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    Massive headache approaching ejaculation
    An_205337 posted:
    Over the last few days, as I've approached ejaculation during sex (or.. even during masturbation... ) as soon as my body begins to tense up, I feel a massive headache building. As I approach ejaculation, the headache can actually become bad enough to "stop the presses" as it were. It seems to start at the base of the neck, but eventually emanates all the way through the skull, and at times feels like a brain ache because nowhere I press on the muscular systems around the neck or temples, etc seems to alleviate it

    Not sure if its sinus related or what, but any ideas would be appreciated.
    An_205338 responded:
    I'm 19 and male and I've had the exact same problem. In fact, it just started a little over a week ago. Every time I approach ejaculation I get the most severe migraine I've ever experienced. Once the headache lasted for almost an entire day. I was scared that I may never be able to enjoy orgasm like I used to again. Based on research I've made this problem is not that uncommon and the migraines are most likely benign. Sometimes it could be the result of high blood pressure. If not, there is medication that you can take before engaging in sexual activities that will prevent the migraines.
    Timothy Collins, MD responded:
    This is called an orgasmic headache, It is believed to be pretty rare, and the number of patients described in the medical literature is fairly small.

    Some of the older articles suggest there is an association with blood vessel problems (like aneurysm) but more recent article seem to question that association.

    I usually recommend an MRI of the brain when I see patients with this complaint, because of the reports of a possible association with aneurysm. So far I have not found abnormalities in any of the patients I have seen.

    Because it seems to be similar to other exertional migraine, we can try to treat it with migraine medications. some of the longer acting triptans (like frova triptan) can work as a prevention, and have a more than 24 hour duration of action.

    I have used prevention medications (like verapamil) in a few patients also.

    This is something you really need to talk with your MD or a Neurologist about. We (MD's) are used to talking about almost anything, and using the medical words (like orgasmic headache) sometimes makes it easier to talk about.

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