Hello. This problem is most likely pre-orgasmic headache, a condition of pain in the occipital or posterior side of your head, from muscular contraction. I would ask you if you have a history of migraine headache, or any family history of CNS vascular problems, such as cerebral aneurysms?
Preorgasmic headache occurs during sexual activity, increasing as sexual excitement increases. It's usually bilateral (on both sides), a dull ache in the head and neck (not Migraine). It can also include neck and jaw muscle tightening.
Orgasmic headache is a severe, sudden headache (not Migraine) that occurs at orgasm.
Both preorgasmic and orgasmic headaches are more common among men than women. Most are short in duration, but for about 15% of those experiencing them, severe pain can last from four hours to 24 hours, which makes treatment necessary.
Treatment is indomethacin, (indocin) an NSAID medication that you take prior to initiating sex, that will prevent the episode. I did ask about aneurysms, but that is an unlikely cause. Cerebral aneurysms can leak during sex, called the "sentinal bleed" it can give a severe, lancinating headache. Although uncommon, it is important to exclude, as eventual rupture can lead to sudden death. For that reason, often patients with this problem get a Brain MRI, just to exclude that possibility.
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