Headaches During Sex
No, it's not a music-hall joke - headaches and intercourse do have a direct connection, rather than the proverbial inverse relationship! Of course, having a headache may prevent you from enjoying intercourse, and its a good excuse for avoiding it, but headaches can occasionally relate to the act of intercourse itself. In complete contradiction to the joke, headaches with intercourse are more common in men!
There are three types of headache that can occur at intercourse. The first is an exacerbation of tension headache, and in patients who get tension headaches, intercourse may bring on a dull ache over the whole head. It may be more severe than tension headaches previously experienced, and it is probably due (amongst other reasons) to over-dilation of arteries in the head.
The second type of headache is caused by a ruptured artery adjacent to the brain: a sub-arachnoid haemorrhage. Blood pressure rises during intercourse and this may be the final straw which causes an already weakened artery to rupture. (About one in forty cases of sub-arachnoid haemorrhage occur during intercourse.
The third type of headache, benign orgasmic cephalgia (which is a bit of a mouthful, so I'll call it 'true coital headache'), is actually quite rare. It's a sudden, explosive, one-sided headache coming on at intercourse, and lasting for a few minutes up to a few hours. Not only is it rare, it doesn't affect the patient every time he makes love. Some patients experience a period of several months during which they get this type of headache during love-making, but then the tendency dies away and they are no longer troubled. In other patients, the headache occurs only occasionally, but on a seemingly random basis.
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What goes wrong?

Type of headache

Orthodox treatment

Self-help

Complementary treatment