It’s an age-old excuse: “Not tonight, honey. I have a headache.” But the next time you feel an actual migraine attack coming on, sex might be the best remedy.
Sound too good to be true? Research backs up this assertion: One study found that 60 percent of people who had sex during a migraine attack experienced some improvement in their headache symptoms. Another 33 percent, though, reported worse symptoms when they had sex during a migraine attack.
These differing reactions to sex during a migraine attack show that while sexual activity may be a balm for some, it’s not going to help everyone with migraine. In fact, for some people, sex may even trigger a migraine attack or another form of headache.
Here are some factors you should consider if you’re trying to figure out if sex could be helpful, or might be a contributor, when it comes to your migraine attacks.
How Sex Could Ease or Worsen Migraine Pain
One theory for why sexual activity can help during a migraine attack is that sex may distract people from their pain. Another is that sex — in particular, an orgasm — releases endorphins, which can also help relieve pain, says Alexander Mauskop, MD, a neurologist and headache specialist who is director and founder of the New York Headache Center in New York City.
Endorphins are opiate-like chemicals that are associated with a happy, positive feeling and can keep pain messages from reaching the brain, Dr. Mauskop explains. Unlike pain medication, which can take up to 15 minutes to kick in, these chemicals can work almost instantly.
But some people aren’t as lucky. Like exercise, sex is a physical activity that can put pressure on a person’s back and neck, potentially bringing on a migraine attack. Plus, sex can increase blood pressure and cause dilation (widening) of blood vessels in the brain, which can also trigger an attack.
“Headaches during sex are most often seen in people with migraine because these people have a genetic predisposition to develop headaches already,” says Mark W. Green, MD, a professor of neurology, anesthesiology, and rehabilitation medicine and emeritus director of the Center for Headache and Pain Medicine at the Icahn School of Medicine at Mount Sinai in New York City.
In this sense, sex may be a migraine trigger like any other — something that puts your brain out of its ordinary state, leading to migraine symptoms, especially when other migraine triggers are at play in a given person.
Sex Can Trigger Different Headache Types
When sex or an orgasm directly causes a headache, that’s known as a sex headache, according to the Mayo Clinic. A sex headache can develop in someone with or without migraine, and can be brought on by any type of sexual activity.
According to Dr. Green, sex can cause at least two different types of headaches that are distinct from a migraine attack — an explosive headache or a tension headache. In a person with migraine, though, both of these headache types can lead to a migraine attack.
The most common type of headache triggered by sex is an explosive headache, which typically occurs right before or at the point of orgasm and involves sudden, severe pain. Anyone who experiences this type of headache for the first time should talk to a medical professional immediately after the incident to rule out a cerebral hemorrhage (brain bleed) or other brain injury as the cause of the headache, says Green.
A tension headache — usually caused by stress, including tension that is brought on by the act of sex — feels more constrictive and usually goes away within 20 minutes. It may build up slowly during sexual activity and linger after sexual activity has stopped.
Most sex headaches last for only a few minutes, but they can also linger for hours or even two to three days, the Mayo Clinic notes.
Sex headaches often happen on a recurring basis for more than a year, according to the American Migraine Foundation. If your doctor rules out other potential causes of a headache that occurs during sexual activity, a sex headache may be treated using certain drugs, including indomethacin, triptans, and propranolol. Talk to your doctor about the potential risks and benefits of different treatments for a sex headache.
Tips on Navigating Sex for People With Migraine
The relationship between migraine attacks and sexual activity is different for every person with migraine. Depending on your situation, here are some tips that could help improve your sex life or ease your migraine pain.
- Discuss migraine treatments with your doctor. Whether sex helps ease your pain or triggers a headache, trying a new treatment may help you experience fewer unpleasant symptoms.
- Communicate with your partner. Letting your partner know what works for you sexually — or how you’re feeling when you can’t have sex — may lead to solutions or greater understanding when you’re having migraine pain.
- Schedule sex for when you’re feeling well. If you’re having a day or streak of days free of migraine pain, consider taking advantage of the situation to have sex.
- Experiment with sexual activities. It’s possible that while certain sexual activities or sexual positions cause or worsen headache or migraine pain, other activities may be more tolerable or even soothing.
- Consider seeing a sex or relationship therapist. If migraine is taking a toll on your relationship or sex life, a therapist may be able to help you and your partner improve your situation.
Keep in mind that sex is only one possible trigger — or remedy — for a migraine attack. Talk to your doctor about other ways to help keep migraine pain at bay.
Additional reporting by Quinn Phillips.