New cases of 'orgasm headaches' shed light on mysterious phenomenon

Doctors are hoping that new cases of intense mind-blowing headaches during sex may help uncover the cause of the rare and painful occurrence. Sometimes mind-blowing sex is not cause for celebration, as some individuals experience intense headaches that explode in pain at the moment of orgasm. Until now, only two cases of these sex headaches had been reported in teenagers. Two new cases, 16-year-old boy and an 18-year-old girl, bring the odd, though not life-threatening, phenomenon to light. And doctors are hoping the sex-headache cases will make both other doctors and teens aware of the temporary disorder. "What I wonder about is whether there are many other adolescents out there who are having this problem and aren't telling anyone," the Discovery News quoted Dr. Amy Gelfand, a neurologist at the University of California, San Francisco School of Medicine as saying. "This is why pediatricians should be aware of this, so an adolescent doesn't have to raise this issue," she noted. About 1 percent of Americans have experienced a headache as the result of sex, called a primary sex headache, in their lifetimes; about 50 percent of individuals who have primary sex headaches also get migraine headaches. Even so, their cause remains a mystery. Primary sex headaches come in two varieties - one that gradually builds up in intensity during sex and the other develops explosively at orgasm. One idea is that muscle contraction during sexual activity may be involved in the gradual type of headache. For the explosive type, scientists have suggested blood vessels in the brain may be particularly sensitive and reactive to sexual activity. In the new case reports, detailed this week in the journal Pediatrics, Gelfand and neurologist Peter Goadsby, also at UCSF, described both headache types. About three weeks before visiting the doctor, the teen girl started experiencing gradual primary sex headaches for the first time in her life. "About 1 minute before orgasm, she would develop a mild- to moderate-intensity throbbing headache in the midforehead," the scientists wrote in Pediatrics. "At orgasm, the head pain would instantly become severe, and she would develop photophobia, phonophobia, and movement sensitivity," they wrote, referring to fears of light and loud sounds, respectively. The teen boy, however, experienced the explosive type of headache that occurred at the moment of orgasm. He rated the pain as an 8 on a 10-point scale, indicating the pulsating, tearing headache built up about five to 10 seconds before orgasm and remitted after between 10 seconds and two minutes. The headaches would occur regardless of sexual position or whether he was having intercourse or masturbating. His primary sex headaches went away after several months. The teen girl's headaches seemed to come on immediately after she switched her contraception, though the researchers have no idea if the two were related; however, she did switch back to her original birth control pill, with the headaches going away about two weeks after her evaluation. Brain imaging on both teens revealed no abnormalities. Gelfand said the brain scans are performed to rule out any secondary cause of the headaches, such as an aneurysm that could be life-threatening. Since only four such cases in teens, including the two new ones, have been reported, researchers aren't sure if these headaches are more rare in teens than adults, or if teens are just less likely to tell a doctor about the odd sexual phenomenon out of embarrassment. The headaches generally go away after several months, with some lasting a year, Gelfand said. In the meantime, they can be prevented with a medicine called indomethacin that's analogous to ibuprofen, but keeps these sex headaches at bay if taken 30 minutes before sexual activity, Gelfand said. Gelfand said she hopes the case reports will encourage doctors to ask teens about these headaches, particularly if the teen has migraines. "For teenagers, if they're experiencing this [know that] they're not the only one, because it's probably even embarrassing to talk about it with their friends," she told LiveScience. "They do need to tell their doctor about it, because we would recommend imaging for these kids; and there are [preventive] treatments that can help them so they don't have to have it," she added.