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Are you taking any ED medications?
You may be experiencing primary sexual headaches, or "coital cephalgia". Several theories have been put forth to explain the underlying mechanism of these headaches. The leading explanation involves exertion leading to a sudden increase in intracranial pressure (similar to headaches caused by weight lifting) or an inappropriate reaction in the cerebral vasculature (eg vasodilation). Neural hypersensitivity, similar to migraine, may also play a role. Risk factors include obesity, kneeling position during intercourse, a high degree of sexual excitement, stress, history of migraine and exertion headache and a family history of headache or occlusive arterial disease. Pharmacological triggers may include marijuana, amyl nitrite, amphetamines, sildenafil, cialis and some anxiolytics.
If these headaches are new and severe, you should see your GP and ask about an MRI of the brain to rule out any possible underlying vascular abnormalities (subarachnoid bleeding, basilar artery dissection, etc).
The primary treatment is usually reassurance as the headaches are not usually recurrent. Drug management can be offered in some cases. Indomethacin and propranolol are the most established and evidenced treatments but all of the following are supported by randomised trials: