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The Sex Headache That Isn’t Bullshit

For some people, an orgasm can arrive with a pounding... headache

When Annabel’s parents went away for a last-minute holiday last summer, she was excited to try out the pink bullet vibrator she purchased on Amazon a few days before. The 24-year-old from the U.K. shooed her cat outside, closed the bedroom door and settled down on her freshly made double bed with the new toy in hand. Annabel stared at the poster across the room, and her mind went blank as she tried to tune into her body’s needs. She masturbated for 20 minutes before feelings of pleasure crescendoed to an orgasm, but then something unexpected happened — moments of bliss and lightness were followed by a crippling headache. 

“It honestly felt like someone had slapped me around the back of the head with a dictionary or something,” she tells me. “It just hits you like a ton of bricks.” Putting the vibrator down, Annabel went to get a glass of water because she thought she was dehydrated. But then it happened again — and once more after that.

Fortunately for Annabel, she isn’t the first (or last) person to experience headaches with an orgasm. She could be suffering from a condition called orgasmic cephalgia, also known as a primary headache associated with sexual activity. A quick search for “sex headaches” will bring up forums of people reporting similar symptoms. One redditor, who thought they were going to die from the headache, said it felt like a “white hot fire poker into the very center of the brain.”

More recently, some people have reported instances of similar sex-related headaches since getting COVID. “They only happen during sex (please be kind, I feel weird sharing this!),” one member of a Facebook group for those recovering from the virus has confessed. “They start at the base of my skull on the left side and spread upward to the rest of my skull and downward into my neck/shoulder muscles. Also experiencing stuffy ears and tinnitus.” Many others commented on similar experiences underneath the post.

There are two things that could be happening,” says Katy Munro, a general practitioner at the National Migraine Centre in the U.K. and co-host of the podcast Heads Up. “The first thing that can cause a headache during sex could be a primary sex headache. But to call it a primary headache associated with sexual activity, it has to be occurring in somebody who only ever gets headaches with sex and never any other time.”

“The second thing is, you could get a headache during sex because you also get a migraine, and sometimes you get a migraine with sex and sometimes you get a migraine not with sex,” she continues. “If that’s happening, it’s more of a symptom of the way that a migraine is affecting you, which may be because you’re dehydrated or something else.”

Either way, Munro recommends getting it checked out immediately as it could be something really serious. “One of the first recommendations for anybody who suddenly has a really bad headache during sex is to make sure that it’s not a bleed in the brain,” she explains. “A thunderclap headache, which is a sudden explosive headache, needs investigating. Take yourself to the emergency room.”

The good news is, at least in the case of sex headaches, if they’re found not to be serious, Munro says they tend to go away over time. They’re also pretty rare. “About one in seven people have migraines, but I read a figure of one percent as being the frequency of people only getting primary sex headaches. Though I don’t think we really know, because most people getting them tend to be ashamed and won’t report them.”

As for the claims of a link between COVID and sex headaches, Munro doesn’t think that’s the case (with the caveat that there’s been no scientific research into such a connection). “At the National Migraine Centre, we’re getting the impression that some people with migraines who also have COVID-19 are getting more prolonged and severe cases of their migraines,” she tells me. “But then again, when you think about what makes migraine worse, it’s stress, poor sleep and not eating well — all of the things that COVID-19 affects, especially long COVID-19. There’s a high likelihood that it will make a preexisting migraine condition worse. Now, whether it would cause a primary new type of headache to develop, I can’t see any reason why it should.”

Regardless of the root cause, a sex migraine can obviously have serious consequences for a relationship. When Annabel briefly started seeing someone last year, she got headaches after they had sex. “They weren’t as intense; I was clearly having a better time on my own,” she jokes. Though she didn’t bring up the headaches with the guy she was fucking, Annabel is worried that it may come up in the future. “I’d find it hard to talk about this with a partner if we hadn’t been seeing each other for that long, because it may make them feel uncomfortable, or stressed out that they have to be careful. I don’t want it to be anyone’s fault, because it’s not,” she says.

Sophie, who has suffered from migraines all her life, knows this all too well. The 37-year-old experienced debilitating sex migraines for about a year, but they stopped when she became less stressed in general. “It put me off orgasm during sex because I didn’t want to go through the pain of a migraine afterwards,” she explains. Luckily, though, her ex-partner was extremely supportive when she told him about the headaches. “He was lovely, but it just so happened that the relationship was petering out anyway, so we didn’t have loads of sex at that point,” she says. 

Which, in the end, was probably for the best. After all, it was one less headache for her to deal with.