Treatment of Sexual Activity Headache

The following could be regarded as treatment of sexual activity headache:

Avoiding sex is not usually an option. Some people would suggest that those with pre-orgasmic headache should be less vigorous and see if headaches are less intense.

These medications have been reported as potentially useful, but great care should be taken - some have erectile dysfunction as a potential side-effect (I've put a star** beside these). That seems like a dramatic way to reduce the risk of headache:

1. Medicines to take one or two hours prior to anticipated intercourse
• Indomethacin 50mg (caution in asthma and stomach/duodenal ulceration)
• Naratriptan 2.5mg (caution in coronary heart disease)
• Methysergide 1-2mg (caution in heart disease, peripheral arterial disease, Raynaud's Syndrome)
2. Preventative medicines to take every day to reduce risk of sex headache
• Indomethacin 25mg three times daily (caution in stomach/duodenal ulceration)
• Propranolol** 80 to 240mg daily
• Metoprolol** up to 50-mg daily
• Atenolol** up to 50mg daily

If orgasm headaches are truly a form of exertional headache then I might also consider acetazolamide or topiramate, but these are unproven.

It can be difficult to determine if your treatment has worked, as by its nature, orgasmic headache will sometimes not recur for months at a time. Any improvement could be due to chance and not due to the medicines.

Return to Acute Headache from Treatment of Sexual Activity Headache

Return to Severe Headache Expert Home Page