Cephalalgia is a medical term for a headache, and coital refers to sexual intercourse. When a person suffers from coital cephalalgia, therefore, he or she experiences a headache during sex, typically at the point of orgasm or close to it. Causes vary from muscle contractions in the head during intercourse to serious hemorrhages that require medical treatment. Often the headache does not recur, but some people can suffer the headaches on and off over the course of several years.
Sexual intercourse uses both the body and the brain, and the difference in the way a person acts and feels when close to orgasm can possibly trigger coital cephalalgia. Physical causes of a headache include a rise in blood pressure, although this does not alone cause headaches. Muscular contractions that occur in the neck and in the head during intercourse at the buildup to orgasm can also be a cause.
Some people who experience coital cephalalgia have a family history of migraines, which seems to contribute to the likelihood of headaches during sex. Certain substances, such as marijuana or amphetamines, also appear to be triggers for the headaches. If a patient is overweight or under a lot of stress, the chance of a sexual headache can also be increased. Intense sensations during intercourse or even using a kneeling position may also be triggers for the condition.
Sometimes serious damage is present in the brain of people who experience coital cephalalgia. When the blood vessels in the brain are not working properly, in a condition known as arteriovenous malformation, then the headache can occur. In some cases, the headache is due to a burst blood vessel that leaks fluid into the gap between the brain and the covering tissues, known as a subarachnoid hemorrhage. For this reason, doctors investigating the condition may have to arrange tests for the patient beyond simply prescribing pain medication. Additional signs that a headache is a symptom of a dangerous condition include problems with vision and vomiting.
Although many people find that a single headache does not return over time, others experience the headaches regularly over a period of years. Men tend to get the headaches more than women, and various intensities of coital cephalalgia exist. They can produce a dull pain that gets worse the longer intercourse lasts, or may be a sudden, explosive pain. When a doctor is satisfied that the headache does not have any sinister causes, medications like proponolol or indometacin may be useful to reduce the chance of recurrence.