In an account documented in BMJ Case Reports, a 61-year-old woman experienced a severe headache during sexual activity, which alarmingly turned out to be a symptom of a serious brain hemorrhage.
Coital cephalalgia, also known as headache associated with sexual activity (HSA) or simply “sexual headache,” occurs in association with sexual activity, manifesting as a sudden, intense headache. While often harmless and self-resolving, it demands attention to rule out more serious conditions.
To be diagnosed with sexual headache, a patient must experience at least two instances of headache that are specifically triggered by sexual activity. These headaches must increase in intensity with sexual excitement or have a sudden severe onset at orgasm, can last up to 24 hours if severe or 72 hours if mild, and cannot be attributed to any other medical condition.
Its prevalence ranges between 0.25% and 1% in the general populace, suggesting it’s not as rare as one might think. Despite its potential to signify serious health issues, its primary form is usually benign and unrelated to any underlying disorder.
The case report detailed the experiences of a 61-year-old woman seeking medical help for a severe headache that emerged suddenly during sexual intercourse. Described as a 10 out of 10 in intensity and located in the occipital region, this headache did not subside with over-the-counter pain relievers.
Further complicating her situation were visual disturbances that prompted her to visit a hospital, where imaging tests revealed a right-sided occipital brain hemorrhage.
Upon transfer to a specialized facility, further examinations, including magnetic resonance imaging (MRI) and computed tomography angiography (CTA), confirmed the hemorrhage without indicating any specific underlying cause.
Despite extensive testing for autoimmune disorders, vascular diseases, and other potential causes, no predisposing conditions were identified. This lack of an identifiable cause was puzzling, as secondary sexual headaches typically stem from identifiable issues such as vascular malformations or hypertension, none of which were present in this case.
Her treatment approach was conservative, focusing on monitoring and rehabilitation rather than surgical intervention. Remarkably, the patient made a full recovery, regaining her vision and returning to her normal state of health within a year, without the need for ongoing medication.
The case report, “A not so happy ending: coital cephalgia resulting from an acute non-traumatic intraparenchymal haemorrhage in a female with no comorbidities,” was authored by Hafez Mohammad Ammar Abdullah, Uzma Ikhtiar Khan, Ezza Tariq, and Muhammad Omar.