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At first onset, patients should have a medical examination to rule out more serious conditions, Dr Achim Frese, University of Munster, Germany, and colleagues suggest in the medical journal Cephalalgia.
The investigators analysed data from 60 patients treated for headache associated with sexual activity at a headache out-patient clinic between 1996 and 2004, and tracked the patients' outcomes after 1 year or longer.The patients were an average of 37 years old when they first experienced either slowly intensifying or sudden severe headache, prior to or during orgasm. The researchers report a combined overall recurrence rate of 43 percent over an average follow up of 6 years.
No further attacks
Of the 45 patients reporting single attacks prior to their initial examination, 37 reported no further attacks at follow-up. Another 7 patients reported at least one further attack, and one patient developed chronic headache associated with sexual activity.
The remaining 15 patients had chronic headache associated with sexual activity; 9 with infrequent attacks (less than 20 percent of their sexual activity); 3 reported attacks during 20-to 50-percent of sexual activity; and another 3 reporting attacks during nearly all sexual activity.
Most attacks of headache associated with sexual activity do not require medical treatment, the investigators note, but about 15 percent of patients report severe pain lasting from 4 to 24 hours.
Beta-blockers may help
"From our experience, beta-blockers (propranolol or metroprolol) for prophylaxis and indomethacin for pre-emptive therapy can be recommended," Frese and colleagues write.
While other headache disorders, including tension and exertional headaches and migraines, were evident in 39 of the 60 patients, data from this study could not confirm an association between other headache disorders and headache associated with sexual activity.
SOURCE: Cephalalgia, November 2007. – (Reuters Health)
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