[pamica]

I have been experiencing headaes exactly as you describe--now 4 times.  Thunderclap lasts about an hour or two followed by migraine lasting 5-6 days.  CT scan clear.  What have you done for this?

[alchemyster]

Hello All.  I've read through most of these links, and I thought I'd share a few things.  I am currently in this "thunderclap" state.  As soon as I get fairly close to an ejaculation (I'm a 48 year old male), KABOOM!!  The pressure and throbbing at the back of my lower head, at the top of the spine, is very close to unbearable. worst headache I've ever had, by far.  Painful!! Worst time for this, too, as, well, you know how great an orgasm is!  Man, I feel at times that this is the Big Guys way of stopping sexual encounters. Seriously it makes the thought of sex scary. And it happens upon getting close, you do not have to actually "fire your gun", so to say.

This is the third time in my life that I have had this cephalorgasmic(coital) cephalalgia.  The good news is, for me, it only lasts about one week.  Then things all return to normal, and I can enjoy sex again.  It will go away for most of you!!  It had been around 6 years since my last episode.  Lasted one week, then had 6 years of pain-free orgasms.  I'm on day three now, and tried to "enlarge" myself, ...... big mistake.

I am very glad to read about the breathing part, as I do hold my breath when nearing climax, and that is precisely when the pain begins.  And yes, I do fall into the injury category.  On my 40th birthday, I had two bicycle wrecks, and in my late 20's had been thrown from a Jeep, landing on my head and making my neck sore for quite a while.  Can't wait for this thing to go away!!

[alchemyster]

Back again with some updates. As of day 9, decided to see if this problem was still present, after abstaining for the past week, and ........it still resulted in a migraine. Though not quite as intense, but very bad still.  Intense pain did subside after a ten minutes.  Waited 4 more days, and BINGO! I experienced absolutely no headache!!!!!!!!  So this lasted for a full two weeks, hopefully gone for good.

[ZeusThunder]

So to be clear, possible causes for the benign thunderclap pain (clear CT, lumbar, MRI, MRA):

High blood pressure
Sinus/tooth/ear bacterial infection
Hormonal imbalance
Anti-depressant interaction
Overweight/diabetes
Stress/tension
Pinched nerves connecting brain to spinal cord

Did I list them all? Trying to eliminate obvious ones.

My first attack was simultaneous with orgasm at elevated altitude. Second was three days later, one hour after receiving a flu shot and 30 min after taking Relpax (no sex or exertion). I am living in mortal terror of the next one....still suffering from lingering pain three days later.

Thank you to all serious posters for your info, especially oneeyedguy and the other suggestion about bacterial toxins. I have low blood pressure, no history of migraines, but chronic sinus infections. Please help!

[flp]

I posted some time back about bacterial infection or inflammation in the head causing this problem. Almost 2 years ago, wow, time flies!

I am pretty sure my theory is correct. But I think the focus should be on inflammation rather than on an infection, although an infection can also be a possible cause.

I have not tried using antibiotics to clear up infections/inflammation in the head. But I don't have the problem any more. After starting to get these headaches, I stopped having sex for a long time, until recently, when I found that I didn't get them during sex.

I used to have a longstanding large abscess in my upper jaw behind my teeth which I had for several years. I also used to have several sebaceous cysts on my back, one of which was about 3cm wide and 1cm high (huge!), and which would regularly get inflamed, and I had had these cysts for several years, during the same period of time I had the jaw abscess.

Since earlier this year, I have started on a mostly organic food regimen, or rather, a regimen of avoiding as much GMO foods as possible. Unfortunately, it is practically impossible to absolutely avoid GMO foods.

The abscess in my jaw cleared up completely. And to think I had been suffering with inflammation, pain, swelling, pus oozing and bad breath for so many years! Now, all gone. The large abscess on my back burst and, after draining its contents, healed nicely, without any sebum filling it up again, which is what would always happen to my sebaceous cysts no matter how often I squeeze out the fat.

Occasionally now, my old jaw abscess would swell up for a few days. That is usually whenever I have eaten out and had probably taken some GMO food unintentionally. And, every time, after several days of cooking at home and eating in, the abscess goes down to zero. My abscess has become a gauge of sorts, swelling up the next day whenever I happen to take any GMO food.

