||This headache disorder article lacks information pertaining to its ICHD-2 diagnostic criteria and/or classification.|
|Classification and external resources|
Coital cephalalgia, also known as "sexual headaches", is a rare type of severe headache that occurs in the skull and neck due to sexual activity or during orgasm from sexual intercourse or masturbation. A pressor response to exercise has been suggested as a mechanism.
Coital cephalalgia is triggered by sexual activity and covers three conditions - early coital cephalgia (pre-orgasmic), orgasmic coital cephalgia (orgasmic) and late coital cephalgia (post-orgasmic).
Early coital cephalgia is usually a dull pain increasing with sexual excitement the symtoms are shared with migraine or exertion headaches.
Orgasmic coital cephalgia appears instantly at the point of orgasm or the first sensation of impending orgasm and scores 10 on the pain scale. It shares the symtoms of iitracranial hemorrhage and intracranial aneurysm. Anyone experiencing orgasmic coital cephalgia symtoms should seek immediate medial treatment to test for cranial hemorrhage or aneurysm.
Late coital cephalgia presents after sex and is identical to a post spinal-tap headache.
These headaches typically last from a few minutes to a few days.
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. Reduction in weight to a more ideal level and increased exercise may also reduce the likelihood of recurrences. 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.
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- Medscape: Etiology of Coital Headaches
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