Answerbox: What a Headache

Dear Answerbox:

A week or so ago, I was having sex with my wife (she was on top), and as I came, I got an insanely bad headache in the back of my skull.  It was so bad, I ended up in the emergency room getting a CAT scan.  The doctor said nothing was seriously wrong and sent me home with some headache pills.  WTF?  Is this going to happen for the rest of my life?

     Signed, 

     I Found Out What Ruins Orgasms

subarachnoid hemorrhage is decidedly not sexy

The good news, IFOWRO, is that if your doctor let you out of the ER, it means you didn't have a subarachnoid hemorrhage (aka big fat brain bleed), which is good, so yay!  Because you've already been to a doctor, I can skip the "I'm not a doctor, go to a doctor to make sure you're actually not dying" speech, which is also good - you're totally on a roll here!

oooooh...sushi roll...sounds hella good right now....

As for what happened in your noggin, from what I can tell, you had what's called a "benign coital headache".  It's also called a "benign sexual headache," "orgasmic headache" or if you want to get super technical, "coital cephalalgia".  The preferred term is "headache associated with sexual activity," but that is BORING so we're going to go with "benign coital headache" because I like it the most.

An' I'm sheriff 'round this here Box, yo

There are two main types of benign coital headache: progressive and explosive.  These peeps say that explosive coital headache is what doctors see most often, I'm assuming because when it feels like your brain is exploding, you mostly want to get that checked out - your case in point.

They also said that explosive coital headache "occurs explosively near or at orgasm, is excruciating, is most often felt in the back of the head on both sides (but some are one sided), and remains intense for about 15 minutes, although some don't disappear for a day or two and may even remain intense for this long."  Does that sound familiar, IFOWRO?

the diagnostic code for sex-related head asplosion is 339.82

Some coital headaches seem to be related to the blood vessels in the brain, and others with muscle tension.  One study suggested that sudden changes in blood pressure which occur during orgasm might cause explosive-type headaches, though that type is generally felt more on the sides of the head, rather than the back.  That same study found, though, that muscle tension held in the face and neck during sex was the culprit for the majority of people who had the exploding feeling in the back of their head.

All that flexing can only end in tears.  Or the ER, apparently.

There isn't really a treatment for benign coital headaches, at least not that I was able to find.  You said your doctor gave you pain pills - that seems to be pretty much what they do.  You might try massage - if it's muscle tension, that might help relieve some of it. There isn't a whole lot in the way of prevention hints, either.  I guess you could try and avoid clenching up your face and neck while you're makin' it, but also admit it might be hard to concentrate on your face when everything else you're doing feels (hopefully) distractingly good.

this guy doesn't even HAVE a face, he's so distracted

Unfortunately, I'm not really able to say much more than "you probably had a benign coital headache and that probably totally sucked for you."  The most important thing, though, is that it's probably nothing to worry about, and it will likely go away on its own.  If it doesn't, or starts to get worse, you should call your doctor back, but rest assured that you are not the first person to experience this, and you probably won't have to experience it for long.

I hope your brains feel better, IFOWRO, and that you will soon be able to enjoy orgasms once again.  Thanks so much for writing!  

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