Primary headache associated with sexual activity: Case report and review of the literature

Abstract

HSA (headaches associated with sexual activity) are by definition benign conditions but the symptoms can be the same as in serious life threatining cerebral conditions and these need to be quickly excluded at the first presentation. The prevalance of HSA is estimated 1 % general population. Onset usually occurs in the latter part of the fourth decade of life, though some patients may experience it in their early 30s.

A 55 year-old Turkish man patient presented with a history of severe headache during intercourse for the last two months. It was localised to bilateral and explosive. The onset was just prior or at the moment of orgasm and lasted for a hour. The patient avoided sexual activity due to headache. The headache was unresponsive to analgesic drugs.

In the classification of the Internatıonal Headache Society these disorders are divided into three subtypes, based on the onset time, related to orgasm. The typical story is that headaches occurs during sexual acyivity is bilateral and stops or less severe if sexual activity stops prior to orgasm. Our case experinced type-2 category and showed dramatical response with a treatment of indomethacin 100 mg/day.