Coital Cephalalgia: Have Sex and Feel Like You're Getting Kicked in the Head
In all likelihood, my life has sucked significantly more than yours has over the past two weeks.
I say that because during that period, each time I've approached sexual climax, a burly man has kicked me in the head as hard as possible with a steel-toed boot -- repeatedly.
That's the sensation, anyway -- an intense, crushing pain shooting through the top of my head as I approach the Moment of Truth.
It is almost certainly a case of coital cephalalgia, a benign form of migraine headache that hits in the moments before orgasm and can linger for hours, or even days, afterward. Any form of stimulation can bring it on, including ... ahem, solo pursuits.
The act of ejaculation is a complex series of events. Headache during coitus may be classified as one of three types, depending on onset:
* Early coital cephalgia, which is usually moderate and of short duration.
* Orgasmic coital cephalgia, which is abrupt, severe and lasts 15 to 20 minutes.
* Late coital cephalgia, which is of long duration (hours to days), and which occurs after orgasmic coital cephalgia.
I suppose I'm experiencing the joys of orgasmic coital cephalalgia ("cephalgia" is an iteration of the Latin word for headache).
It is, thankfully, temporary in most cases, although about half of those suffering from it will have a relapse at some point within five years of its first uninvited appearance.
Dr. Ninan Mathew, a headache expert, told Esquire magazine: "It could occur a few times and may not happen at all after that. It may happen recurrently for a while, and then it goes away."
According to a backgrounder at the Mayo Clinic's website, a cluster of headaches over a period of a month or two is quite common. (Murphy being an optimist, I just started seeing someone. So while the transient nature of the condition is keeping me from thoughts of doing something drastic, the timing just really couldn't be any worse.)
"Sex headaches" can pop up at any time, and studies suggest they do at some point in the lives of about 1 percent of the population. But some experts believe that embarrassment may prevent people from reporting the condition to their doctors and argue that as many as 1 in 10may get the problem at some point.
The condition can strike either sex, but men are three times more likely to get it than women. According to Dr. Randolph Evans at the University of Texas, people with a history of migraines are more likely to get "sex headaches."
The middle-aged (I'm pushing 40, but haven't yet hit it), obese (nope) or people who suffer high blood pressure (also not!) are also at a higher risk for coital cephalalgia.
Despite the fact that 1 in a 100 people will get the ailment, the disorder is relatively unknown. Fearing for my health, as well as my sanity, I went to a doctor. He asked me what the problem was, and when I told him that a Google search-based diagnosis suggested that I suffered from coital cephalalgia. he whipped out his iPhone and started tapping away.
"I have to look this up," he told me, adding: "Don't worry, I'm not texting my girlfriend." (He was doing just that, of course, and the text no doubt began: "You'll never believe how screwed this poor dude sitting at my desk is …")
He isn't alone -- medical science doesn't have a clear understanding of the exact physiological processes that are happening to me. According to the Mayo Clinic, some types of headaches that occur during sex "might be caused by tightening the head and neck muscles during sexual activity."
A sudden drop in blood pressure may also cause the attacks, or they may result from a rise in pressure causing the blood vessels in the brain to dilate.
The best treatment for most "sex headaches" is propranolol, a beta blocker that brings down the blood pressure that may account for the phenomenon. Murphy being an optimist, the drug's most frequent side effect is -- you guessed it -- sexual dysfunction.
That's why the second most-prescribed treatment is indomethacin, a powerful anti-inflammatory -- like an Advil on steroids. While it may destroy your digestive tract, indomethacin does treat the symptoms (but not the disease) by relaxing dilated blood vessels -- it's working for me OK so far (albeit with less spontaneity than I'd prefer -- one has to take the drug at least an hour before any "activity").
This condition may be related to the more common "exertion headaches" that can accompany any kind of strenuous exercise (I ruled this out based on the fact that I don't get headaches when running or working out). About 4 in 10 people who suffer from coital cephalalgia also experience exertion headaches.
Headaches during sex -- or other exertion -- may also be a sign of something far more serious, namely a bleeding aneurysm (which I ruled out largely because I had neither dropped dead nor become a vegetable during that first week). According to Evans, sexual activity is responsible for about 1 in 8 saccular aneurysms, and 1 in 20 bleeding arteriovenous malformations.
While rare, those conditions aren't jokes, so if you should be unfortunate enough to experience the joys of being kicked in the head with a steel-toed boot when getting your groove on, consult a physician to rule them out, especially if it's the first time (for the headache, I mean).