So, my cure, I am sure, was going on the non-GMO foods regimen.

There have been no proper studies on the long-term effects of GMO foods on human health. Whereas, only the short-term effects on laboratory animals of consumption of GMO foods have been observed, and most of these effects are not nice at all, some downright nasty, but these results have reportedly either been altered or suppressed. The US FDA has approved and sanctioned masses of GMO foods and GMO food derivatives, allowing them to be introduced into the food chain. GMOs, both the crops and their derivatives and the foods they are made into, are exported throughout the world and can be found in every country. We are eating large amounts of such foods every single day.

Going on a non-GMO diet is very, very hard. Almost everything in the supermarket, including some fresh produce, contain GMOs.

Ever since the 1990s, over 80% of our foods contain GMOs. Also, ever since then, there has been a persistent epidemic of all sorts of chronic health problems.

There are many stories of personal experiences, which you can find on the Internet, of the effects of consumption of GMO foods. Here is just one victim's story: newbielink:http://aspartame.ca/page_a9br1.html [nonactive]. The main website has a lot of info on Aspartame and GMOs. I have had other bad health problems too, which stopped after I stopped taking another GM food, but I won't go into detail here.

What could be the possible connection between consumption of GMO foods and coital cephalgia? Inflammation.

It is believed that GMO foods sets up an allergic reaction in the body of a constant inflammation state at the cellular level. Since this abnormal inflammation is so pervasive, the body probably cannot deal with it efficiently, or perhaps cannot use substances which it does not recognise. The liver and kidneys are either unable to process these substances, or they cannot cope with the inflammation. Instead, these substances accumulate in the body and/or cause a reaction, creating all kinds of chronic health problems, such as pockets of inflammation. If you have inflammation in the head, then you may get the coital cephalgia.

Nano-particles, e.g., have been found to accumulate in the liver and kidneys in large amounts, indicating that these waste processing organs had attempted to process the nano-particles but were unsuccessful. And, yes, we are already also ingesting/absorbing nano-particles through mass-produced consumer products. Many sunscreens and cosmetics contain them.

What you can try: Avoid GMO foods. If you can avoid the Big 4 GMOs, you will be able to cut out about 90% of these foods from your diet. The Big 4 are Corn, Soy, Canola and Cottonseed. Alert: each of these or their derivatives can be disguised as other names in ingredient lists, with their source almost always never stated.

For starters, cut out Aspartame. No Diet Coke/Pepsi/sodas, or any kind of diet drink or diet food, or anything that says low-sugar or sugar-free or sugarless (e.g., almost all breath mints contain Aspartame and/or Acesulflame). No artificial sweeteners of any kind (Equal, Nutrasweet, Splenda, Sucralose, Sweet N Low, etc). Aspartame can cause diabetes. Try laying off Aspartame and all artificial sugars (another one is saccharin) for a few days and see if you still get the headaches.

No spreads, such as jams or peanut butter (make your own). No soft drinks or cordials or sweet drinks of any kind (talking about manufactured drinks). No foods containing high fructose corn syrup, corn syrup, golden syrup, liquid sugar, fruit sugar, fructose, glucose, sucrose, dextrose, maltose, maltodextrin, maltitol, sorbitol, xylitol, and many more sweeteners (they change/disguise the names all the time). No foods made from or containing phenylalanine (many candies and even vitamins contain this). No ascorbic acid, a Vitamin C manufactured from starch. Almost all of these are made from GM corn. In fact, no foods made from or containing any form of corn or corn derivatives. Another name used on labels for corn is maize.

No reconstituted or filled milk or 'fortified' milk. No foods made from or containing soy oil or vegetable oil or containing soy derivatives, such as lecithin. No foods containing vegetable or soy or hydrolysed protein, among other names.

No margarine or soft butter or dairy spread. No non-dairy creamer in any form (made from Canola oil). No Canola oil or any food made from or containing it.

No Cottonseed oil or any food made from or containing it.

No MSG or any foods containing it.

If in doubt about the source of some of the ingredients on packages, the safest is to not buy the product.

