Young men more prone to explosive headaches during sex

A headache is often regarded as an excuse for not having sexual intercourse, but neurologists in Germany have been conducting a trial to investigate the true nature of this condition. They found that men in their early 20s are more likely to get a sexual headache, delegates at the European Federation of Neurological Societies congress were told today (28 October).

Sexual headache occurs in up to one percent of the population who suffer from it at least once in their life. It is not caused by a cerebral lesion or by another disease. Before diagnosing a sexual headache, the physician must rule out a symptomatic headache during sexual intercourse caused for example by bleeding inside the skull. The study by German headache researchers, Dr Achim Frese and Dr Stefan Evers from the University of Münster examined clinical features and the prognosis of sexual headache in a group of more than 45 patients with sexual headache.

Dr Frese and Dr Evers found a clear male preponderance with a ratio of approximately three times more men than woman who experienced a sexual headache. There appeared to be two peaks of the age of onset. The group at highest risk of having their first attack of sexual headache was between 20-25 years and the second peak occurring between 35-45 years. “We found that the vast majority of patients suffered from an explosive and very severe headache starting suddenly around the orgasm. The others suffered from a dull headache with the pain increasing more gradually before the orgasm,” said Dr Frese.

Generally, the headache did not depend on special sex partners or special sexual habits. Most often, it appeared during sexual intercourse with the usual sex partner or during masturbation. “About half of the patients had realised that they could avoid some of the headache attacks by intensifying the sexual excitement more gradually,” he said.

Some of the patients were prescribed preventive treatment such as betablockers (to prevent migraine) or indomethacin (painkiller). The researchers found that generally, the prognosis was good. Typically, the sexual headache appeared in bouts of a few weeks duration and resolved spontaneously. Most patients had had only one bout, others two or three bouts.

The study is the largest clinical study dealing with sexual headache so far. “From the patients` point of view, it gives clear information about the benign prognosis of the disorder and demonstrates that it is treatable,” said Dr Frese. He added that further studies are needed to confirm the effects of betablockers in large placebo-controlled studies and to learn more about the underlying mechanisms of sexual headache.