We've all heard the old joke: "Not tonight, dear. I have a headache." Surprisingly, for some people, there actually is a correlation between sexual activity and headache relief.

Headaches Linked to Sex

For some people, sexual activity can actually cause headaches. Such headaches may be benign exertional headaches brought on by strenuous activity, including sexual activity.﻿﻿

Or they may be sexual, or coital, headaches, a rare type of primary headache that occurs in the skull and neck during sexual activity, including masturbation or female or male orgasm.﻿﻿

Coital headaches may last up to 24 hours and are most common among men.

Although such episodes are usually benign, it is important that they be correctly diagnosed to rule out organic causes that can be very serious, even life-threatening. Tests used to confirm a diagnosis include a computerized tomography (CT) scan, magnetic resonance imaging (MRI), or magnetic resonance angiography (MRA).﻿﻿

Headaches, including migraines, induced by sexual activity may strike prior to, at the time of, or following orgasm. Such attacks have also been documented after masturbation. There are three patterns of occurrence for coital headache:

Sudden onset : This pattern applies in 78% of coital headaches, and begins just before, during, or immediately after orgasm. This type of headache is severe, usually throbbing, and may build over minutes or be explosive. The average duration is several hours.

: This pattern applies in 78% of coital headaches, and begins just before, during, or immediately after orgasm. This type of headache is severe, usually throbbing, and may build over minutes or be explosive. The average duration is several hours. Subacute, crescendo headache : This pattern applies in approximately 22% of cases. The onset is much earlier than an orgasm, with intensity increasing until the time of orgasm. Frequently in the back of the head, the pain is dull and aching. Rarely, nausea and vomiting may occur.

: This pattern applies in approximately 22% of cases. The onset is much earlier than an orgasm, with intensity increasing until the time of orgasm. Frequently in the back of the head, the pain is dull and aching. Rarely, nausea and vomiting may occur. A postural headache: This is the least common of coital headaches. The pain occurs in the lower back of the head and is greatly increased when the patient stands. This form is more likely to be accompanied by nausea and vomiting. ﻿ ﻿

Treatment

Once coital headaches are diagnosed as benign, medications can be taken one to two hours before anticipated sexual activity to help avoid future coital headaches.

If the problem persists, daily preventive medications may be in order. While not extensively studied, indomethacin taken 30 to 60 minutes prior to sex may prevent a headache. Propanolol and possibly even Topamax (topiramate) may be used as a preventive medication, although the scientific data supporting its use is weak.﻿﻿

Headaches Relieved by Orgasm

Research shows that, in some cases, orgasm can actually relieve a headache. In a 2013 study, 60% of people with migraine reported that sexual activity improved how they felt during a migraine attack (33% said that sexual activity made their migraine worse).﻿﻿ Some study participants reported that they used sexual activity as a "therapeutic tool."

The same study showed that sexual activity can sometimes relieve cluster headaches as well. Just over a third of study participants (37%) reported an improvement of cluster headache attack, while 50% reported worsening.﻿﻿