Consume foods which are as close as possible to its whole form or as found in nature.

Good luck!

[weebles]

Hi all,

I just had my first thunderclap headache with orgasm, and definately see from this blog that there are overlapping antecedents to the migraine to what I experienced. What we need to consider are medications we are taking, other symptoms present prior to migraine, and understand that migraines are often, if not typically a result of sudden vascular dilation.  Here is my experience:

- I have had a mild sinus headache and symptoms of a cold for 2 days, and have been taking OTC sinus medication.
- I am also on an SSRI antidepressant that is known to increase difficulty of achieving orgasm in men and women (not ED, but difficulty climaxing). Thus, I have had to "work harder" than usual to achieve orgasm regardless of the circumstance
- I had 3 cups of coffee this morning (caffeine is a vaso-constrictor that may want to consider as a factor that could enhance the vasodilation that occurs during orgasm
- This morning, my wife and I were in a rush but started making love. It was taking awhile to climax...  I had to work exceptionally (mentally and physically) to climax
- I experienced a massive headache immediately before and during orgasm
- I ate 2 aspirin, used cold compress, then took hot shower to open sinuses.  1 hour later, I still have a mild headache and some nausea

From my experience and from your postings some of the common themes are: sinus issues, rushing/working harder than usual to climax

Other factors to consider:  caffeine consumption prior to sex; OTC sinus medication ingredients; SSRI antidepressant medication

hope this helps
When

[Oneeyedguy]

Update on my headaches since last post (Nov 2009). At that time I was concentrating on breathing techniques, and they have definitely helped, though the 'success rate' - i.e. relatively headache-free orgasms - has been patchy. I've been frustrated at the lack of consistency of any of my 'counter-measures'.

Then I read this: http://casereports.bmj.com/content/2010/bcr.10.2009.2359.abstract [nofollow]

This is just a summary of a full medical report that you'd have to pay about £30 for, and I haven't. But the basic story seems clear: a guy who suffered from orgasm headaches for years on end cured them by making love to his wife while she was pregnant, thereby exposing himself to the considerable amounts of progesterone women produce during that period (8-10 times higher than normal cycle). His doctor prescribed progestogen medication to continue after the birth.

I had already done some reading on the role of hormones, without coming to any hard conclusions (I'm pretty scientifically literate I think, but some of this stuff is full-on). There's quite a lot of material on the web about the link between oestrogen and headaches, e.g. http://premenstrualmigraineprevent.com/ [nofollow]

And there's a fair amount on 'oestrogen syndrome', a condition where the balance of progesterone and oestrogen in both men and women (both sexes have both hormones) is upset by the presence of xenoestrogens and phytoestrogens, i.e. potentially harmful chemical and plant-based compounds that have oestrogen-like effects, such as insecticides and herbicides used in agriculture, PCBs, preservatives, plasticizers, parabens, detergents. Both men and women can end up overloaded with oestrogens. Women are the obvious candidates for major falls in hormone levels, during menopause, but men's levels of progesterone - which is necessary for the production of testosterone - fall in middle age too. Not as drastically, but it is implicated in prostate enlargement among other things. One solution offered is natural progesterone cream.

Well, cut a long story short, I decided to try it. I ended up here -  http://www.progesterone.co.uk/menandprogeserone.htm [nofollow] - which makes for interesting reading, and I've been using it for about 2 months now, and I haven't had a bad headache with orgasm since then. I'm not claiming a cure, nowhere near. The feeling of tension and 'near-headache' I've been having more or less constantly lately is still there. I still feel I need serious ongoing massage to neck and shoulders (can't afford it though, in London you're talking £40 a session for any serious masage), and once or twice I've had a minor intensification of this dull buzz after orgasm. But no headbusters or anything near.

2 months isn't long - I've had a period of natural remission that was longer than that, and in any case we're not talking very many orgasms in total, maybe 1 every 5/6 days, say 10-12 (God, did I ever think I'd be posting my orgasm frequency on the web?!) - but I'm cautiously optimistic.

