ADVICE: My bf gets throbbing headaches after sex

A woman is concerned her partner's post-coital pains may be a sign of something more serious

Maja Begovic October 16, 2020
Advice column

Illustration, Brice Hall.

Dear Asking For a Friend,

My boyfriend sometimes gets a sudden throbbing headache after sex and it can last anywhere from a few minutes to several hours. We haven’t had sex in a few weeks because I’m worried and want him to get it checked. What causes this and is it a sign of something more serious?

Signed, All in the Head

Dear All in the Head,

We all know that sex is great for our immune system and overall health. It can build intimacy with our partner, help lower blood pressure, relieve stress and tension, and improve our mood. But getting it on can also cause the onset of sudden throbbing or dull head and neck pain that can last for several minutes to several hours or days. Men are more susceptible to these types of headaches, but women get them too and orgasm is to blame.

Dr. Evan Cole Lewis, a neurologist, clinical neurophysiologist and director of the Neurology Centre of Toronto (NCT), says that symptoms “can present as a building headache leading up to orgasm or explosive onset during orgasm” and it can be triggered by masturbation or partnered sex. While the cause is unknown, headaches often come in clusters, can stick around for several months and disappear as suddenly as they first appeared.

Most people describe the headaches as intense and painful episodes that reach their peak 15 minutes after orgasm and gradually ease thereafter. People in their 40s and those with a history of migraines or other headaches may also experience sexual activity-related headaches. While post-coital head and neck pain is usually not a sign of a serious issue, your boyfriend should consult with a doctor who can help properly assess and diagnose his symptoms.

“We see patients via our Virtual Rapid Access Clinic within one day of referral,” says Lewis. Usually, an MRI or a CT scan is performed to examine the structure of the head and brain. Neck and brain arteries can be assessed through a cerebral angiogram and any bleeding or infection can be determined through a spinal tap. The doctor will want to rule out more serious conditions that require long-term treatment, such as brain hemorrhage, aneurysm, stroke, tumor, bleeding and inflammation.

If your boyfriend is in the clear, you can continue with your sex life, with some modifications. He might be encouraged to avoid strenuous sex or advised to gradually build up to orgasm, but usually, an over-the-counter or a prescribed pain reliever can be enough to stop a sexual activity headache in its tracks. “Optimizing lifestyle factors, such as healthy eating, sleep, hydration, exercise habits, and reducing stress and anxiety can also help,” adds Lewis.

Most headaches are nothing to worry about, but symptoms such as severe pain that lasts more than 24 hours, loss of consciousness, seizures, vomiting and stiff neck could signal an underlying issue and a health emergency that requires immediate medical attention. Sexual activity headaches can be a pain to deal with, but they often do resolve on their own.

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