Coital cephalalgia

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Coital cephalalgia
Classification and external resources
ICD-10 G44.805
ICD-9 339.82

Coital cephalalgia, also known as "sexual headaches", is a rare type of severe headache that occurs at the base of the skull before orgasm during sexual activity, including masturbation. A pressor response to exercise has been suggested as a mechanism.[1]


The pain usually moves from the base of the skull through the head towards the frontal lobes. Extremely severe and sharp pain behind the eyes is also a symptom. The headaches usually have an immediate onset, with some gradually worsening during sexual intercourse and others (referred to as "explosive headaches") occurring almost instantaneously at the moment of orgasm.[citation needed] The headache is usually worsened by movement. These headaches typically last for a few minutes to a few hours, although it is possible for such headaches to last up to a few days.[2]

Coital cephalalgia can frequently occur in a timeframe that exertion headaches occur.


It is most common for men to experience these headaches for the first time in their early 20s, or between the ages of 35-44; the reason for this is unclear.

More prevalent in men, by a ratio of 3:1, these headaches appear in roughly 1% of the population, though it has been suggested that the prevalence may be higher, due to the embarrassment of presenting with the disorder, especially in cases where spontaneous remission occurs after a few days. Up to 10% of patients taking medication for erectile dysfunction may experience these headaches. If such symptoms are experienced by a patient, it is important for a physician to rule out a potential brain aneurysm, or tumors. In most cases, these headaches are benign. More serious symptoms include a stiff neck, confusion, dizziness and the most extreme cases, death.


As for treatment, a physician may recommend reducing heavy sexual activity and masturbation for a short period of time ranging from a few days to a few weeks. In addition, physicians may recommend medications such as Propranolol that can be taken in advance of sexual activity to prevent such headaches.[citation needed] Reduction in weight to a more ideal level and increased exercise may also reduce the likelihood of recurrences.[citation needed] A physician may wish to order a CT scan to exclude intracranial bleeding or a mass lesion as a cause for this pain, however, in the absence of other symptoms this may not be routine. Indomethacin has also been tried.[3]

See also[edit]


  1. ^ Staunton, H P; Moore, J (1978). "Coital cephalgia and ischaemic muscular work of the lower limbs". Journal of Neurology, Neurosurgery & Psychiatry 41 (10): 930. doi:10.1136/jnnp.41.10.930. 
  2. ^ "Sexual Benign Headaches". National Headache Foundation. Retrieved 4 January 2013. 
  3. ^ Anand KS, Dhikav V (May 2009). "Primary headache associated with sexual activity". Singapore Med J 50 (5): e176–7. PMID 19495503. 

External links[edit]