih.gov]
If you are, that may explain your morning cough. But if you don't smoke, the infection could have made your bronchial tree hyper-irritable. [independent.co.uk]
Cardiovascular
- Hypertension
Hypertensive crisis: Hypertensive emergencies and urgencies. Cardiol Clin 2006;24:135-146. Tulman DB, Stawicki SP, Papadimos TJ, et al. Advances in management of acute hypertension: A concise review. Discov Med 2012;13:375-383. [reliasmedia.com]
Red flag features include headaches lasting more than a few minutes after intercourse, severe headaches, focal lateralizing signs, alteration in the characteristics of the headache, history of uncontrolled hypertension and performance enhancing drugs [smjonline.org]
[…] caution is advised when diagnosing the first sex headache since sexual activity is the precipitant of up to 12% of ruptured saccular aneurysms and 4% of patients with SAH due to bleeding AVM's. [5] Rarely, pheochromocytomas can present with paroxysmal hypertension [medscape.com]
However, there's no evidence at all that coital headaches are more likely to occur among people who have a high BP (hypertension). [netdoctor.co.uk]
Delivery Models Health Care Economics, Insurance, Payment Health Care Policy Health Care Quality Health Care Reform Health Care Safety Health Care Workforce Health Disparities Health Informatics Health Policy Hematology History of Medicine Humanities Hypertension [jamanetwork.com]
- Heart Disease
If your sex headache is accompanied by neurological problems such as a stiff neck or vomiting, it could mean you’re dealing with: brain hemorrhage stroke tumor bleeding into the spinal fluid aneurysm coronary heart disease inflammation medication side [healthline.com]
ED may also be an early sign of cardiovascular disease. The main risk factors for coronary heart disease (high LDL, smoking, hypertension, diabetes) and ED are the same. [read.qxmd.com]
Behcet’s disease Antiphospholipid antibody syndrome Systemic lupus erythematosus Wegener’s granulomatosis Churg-Strauss syndrome Endocrine diseases Diabetes mellitus Hyperthyroidism Other Trauma Long flights Dehydration Irritable bowel disease Lumbar [reliasmedia.com]
Psychiatrical
- Fear
I set up camp in a corner of A&E and – grateful that I had a book with me – whipped out Hunter S Thompson’s Fear And Loathing In Las Vegas. [theguardian.com]
Apart from the pain of the headaches themselves, some individuals find the associated fear, apprehension, distress and consequent negative impact on their sexual relationships is a significant issue. [bodyandsoul.com.au]
HSA can be very distressing for both patient and partner with the development of fears around sexual activity and orgasm. Patients may develop patterns of impaired sexual arousal. [bjmp.org]
The pain he had experienced, though short-lived, was enough to make Jack fearful of making love again. Though reluctant to discuss his sex life with his doctor, Jack made an appointment and described his symptoms. [wkhs.com]
[…] secondary when it is associated with an underlying intracranial pathology, notable among which are cerebral artery aneurysms and other vascular disorders. [4] It is known generally that headache and sex are not co-travelers on the same route and that the fear [smjonline.org]
Neurologic
- Headache
[…] for Benign coital headache and additional synonyms G44.82 Headache associated with sexual activity Synonyms: Benign coital headache|Benign coital headache (finding)|Headache associated with sexual activity (finding)|Orgasmic headache|Preorgasmic headache [averbis.com]
Let us discuss post-coital headache also at times referred to as orgasmic headache. What is post coital headache? The history is quite typical. This is a throbbing and at times intense headache which comes on at or near the height of orgasm. [braindiseases.blog]
[…] of the International Headache Society 2013 ; Headache Classification Committee of the International Headache Society 2018). [medlink.com]
[…] and orgasmic headache. [en.wikipedia.org]
Previously used terms: Benign sex headache; benign vascular sexual headache; coital cephalalgia; coital headache; intercourse headache; orgasmic cephalalgia; orgasmic headache; sexual headache. [ichd-3.org]
- Orgasmic Headache
The second type is a vascular headache. It is a very intense, severe headache usually occurring just before orgasm. It has been called an “orgasmic headache” or “orgasmic cephalalgia.” [headaches.org]
[…] for Benign coital headache and additional synonyms G44.82 Headache associated with sexual activity Synonyms: Benign coital headache|Benign coital headache (finding)|Headache associated with sexual activity (finding)|Orgasmic headache|Preorgasmic headache [averbis.com]
[…] as a specific variant of pre-orgasmic headache. [webmedcentral.com]
