Sex headaches are not something to laugh about. Dr Jose Biller, a neurologist and headache specialist at the Loyola University Medical Center, has treated many patients for headaches associated with sexual activity (HAS). Most headaches are usually caused by disorders like migraines or tension but could also be related to other serious conditions such as hemorrhage, stroke, cervical artery dissection or subdural hematoma. The majority of headaches that are associated with sexual activity are benign, however, there is a small percentage that can be due to serious and life-threatening conditions. According to Biller, men are more likely (three to four times) than women to experience HAS and these headaches can occur in three forms.

It can be a dull ache that starts before orgasm in the head and neck and gets worse as sexual arousal increases.  Similar to that of a tension headache.

The Thunderclap headache is intensely painful and begins during orgasm and lasts for hours after. It is called the Thunderclap because it hits you hard out of nowhere.

The last is that of a headache that starts after sex ranging from mild to extremely painful. It normally gets worse when the patient stands and lessens when they lie down. It is caused by an internal leak of spinal fluid, which extends down from the skull into the spine. From such a leak the brain sags downward when you stand thus being the cause of the pain.

With each type certain medications can help relieve the pain and prevent them. By exercising, avoiding excess intake of alcohol, having a healthy weight and counseling will help reduce the risk of sex headaches.

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

When she complains of a headache the next time, don’t think she is faking it just to get out of sex.  Be understanding. Something could actually be very wrong.