Sex Headache, Primary

Primary sex headache is a benign headache precipitated by sexual activity. It usually starts as a dull bilateral ache as sexual excitement increases and suddenly becomes intense at orgasm, in the absence of any intracranial disorder. The most important differential diagnosis is subarachnoid hemorrhage (SAH) that must be ruled out by appropriate methods. The prognosis of primary sex headache is good, most cases present only with one episode in their life. It can be treated with indomethacin as short-term prevention or with beta blockers for long-term prophylaxis.