Post-Coital Headache, Is It Real?


By: Elizabeth Obigwe. Freelance Writer, with medical review and editorial support by the DLHA Team


Black man sitting on a bed holding both sides of heaad due to suspected sex headache

Black man probably experiencing post-coital headache




  • Post-coital headaches can happen when you engage in any form of sexual activity that can  lead to orgasm
  • It is a rare condition affecting about 1–1.6% of the general population
  • Men tend to suffer from post-coital headaches more than women
  • There is no known cause of the condition





You may have had those times when you were in the heat of the moment, things were getting steamy and out of nowhere, a throbbing headache crashed the party. It probably got worse as you tried to stand up and so you had to lie down for much longer and the pain probably lingered afterwards for a few minutes or hours. 


You were most likely experiencing a post-coital headache and you will get a clearer understanding of what that is from this article. We will discuss the causes, risk factors, preventive measures and treatment among other important aspects.



What is a Sex Headache?


A post-coital or sex headache is the type of primary headache you get when you engage in any form of sexual activity that can lead to orgasm.


Although not a common condition, sex headache is a real thing. It usually starts as a dull ache behind or on both sides of the head as sexual excitement increases and suddenly becomes intense at orgasm.  


The condition is also known by several other names including; post-sex headache, orgasm headache, coital cephalgia, sexual headache, etc. However, it was most recently named by the  International Classification of Headache Disorders (ICHD) as “primary headache associated with sexual activity,”. A seemingly more befitting name. Nonetheless, we may use some of these names interchangeably as we advance.



Types of Post-Coital Headache


Previously, the  ICHD classified sex headaches into two distinct subtypes; preorgasmic headache and orgasmic headache.


Pre-orgasmic headache was defined as a dull, pressure pain at the back of the head that appears during sexual activity and increases with mounting sexual excitement.


Orgasmic headache was defined as a sudden explosive headache followed by severe throbbing head pain that occurs just before or at the moment of orgasm.


However, on its 3rd edition website, the ICHD states that the condition, primary headache associated with sexual activity, is now considered a single entity with variable presentation.



What Causes Sex Headaches?


Sexual headache is a primary headache. This means that it has no known underlying cause and usually occurs in the absence of other intracranial disorders (brain disorders).


Keep in mind that other types of headaches can also occur during sexual activities and they usually manifest as thunderclap or explosive headaches. 


These headaches may be a result of an anomaly in the brain typically affecting the blood vessels such as; narrowing of the wall of an artery (reversible cerebral vasoconstriction), widening of the wall of an artery (intracranial aneurysm), tearing of the inner wall of an artery (arterial dissection), etc.  


They are not considered primary headaches associated with sexual activity. Some researchers refer to them as secondary headaches associated with sexual activity since they have underlying conditions.



Risk Factors Associated With Sexual Headache


Anyone who is sexually active can come down with a sex headache. However, there are factors that can increase your chances of experiencing this condition.


  • Being male: Post coital headaches occur in about 1–1.6% of the general population and it is nearly four times more common in males than in females. Headache after sex in males is also more common among middle-aged men with a mean onset age of 39.2 (±11.1) years.
  • History of some other headache types: People who experience migraine and exertional headaches are also at higher risk of suffering from post coital headache.  
  • Family history: Headache after sex can also run in the family. Also, having a family history of migraine might equally increase your chances of experiencing this condition.



Symptoms of Post-Coital Headache


The main symptom of post-coital headache is the headache itself. It often manifests as a dull headache that intensifies with sexual excitement or a sudden throbbing headache that appears just before or at the point of orgasm. You may experience either or both of these presentations at a time. 


Although post-coital headaches can sometimes feel like migraine, they do not present with migraine symptoms


Also, they do not present with abnormalities like loss of consciousness, vomiting, or visual, sensory or motor symptoms. These are more common with secondary headaches associated with sexual activity.  If you notice any of these symptoms, see a doctor as soon as possible.



Conditions for Diagnosing Post-Coital Headache


Before your doctor can conclude that you have post-coital headache, he must establish that you experience the following:


1. Headache caused by sexual activity only.

2. Either an increase in the intensity of pain with increasing sexual excitement; or a sudden explosive pain just before or with orgasm; or both

3. Pain that lasts for 1 minute to 24 hours with severe intensity and/or up to 72 hours with mild intensity

4. At least two episodes of such pain in the head and/or neck


If a person experiences this type of headache once in their sexual life, it is regarded as a “probable primary headache associated with sexual activity.”



Treatment of Post Coital Headache 


Due to the rarity of the condition, most of the treatments administered to patients are often designed to target their individual situation or are based on the personal experience of the doctor. Nonetheless, there are a few common ways to manage sexual headaches.


Behavioural Adjustment


You may be asked to refrain from sexual activities for up to three months as continuing to have sex after an attack can lead to more intense recurrent headaches. Also, you may be advised to take on more passive roles during coitus.


Drug Treatment


Taking triptans before intercourse can help with short-term headache prevention.


For those with chronic or long-lasting headaches, beta-blockers such as propranolol, metoprolol or nadolol can help.


If you do not respond to beta-blockers, your doctor may recommend indomethacin,  verapamil, flunarizine or nimodipine.


Other painkillers like NSAIDs (ibuprofen, diclofenac), paracetamol, acetylsalicylic acid (ASA), ergotamine, and benzodiazepines may not be effective for treating post-coital.



How to Prevent Post Coital Headache


Because the cause of primary headache associated with sexual activity is unknown, there are no established preventive measures. However, using the treatments discussed above can help with preventing future occurrences.



When to See a Doctor


Post coital headaches are usually not a cause for concern. However, you should see a doctor if;

  • You experience it frequently
  • It happens to you for the first time, especially if the presentation is abrupt and explosive
  • You notice any of the additional symptoms common to a secondary type of headache (check symptoms). 


Seeing a doctor will help you ensure that you do not have an underlying condition that may be responsible for the headache.



What You Need to Know if You Experience Post-Coital Headache


Aside from the pain you feel, sex headaches do not cause any structural harm to your brain. So, there is no cause to worry. Also, this headache sometimes disappears by itself with time. It may however occur more than once a year in up to 40% of people. If you experience after sex headache often, and you are concerned, visit with your doctor. Getting prescribed medications can help.





Post-coital headache is the pain you feel building up in your head during intercourse. It typically peaks at orgasm and can last from a few minutes to hours after sex. Although it does not cause any damage, primary sex headaches can be discomforting as they can be as severe as a migraine. Notably, you can also experience headaches during sex as a result of underlying conditions. You should see a doctor to rule out all possibilities.





  • American Migraine Foundation. Primary headache associated with sexual activity (orgasmic headache). [Internet. July 10, 2016]. Available from: Cited 27 Feb 2024. 
  • Evers S. and Lance J. W. International Headache Society. Primary Headache Attributed to Sexual Activity  [Internet. August 17, 2005]. Available from: Cited 27 Feb 2024. 
  • International Classification of Headache Disorders. 4.3 primary headache associated with sexual activity. [Internet. N.d.]. Available from: Cited 27 Feb 2024. 
  • Scislicki P, Sztuba K, Klimkowicz-Mrowiec A, Gorzkowska A. Headache associated with sexual activity - a narrative review of literature. Medicina. 2021 Jul 21;57(8):735. doi:10.3390/medicina57080735. Available from:




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Published: March 3, 2024

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