know your headache
By Erin Golden
The Romance Buster
When sex triggers head pain, treatment may be needed to get your love life back on track.
Not tonight, dear, I have a headache. Maybe you’ ve heard that one before. But if you or your partner experiences sexual headache, it’ s the kind of excuse to take seriously.
“ It will stop you in your tracks,” says Frederick G. Freitag, DO, a member of the NHF board and medical director for the Comprehensive Headache Center at Baylor Health Care System and director of headache medicine research at Baylor Research Institute in Dallas.
Sexual headache is probably not life threatening. But the pain can stick around for hours after sexual activity. Learn more about this headache to determine whether you might need to see a headache specialist for treatment.
RECOGNIZE YOUR HEADACHE
Coital cephalalgia, or sexual benign headache, is triggered by sexual activity. It may appear in two forms: as a tension-type headache( the result of the alternating tension and relaxation) or an exertional headache( the result of the blood-pumping activity and excitement).
People who experience coital cephalalgia may have similar symptoms to migraineurs including nausea and sensitivity to light, says Jerome Goldstein, MD, director of the San Francisco Headache Clinic. The pain itself may feel sharp and could last between 12 and 24 hours. But unlike most migraines, a sexual headache is usually a new development that makes its first appearance after sexual activity.
IDENTIFY THE TRIGGER
Researchers aren’ t exactly sure why sexual activity triggers coital cephalalgia. What they do know is that a specific segment of the population is more prone to these headaches. They affect more men than women, more people at middle age than young people, more migraineurs than people with other types of headaches and more people who have other health issues including high blood pressure and obesity.
“ The biggest issue is the state of general physical health,” Dr. Freitag says.“ If you are 30 years old, horribly out of shape and haven’ t done anything physically active in a decade, you could get an exertion-related headache.”
FIND RELIEF
Taking the headache out of sex starts with a visit to a headache specialist. Whether it’ s your first sexual headache or it just won’ t go away, Dr. Goldstein says it’ s important to get a full diagnostic workup( likely including an MRI and possibly an MRA scan of the blood vessels). Because this type of headache may involve incredibly sharp pain or pain with a longer duration, Dr. Goldstein says it is important to rule out bigger problems such as brain aneurysm, brain tumor, meningitis or encephalitis, or a systemic inflammatory condition such as giant cell arteritis or polymyalgia rheumatica.
Once sexual headache is diagnosed, a headache specialist may prescribe an anti-inflammatory medication, such as indomethacin, as treatment.“ This type of medication is taken a half hour to an hour before sex,” Dr. Freitag says.“ This could be a problem for those for whom sex is entirely spontaneous. But for most people it’ s not entirely spontaneous, so there is the opportunity to do something before you begin.” Other patients may find relief with the help of a beta blocker such as propanolol.
In many cases, half the battle is reducing the anxiety that can come with the headaches. Dr. Goldstein says it’ s a bad cycle for many of his patients: They get a headache during sex, so the next time they become anxious about getting a headache, which leads to another headache. Dr. Goldstein says information is the most powerful treatment for this type of anxiety:“ The most productive thing a health specialist can offer is appropriate counseling to put the patient at ease that this condition is not harmful.” HW
www. headaches. org | National Headache Foundation 25