What is an orgasm headache?

An orgasm headache is intense and it starts suddenly, just before or during an orgasm. These headaches are usually harmless, and a person can often treat them with over-the-counter pain medications.
However, headaches during sex can sometimes signal a more serious condition.
In this article, we describe what orgasm headaches are, what they feel like, and what causes them. We also explore risk factors, prevention, treatment, and when to see a doctor.
An orgasm headache is a primary headache that some people get during sexual activity. A primary headache is a condition itself, not a symptom of another health issue.
A person may experience an orgasm headache just before or during sexual climax. These headaches can happen during masturbation or partnered sex.
Orgasm headaches are one of two types of primary sex headache. The other type is a sexual benign headache, which doctors also call a pre-orgasm headache.

What do they feel like?
People typically experience orgasm headaches just before or during an orgasm.
The pain may feel:
intense
explosive

like a clap of thunder
An orgasm headache may be most painful behind or around the eye area.
Around 75 percent of people who experience these headaches report feeling pain on both sides of their head. Moving around may make the pain worse.
A common feature of primary sex headaches is intense pain for 5–15 minutes that gradually eases.
The pain occurs abruptly, and after it diminishes, a person may feel a throbbing in their head, which can sometimes last for several hours or even days.
Unlike migraine headaches, orgasm headaches do not usually occur with nausea or sensitivity to light or sound.
In contrast, a sexual benign headache feels like a dull background headache. This type of pain builds slowly, rather than starting suddenly, and it may feel similar to a tension headache.
Some people experience both pre-orgasm and orgasm headaches.
Causes
Doctors do not know what causes orgasm headaches, but they may be a type of vascular headache. These result from blood vessels swelling in the brain.
When a person has an orgasm, their blood pressure increases rapidly. This surge in pressure causes blood vessels in the head to dilate quickly, which can trigger sudden, intense headaches in some people.
A sexual benign headache, on the other hand, results from increased muscle tension. As a person becomes sexually excited, muscles in their neck and head can contract, which may trigger a tension headache.
Risk factors
Anyone can experience orgasm headaches. However, a 2010 review reports that males are four times more likely to experience primary sex headaches than females.
According to a case report from 2013, the average age of onset for these headaches is between 40 and 49 years.
People with a history of migraine headaches, exertional headaches, or cough headaches may be more likely to get orgasm headaches.