The headaches actually fall into two categories: pre-orgasm and post-orgasm. The former is a better tolerated pain that starts in the neck, jaw and head, and builds slowly. [globalnews.ca]
The other type is a sexual benign headache, which doctors also call a pre-orgasm headache. What do they feel like? People typically experience orgasm headaches just before or during an orgasm. [medicalnewstoday.com]
- Excitement
During coitus as sexual excitement increases, the muscles around the shoulder and neck become tense. [braindiseases.blog]
These headaches are usually benign, but occasionally are caused by intracranial hemorrhage and cerebral infarction, especially if the pain is sudden and severe. [1] They may be caused by general exertion, sexual excitement, or contraction of the neck [en.wikipedia.org]
Description: Headache precipitated by sexual activity, usually starting as a dull bilateral ache as sexual excitement increases and suddenly becoming intense at orgasm, in the absence of any intracranial disorder. [ichd-3.org]
Symptoms of a Sexual Headache A sexual headache can feel like a dull ache in the head and neck that gets worse as excitement builds up. [vanquishheadacherelief.com]
Other risk factors may include obesity, certain sex positions (such as kneeling), and degree of sexual excitement. [sexinfo.soc.ucsb.edu]
- Confusion
During her hospitalization she suffered multiple severe transient headaches associated with confusion, blurred vision, and speech difficulties with progressive right hemi-body weakness. [n.neurology.org]
Prevalence in the general U.S. population is reported around 1%. 3 However, this condition may also be underreported due to embarrassment, misdiagnosis, or confusion about symptoms. [sexinfo.soc.ucsb.edu]
Your partner may be confused by the fact that you suddenly 'break off' during sex for no apparent reason and later are reluctant to have any subsequent sexual encounters. ✔️ The best immediate treatment is to take ibuprofen, aspirin or paracetamol – provided [netdoctor.co.uk]
You might also have several other symptoms, including: Changes in vision Confusion Nausea Numbness Vomiting Weakness Fever Seizures Causes Thunderclap headaches could be caused by bleeding from an artery into the space surrounding your brain. [webmd.com]
It certainly seems confusing. The sudden onset of an explosive headache may be the only warning of a deadly condition. On the other hand, the vast majority of the time these headaches are benign and not a cause for alarm. [huffpost.com]
- Post-Coital Headache
Let us discuss post-coital headache also at times referred to as orgasmic headache. What is post coital headache? The history is quite typical. This is a throbbing and at times intense headache which comes on at or near the height of orgasm. [braindiseases.blog]
Coital Headache Treatment There are two types of sexually-associated headaches: pre-orgasmic headache, and orgasmic headache, or post-coital headaches. [migrainesurvival.com]
DR BYRNES: Post-coital headaches are thought to occur in about 1pc of the population. They are more common in men. Those who are middle-aged, overweight and unfit are at risk. [independent.ie]
These headaches are known medically by various names, such as: Post-coital headache Sexual headache Orgasmic headache Coital cephalgia Coital cephalalgia The words cephalgia and cephalalgia are alternative spellings of a medical word meaning headache. [netdoctor.co.uk]
Workup
Age and male sex positively correlated with radiological imaging workup (p table 2 ). [journals.plos.org]
The 2011 Scientific Statement from the AHA/ASA includes an algorithm for workup of suspected CVST. [reliasmedia.com]
[…] decreased level of consciousness, a stiff neck, hemiparesis or hemisensory symptoms, visual changes, a seizure, or severe pain for more than 24 hours are not the features of primary headache associated with sexual activity and require immediate diagnostic workup [doctormigraine.com]
Treatment
Treatment, when necessary, is usually indomethacin and/or propranolol. [americanmigrainefoundation.org]
Sexual headaches: Case report, review, and treatment with calcium blocker. Headache 1991;31:141-5. [smjonline.org]
Pre-emptive treatment Propanolol hydrochloride ( Inderal) is effective in the prophylaxis of HSA [19]. [bjmp.org]
For this patient, prophylactic treatment with beta-blockers and/or preemptive therapy with indomethacin was successful. [ncbi.nlm.nih.gov]
Fortunately, treatment to prevent a recurrence of benign sexual headaches is both simple and effective. [wkhs.com]
Prognosis
Primary HAS has an excellent prognosis. [smjonline.org]
Prognosis Prognosis is usually good for HSA as it is a benign self- limiting disorder and disappears without any specific treatment in the majority of patients [17]. [bjmp.org]
