October 8, 2014: Orgasmic headache

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October 8, 2014

The classic orgasmic headache (OH) is typically severe, throbbing, or explosive in nature and occurs at the time of or shortly after an orgasm. [1] The etiology of OH, a type of thunderclap headache, is unknown. However, transient arterial vasospasm and blood pressure elevations during orgasm have been suggested to play a role. [1,2] This may partly explain the usefulness of beta blockers and calcium channel blockers in the treatment of OH. [2] Although OH has a benign course, it warrants at least head CT and MRA to exclude intracranial dissection and subarachnoid hemorrhage.


  1. Valença MM, Valença LP, Bordini CA, et al. Cerebral vasospasm and headache during sexual intercourse and masturbatory orgasms. Headache. 2004 ;44: 244-248.
  2. Schlegel D, Cucchiara B. Orgasmic headache with transient basilar artery vasospasm. Headache. 2004; 44: 710-712.

Submitted by Anteneh M. Feyissa, MD, MSc. Chief Resident, Department of Neurology, University of Texas Medical Branch at Galveston, Texas. 

Disclosures: Dr. Feyissa reports no disclosures.

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