He Said to Her, 'Not Tonight, Honey, Sex Gives Me a Headache'

Men are more likely to suffer from headaches associated with sexual activity (HSA) than women. Archive photos.

THE second oldest line in the book is probably, “Not now, Honey, I have a headache.” But a headache during the act? Right!

Yes, right! There are people who actually come down with headaches during sex – even during orgasms. Apparently this is not new; even Hippocrates has asserted as much.

“One should be able to recognize those who have headaches from gymnastic exercises or running or walking or hunting or any other reasonable labor or from immoderate venery.”

Venery is an old (really old) school way of saying sexual indulgence. In a word, sex.

“Many people who experience headaches during sexual activity are too embarrassed to tell their physicians, and doctors often don’t ask,” says Jose Biller, chairman of the Department of Neurology at Loyola University in Chicago. He says that about 1 percent of adults report the headaches, but the actual percentage is surely higher for the reasons stated.

According to JB, there are three major categories of headaches associated with sexual activity (HSAs):

Exercise such as jogging can relieve HSAs.

• A dull ache in the head and neck that begins before orgasm and worsens as sexual arousal increases. It is similar to a tension headache;
• An intensely painful headache that begins during orgasm and can last for hours. It’s called a thunderclap headache because it grabs the attention like a clap of thunder;
• A headache that occurs after sex, ranging from mild to extremely painful. The headache gets worse when the person stands and lessens when s/he lies back down. This headache is caused by an internal leak of spinal fluid, which extends down from the skull into the spine. When there’s a leak in the fluid, the brain sags downward, causing pain when a sufferer stands up.

HSAs have been classified a distinct form of primary headache by the International Headache Society.

According to JB, most incidences of (HSAs) are not serious because the exertion involved in sex is a form of exercise afterall. But in some these headaches can be tied to conditions such as a stroke, brain aneurysm and hemorrhaging. Consequently, it's important to seek medical advice.

“... we recommend that patients undergo a thorough neurological evaluation to rule out secondary causes, which can be life-threatening,” says JB. “This is especially important when the headache is a first occurrence.”

Interestingly, JB, who is certified in Headache Medicine by the respected United Council for Neurologic Subspecialties, notes that men are three to four times more likely to suffer from HSAs than women.

So, what can be done about HSAs, gender notwithstanding?

Avoiding binge drinking can help avoid HSAs.

Certain HSAs, he said, can be relieved or prevented by taking drugs. In general, sufferers can reduce the risk of these headaches through counseling. Maintaining a healthy weight also helps, as does exercise and refraining from excessive alcohol intake.

“Honey, not tonight, I've had too much to drink and don't want to have a headache, too.”

Visit http://www.ihs-headache.org/ to learn more about HSAs and other headaches.