I'm in no way recommending the use of the cream - that's a personal decision for everyone, in a way it's practically HRT for men; I'm just relating my experiences. There are several websites promoting progesterone cream for men; many of them seem genuine to me. There seems to be a general opinion that yam extract isn't as good as the 'natural' progesterone creams but on the other hand all these products seem to be plant-based (I guess the only truly natural progesterone is produced in the body) which is why I've used inverted commas.

There's no denying that this isn't accepted mainstream medical treatment but in my opinion it's not utter quackery either. I think the effects of hormones on our health in general, especially male health, are poorly understood, certainly by most men. We usually attribute 'hormonal' behaviours and symptoms to the opposite sex, but I've often had a sneaking suspicion that men aren't as constant in this respect as we'd like to think - and if the environmental oestrogens are as powerful as some say, then it's perhaps no surprise that more and more men are exhibiting symptoms of an excess of feminizing hormones - fat retention, 'manboobs' (gynecomastia) - and headaches. I don't imagine xenoestrogens cause orgasm headaches all by themselves, but I think headaches/migraines may result from a build-up of factors which, when they 'overflow', lead to illness.

One more thing: since reading about oestrogens, and various chemicals that mimic oestrogen, I've been thinking about what I use. And I have to admit that both baby oil and Vaseline have played a big part in my sex life - well, my solo sex life, certainly. I've used them as lubricants and because they just felt sexy! But maybe rubbing these substances into my cock several times a week hasn't exactly helped? I've certainly stopped now.

Does the progesterone really work? Are these creams just placebos? I don't know. But I've noticed a marked shortening of my temper, increased feelings of anger and competitiveness since using the cream - I've had to be a bit careful not to snap at people! If it is getting into my system - and the websites agree that via the skin is by far the best way (oral ingestion would lead to most of the dose being filtered out by the liver) - then an increase in testosterone would be expected. I've had no other signs, no increase in libido - but then that's a very fraught area since the headaches began.

Anyway, I'm still breathing! And now, rubbing in the cream once a day. I hope it works, I'm not ready to surrender sex and the whole erotic side of life just yet. I'll try to update sooner than 11 months' time...

[horizon]

Some of you may want to look for the POIS (post orgasm illness syndrome) thread
in the "new theories" section on this forum.

[Hugh888]

First, don't give up. Many of these headaches simply go away in time. And even if they don't, there are various ways to deal with them.

Talk to your doctor and discuss your family history. Often, you'll find that a history of migraine may give you a clue about the cause.

[marynancy]

Re blinding, searing headaches alongside arousal/orgasm. I know I won't care much when I'm dead, but what an embarrassing sort of mess for someone to find when they come home from work.(Stroking out, batteries dead, me too) Can't help but wonder what the relationship is within the vascular system that leaves me feeling as though someone has taken my brain out of its safe casing and tossed it into a flaming wok. Getting so that the 15 second orgasm is not worth the three hour headache.

[Bobbel Head]

I started getting these about 4 years ago. I curl up in a ball and hold my head. Freaked my girl out the first time it happened. I thought my head was exploded. I only get them after drinking a little too much the night before. Kind of during the hangover headache. I feel it start to build as I get ready to ejaculate. if I feel it coming on. I stop and just have a dull ache.
Im glad I found this page to know other have had it also. I dont get them less I had been drinking. I was wondering if anyone else here have the same circumstances?

[Bobbel Head]

I just found this on Wikipedia, what a blessing!

Coital cephalalgia

[Incognito]

   First of all I want to thank all of you for your insight on this most concerning topic.

   I did not realize reading through the first four of five pages that the majority of you were women? Suffice it to say that revelation actually turned me on. However, in light of my very new headache issue I'm not nearly as thrilled about that as I would have been a week ago. lol

    I am a healthy, fit and sexually active 44 year old male. About a week ago, for the very first time, I suffered the dreaded "back of the head" headache during masturbation. It happened just before ejaculation and was as severe as any headache I have EVER experienced. Frankly, it scared the hell out of me. Next day, the very same story. I have not seen a DR. as has been advised by some of you as of yet. I may very well do so if this continues on for very long. I also have not told my wife about this episode. She is not as sexual as I am so I am hoping to "cure" the problem before intercourse will take place. I can satisfy her other ways and avoid intercourse for the time being.