Even in those with chronic courses, 69% of these patients reached remission over the course of 3 years. 3 Therefore, sexual headaches typically have a favorable prognosis. [sexinfo.soc.ucsb.edu]
Even in chronic HAS, the prognosis is favourable, with remission rates of 69% during an observation period of 3 years”. [drmarkgriffiths.wordpress.com]
Headache Associated With Sexual Activity: Prognosis and Treatment Options. Cephalalgia, 2007:1265 -1270 vol. 27: Available at: http://cep.sagepub.com/cgi/content/abstract/27/11/1265 [migrainesurvival.com]
Etiology
Lack of angiographic evidence early in the course of recurrent headache in the presence of both intraparenchymal and sulcal subarachnoid blood should prompt vigilance as RCVS may be a potential etiology. [n.neurology.org]
Question What is the likely etiology of recent onset of coital headaches in an otherwise healthy 42-year-old man? Headaches begin at orgasm, are extremely intense, and localized near the top/center of the head. [medscape.com]
Minor leak before rupture of an intracranial aneurysm and subarachnoid hemorrhage of unknown etiology. Neurosurgery 1992 ;30: 7 – 11 Google Scholar | Crossref | Medline | ISI 7. Leblanc, R. The minor leak preceding subarachnoid hemorrhage. [journals.sagepub.com]
External links [ edit ] Medscape: Etiology of Coital Headaches Dexter, S. (2010). "Benign coital headache relieved by partner's pregnancies with implications for future treatment". Case Reports. 2010 : bcr1020092359. doi : 10.1136/bcr.10.2009.2359. [en.wikipedia.org]
External links Edit Medscape: Etiology of Coital Headaches Dexter, S. (2010). "Benign coital headache relieved by partner's pregnancies with implications for future treatment". Case Reports. 2010 : bcr1020092359. doi : 10.1136/bcr.10.2009.2359. [en.m.wikipedia.org]
Epidemiology
Epidemiological research has further shown that 4.3 Primary headache associated with sexual activity can occur at any sexually active age, is more prevalent in males than in females (ratios range from 1.2:1 to 3:1), occurs independently of the type of [ichd-3.org]
We report 2 new adolescent cases and review the semiology, epidemiology, and treatment of primary sex headache. KEY WORDS migraine primary sex headache adolescent sexual development Accepted February 29, 2012. [pediatrics.aappublications.org]
[…] headaches. [1] [5] Propranolol, Bellergal, and triptans have also been used with success. [1] Anecdotal and indirect evidence suggests a trial of magnesium supplementation may improve symptoms (in subjects with known or suspected low Mg levels). [6] Epidemiology [en.wikipedia.org]
This is generally benign and self-limiting but clearly requires investigation. [ 9 ] Epidemiology Little is known about the incidence but studies of neurological patients presenting with headache in France and Denmark have quoted figures of up to 1.3% [patient.info]
Pathophysiology
Notes (2): the pathophysiology of TCH in the absence of underlying pathology is not well understood primary TCH has a distinctive clinical and angiographic profile and must be distinguished from central nervous system vasculitis and SAH Reference: BMJ [gpnotebook.co.uk]
CONCLUSIONS: RCVS remains a rare and difficult entity to treat; in part because the underlying pathophysiology is poorly understood. [n.neurology.org]
The exact pathophysiology of primary HAS is not completely understood, it is however believed that there is both a vascular and a muscular basis for the headache. [17] Local cerebral vasospasm in the concept of Reversible Cerebral Vasoconstriction Syndrome [smjonline.org]
Factors related to the pathophysiology of sex-related headaches are mainly a trigeminovascular effect, but there is a definite muscular component and impaired cerebrovascular autoregulation [ 1 ]. [ncbi.nlm.nih.gov]
Pathophysiology HSA are not clearly understood but by definition lack serious underlying disease. They are however, unpleasant, frightening, repetitive and episodic. [bjmp.org]
Prevention
(40-200 mg total per day) and diltiazem (60 mg 3 times daily) [12] can be given as a daily preventive if this headache type occurs frequently. [medscape.com]
Prevention Options Analgesics, such as ibuprofen or acetaminophen, have little effect once the headache begins. Fortunately, treatment to prevent a recurrence of benign sexual headaches is both simple and effective. [wkhs.com]
You could also take a more passive role during sex to help prevent or ease the pain of a sex headache. [healthline.com]
It may be prevented by postponing orgasm. It is the most common type of headache associated with sexual activity. [patient.info]
Other than avoiding sex, options include ceasing sexual activity before orgasm (which may shorten the duration of the headache or even prevent it) or taking medication (such as anti-migraine medication or beta blockers) prior to sex (to prevent a headache [bodyandsoul.com.au]