Coital cephalalgia

Coital cephalalgia
Classification and external resources
ICD-10	G44.805
ICD-9	339.82

Also known as "sexual headaches", coital cephalalgia is a rare type of severe headache that occurs at the base of the skull before orgasm during sexual activity, including masturbation. A pressor response to exercise has been suggested as a mechanism.^[1]

Presentation

The pain usually moves from the base of the skull through the head towards the frontal lobes. Extremely severe and sharp pain behind the eyes is also a symptom. The headaches usually have an immediate onset, with some gradually worsening during intercourse and others (referred to as "explosive headaches") occurring almost instantaneously at the moment of orgasm. These headaches typically last for a few minutes to a few hours, although it is possible for such headaches to last up to a few days.

Coital cephalalgia can frequently occur in a timeframe that exertion headaches occur.

Epidemiology

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. It is important to see a doctor if you have such symptoms in order to rule out a potential brain aneurysm, or tumors. In most cases, these headaches are benign. More serious symptoms include a stiff neck, confusion, and dizziness.

Treatment

As for treatment, a doctor may recommend abstaining from sexual activities and masturbation for a short period of time ranging from a few days to a few weeks. In addition, doctors may recommend medications such as Propranolol and Viagra^{[citation needed]} 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 doctor 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.^[2]

See also

• Postorgasmic illness syndrome
• Intra-axial hematoma
• Subarachnoid hemorrhage

References

1. ^ Staunton HP, Moore J (October 1978). "Coital cephalgia and ischaemic muscular work of the lower limbs". J. Neurol. Neurosurg. Psychiatr. 41 (10): 930–3. doi:10.1136/jnnp.41.10.930. PMC 493197. PMID 731244. http://jnnp.bmj.com/cgi/pmidlookup?view=long&pmid=731244. 
2. ^ Anand KS, Dhikav V (May 2009). "Primary headache associated with sexual activity". Singapore Med J 50 (5): e176–7. PMID 19495503. http://smj.sma.org.sg/5005/5005cr9.pdf. 

External links

• Medscape: Etiology of Coital Headaches