  Again, you guys have described my problems to a tee here and I FEEL MUCH BETTER about it now than I did this morning..  It has really consumed my thoughts the last few days. 

I believe the term Coital Cephalagia is how it is mostly described throughout the internet?. I hope it goes away on its own as many of you have said it may...  I will keep you updated. Thanks to all for sharing as I know how personal this is.   
   

[Oneeyedguy]

Update since last November: I've been continuing with the progesterone cream but if I'm honest I'm using it only about once or twice a week. I'm still doing the deep breathing leading up to orgasm. Two new things: I'm now getting proper massages - and finding out just how inflexible and unfit I've become this last ten years or so! - and I'm deliberately leaving it longer between orgasms. This seems to help quite a bit.

I've read a lot around this subject - I'm guessing we all have - and there's a fair bit of stuff out there talking about the enervating effects of ejaculation. I must admit, I've largely ignored it, mainly because it's not what I want to hear. These bloody headaches are ruining my orgasms, the last thing I want to read about is how orgasms are somehow 'bad' for you anyway. But spacing things out does appear to work. I'm talking sort of 2-3 week gaps here, whereas previously it was 2-3 days. Still a far cry from teenage years, when it was 2-3 hours some days... But, not to put too fine a point on it, spacing 'em out means a better experience all round: better erection, more arousal, more satisfying orgasm - and, crucially, less head pain.

It might all be down to the effects of the massage on my appalling posture (forward head posture, upper crossed syndrome, whatever, I'm so round-shouldered it's untrue & this makes my neck ache) - or the progesterone - but I don't think so. Oddly, what seems to work best is to aim for a longer, more drawn-out experience during sex, not worrying particularly about erection coming and going, concentrating on my partner much more gives a really satisfying 'return', i.e. turning her on turns me on. And during masturbation, the opposite: aim for a short experience. Get aroused quickly, bring it to a quick conclusion, sort of not giving the headache much chance to build. And you can't do that if you're doing it too often. It can end up being 'hard work' - and that's maybe a big part of the problem? I dunno - it's a bit paradoxical, but I'm just reporting what works at the moment.

Overall, I'm having more good orgasms than bad, roughly 2 to 1. By 'good' I don't mean always pain-free, but some of them definitely are absolutely pain-free. Others are still accompanied by the general background 'buzz' of borderline headache, which sometimes intensifies a bit at orgasm - or, more usually, thanks to the breathing, some seconds afterwards. And then there are the proper headaches - still delayed, mostly - which make me think I'm making no progress whatever. But I am; it's patchy and frustrating and sometimes seems to follow a pattern and sometimes not, but I am enjoying sexual activity more often than not.

So I'm carrying on with the massage - and plenty of exercise - with a bit of optimism. Best of luck to everyone; never give up.

[Mr. Data]

Do you even know what causes your headaches? Sure it may appear when having sex, but like all of us, headaches are caused by blood rushing to the head.

Out of curiosity, are you using Viagra?

[Mr. Data]

What I am saying, is just because you have a headache during sex does not necesserily mean that the sex is causing your pain. Viagra loosens blood flow, so after sex, just after the orgasm, the blood is racing through your body at a much higher rate than usual. Not to mention, blood clots, or even cancer can lead to headaches. Please don't specify your problem to such a simplistic form of catagorizing.

[micheledias]

Gosh, I though I was some kind of freak getting so much pain in my head when I orgasm! Good to know I'm not the only one (and you can't really talk about it or expain to your client why you'd rather chop you head off than keep it on!)
Thundercap has happened to me about 5 times now during climaxing and immediately before - I've tried relaxing my neck and shoulders and not tense up, but when the thundercap comes on there's nothing I can do to stop it.
Last one I had was a full 7 days ago and the headache just wont stop - I cant keep taking strong painkillers at night just to be able to sleep, and am struggling to do my work etc., etc.
The pain seems worst on the left side of my neck to the cap of my scull and benind my left ear and left shoulder, L'm wincing at every hearbeat as the pain pulsates.
Gosh I sound like a real whinger - but am at my wits end! Please don't send me to the doctor - he'll give me asprin or something equally useless!
By the way I'm a woman, 51. It seems mostly men suffer and many around my age. I haven't read much about it going on for this long though.
Help & advice on this prolonged problem will be much appreciated.
Thanks all xx M

