Primary Headaches Associated with Sexual Activity—some Observations in Indian Patients

Abstract

Primary headache associated with sexual activity appears to be relatively uncommon in a clinic-based study in Indian patients. Only 24 patients (M:F 18:6) were encountered over a 20-year period (1985-2004). Of the 18 male patients, 14 (age 33-42 years) had preorgasmic headache of tension-headache type for 2-8 months, one patient (age 58 years) had orgasmic headache of vascular type for 1 month and three subjects (age 19-23 years) had masturbatory headache also simulating tension-type headache for 3-7 weeks. These observations are at variance with those generally reported from western countries. Of the six female patients, four (age 26-32 years) had typical orgasmic headache of the vascular type (for a few months to a few years), only one of whom had been a migraine sufferer. One patient (age 35 years) presented with a single episode of thunderclap headache where angiography had been negative. Another female subject (age 30 years) experienced typical orgasmic headache only during masturbation but not during actual sexual intercourse. Occurrence of sexual headaches in both male and female subjects had been unpredictable. Few had associated migraine and none ever experienced exertional headache.

Sexual Behavior, Function and Satisfaction in Headache Associated with Sexual Activity: A Systematic Review of Literature

“…Second, intracranial vasospasm is occasionally found in primary and secondary HSA [22] [23] [24]. Third, Charavaty [25] reported a woman (Case E) who acknowledged her HSA occurred under a passionate sex with husband during shower. Fourth, propranolol and other sympatholytics favorably benefit for HSA [21]- [26] [29].…”

“…The penile-vaginal intercourse benefits the blood pressure reactivity to stress but masturbation unfortunately reduces this beneficial effect [60] [61], suggesting that masturbation exposes individual to risk for hypersympathetic status. Second, a modest prevalence of exertional headache is seen in HSA [29] and a cessation of intercourse [25] [26] or masturbation [24] [25] [26] can abolish or attenuate the pain, Clearly, exertion during intercourse or masturbation is another factor crucial for HSA occurrence.…”

“…In the series of Chakravarty [25], preorgasmic headache occurred in 14 males patients, whereas orgasmic headache in 1 male patient and 5 female patients.…”

“…Chakravarty [25] reported all 15 men to have HSA during or after intercourse with their usual partners, whereas 2 women with their husband. No identity was mentioned in another 4 women.…”

“…Silbert et al [29] reported the sexual act to be intercourse only in their 45 patients. Chakravarty [25] [40]. These patients included both genders.…”