[Resource]

I am a 59 year old female who just experienced a Thunderclap Headache during orgasm 3 days ago.  I was stunned.  It's never happened before.  It FREAKED ME OUT!  It's happened twice since and I kept wondering if it was a precursor to a stroke.  I have been googling all morning and just found this link.  I'm astonished at how many people experience this.  Like everyone else, it's just prior to climax.  The first time was during sex.  Then twice after during masturbation.  Frustration does not BEGIN to cover my feeling about this.  Last night was the worst because it ended up being so severe, it felt like someone was shoving knives into my eyes!  The pain kept up for a while and I had to take an Alieve to get it to calm down.  Anybody have any suggestions for how to make this better, what causes it, etc.?  Thanks!

[hokiehog]

I am a 59 year old female who just experienced a Thunderclap Headache during orgasm 3 days ago.  I was stunned.  It's never happened before.  It FREAKED ME OUT!  It's happened twice since and I kept wondering if it was a precursor to a stroke.  I have been googling all morning and just found this link.  I'm astonished at how many people experience this.  Like everyone else, it's just prior to climax.  The first time was during sex.  Then twice after during masturbation.  Frustration does not BEGIN to cover my feeling about this.  Last night was the worst because it ended up being so severe, it felt like someone was shoving knives into my eyes!  The pain kept up for a while and I had to take an Alieve to get it to calm down.  Anybody have any suggestions for how to make this better, what causes it, etc.?  Thanks!

Read this and listen to me

My wife died just under three weeks ago from an orgasm that was so intense she had a brain aneurysm and died....

This is serious business and I want you to go get an MRI immediately.  This is not something to play with.. I wish we had a warning sign, but I am left alone to ponder  as a 47 year old woman shouldnt died

David

[Oneeyedguy]

Some developments - and hope? - to let you know about. Here's a brief summary of how I got here:

• April 2007: First orgasm headache aged 46, male, 6ft, 15st/240lb, after abdominal op. Took up Pilates for neck/shoulder tension, also started to see osteopath
• Dec 2007: 1st post on this board
• Feb 2008: CT scan to rule out aneurysms, malformations etc: negative. Acupuncture, which helped my eyesight but not the headaches
• Apr 2008: after bad flu, headaches begin to fade even tho neck still not good. WTF?! Saw nice neurologist who said keep an orgasm diary.
• Jun 2009: they're back, with a bang —> hospital with a massive one + abdo cramps. Have given up all osteo etc - can't afford it. Start paying attention to breathing, as per Zoec's advice. Oxygen constricts brain arteries, CO2 dilates them, so if dilation=pain, oxygen is good? Seems to work!
• Nov 2010: Breathing strategy having only patchy success; I spotted a case report in the BMJ - http://casereports.bmj.com/content/2010/bcr.10.2009.2359.abstract [nofollow] - about a guy whose sex headaches go away whenever his wife gets pregnant, so his doc gives him a progestogen pill & it works in between pregnancies. I start using progesterone cream - it seems to work, but we've been here before...
• June 2011: Spacing orgasms by weeks, having more 'OK' ones than bad ones but neither cream nor breathing is a magic cure, the headaches still seem random - and there's a constant 'buzz' of borderline headache. GP has prescribed Sumatriptan, dreadful: felt like I was having a heart attack. Referred to neurologist No.2, he prescribed calcium channel blockers, diltiazem - why? They were rubbish, made headaches worse. They relax arteries, so why would they help?

Right, up to date. I'm afraid physically I feel I'm back to square one, just had another massive head-and-stomach job like June 09, had to call ambulance, it was so crippling. And once again, hours in A&E until pain eases off a bit, then home. Back to GP, back to neurologist, hoping for nice No.1, maybe it'll be No.3?

Trying to review my approach to coping with this bloody condition, it seems to me that, just as I think something's working, it stops working. I'll leave myself alone for 3 weeks, follow all my guidelines, breathe properly etc, and whammo, I get the big ache. The BMJ report I found on the web still seems the best hope, so instead of just reading the summary, I bought the full text, it makes very interesting reading. It turns out the guy in question was getting the Type 3 sexual headache, ie the ones that build up after orgasm, in his case about 20 minutes afterwards, and pounding for 3 days! Not the explosive-at-orgasm-then-gradually-fading Type 2s that most of us on this board suffer from. Still, his headache relief matches up with typical female progesterone (P4) production during pregnancy, ie from 8 weeks after conception until delivery - so it seems it's definitely the P4 that's helping. The article, oddly enough, is a bit inconclusive on the actual mechanics - it seems clear to me that he is getting exposed to his wife's P4 via sexual intercourse - how else? The article says:

'Close cohabitation and absorption of progesterone through touch and smell could be the beneficial mechanism. Progesterone could also be absorbed per urethra during coitus, but this would not explain the beneficial affects of the compound after non-coital sexual activity.'

Hm, touch and smell? Anyway, in between two pregnancies, he persuades his doc to prescribe him  P4 pills after trying 8% progesterone cream rubbed into the top lip and nostrils - which doesn't work - and another drug, the dopamine agonist bromocriptine, which also fails. The actual drug he gets is norethisterone, used in contraceptive pills. He takes one (5mg) about 30 mins before sex, and gets 95% relief from pain. Sometimes he waits, and takes 10mg a few minutes after sex, ie in the 20-minute window before the headache starts, and gets 100% relief!

The guy's symptoms were more than just the headache - which was a pounding sensation felt across his whole head, with no nausea or vomiting - he also suffered, amongst other things,

• Photophobia
• Increased muscle tension and irritability
• Anxiety and impaired cognitive functioning
• Difficulty concentrating
• Nightmares
• Fatigue, especially in the mornings

All of which look a lot like the Post-Orgasmic Illness Syndrome (POIS) discussed elsewhere on this site. There is clearly a lot of overlap between the two conditions. He took the oral norethisterone for about 9-10 months, seemed to tolerate it well, didn't seem to suffer side-effects and had relief from his other symptoms as well as the headaches. They tested his progesterone levels during his wife's second pregnancy - ie while he wasn't taking the pills - but didn't find them raised above the normal range for a male.

I'm still working out the implications of this, but one thing seems clear: the cream doesn't necessarily work, at least not for everyone. But the finger of causation - or at least, a finger - is still pointed squarely at the body's endocrine functions. Of all the complex, interreacting hormones, norepinephrine (noradrenaline) seems to stick out as capable of provoking headaches - eg in this case report - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2148749/ [nofollow] - (link to full text PDF available) when norepinephrine mixed with dental local anaesthetic causes a series of sudden, intense headaches. Norepinephrine certainly spikes at orgasm, but not everyone gets the headaches. There's clearly something else going on. Either we get way more norepinephrine than most, or something else potentiates it, eg a blood pressure spike, or the pre-existing state of our cerebral arteries.

You'll have noticed a lot of sites, such as herballove.com, drlin.net, cure-erectile-dysfunction.org, actionlove.com, talking about hormones and neurotransmitters in terms of 'burnout', usually as the alleged result of 'sexual exhaustion' or 'over-masturbation'. I'm not sure I take their claims at face value, given that a) they appear to claim that practically every hormone we've got is 'destroyed', 'disabled', out of whack in some way, b) they all end up selling you a nutrition potion and c) I simply don't believe I have ever been sexually exhausted, certainly I've never masturbated to the alarming levels described in some of their case studies! But I am quite stressed out, have had really bad sleep because of shift work, feel a lot of anger and depression at times - not just over orgasm headaches. So I don't dismiss their claims entirely; they may be onto something.

And I'm off to my GP asap, to get referred back to a neurologist. And I'll ask, why have I never yet, in 4 years, been prescribed either of the two drugs most often quoted as effective in sexual headache - propanolol and indomethacin? And can I have a trial of oral norethisterone, please? I suppose I could always go to my local Family Planning Clinic and ask to be put on the progesterone-only Pill...