Every Time I'm Close to Orgasm I Get a Huge Headache and Have to Quit??!

Dear Couch,

Every time I am close to having an orgasm, I get a huge throbbing headache and have to stop whatever's going on. It has happened 4 times now. Once about 4 years ago and the other three recently. What could be causing this?

Sick of Aching

Dear Sick of Aching,

First we have to say, see your doctor (this is an online advice column so physical symptoms MUST be diagnosed by your doctor). Weird, consistent, headaches are nothing to take lightly. We could all use a yearly checkup anyway and if you've been within a year, consider an early trip.

What you may be experiencing (and we emphasize 'may' as we can't really tell from here so all you lawyers reading this can quit licking your chops) is orgasmic cephalgia. It is reported to have a lifetime prevalence of about 1 percent (Neurology 1992 42:1225). Per this Family Practice site (scroll down to 'Thursday'), the condition may be thought of as ' ....an 'erectile function of the sinuses...' ' which if true could be relieved by over the counter nasal decongestants if taken prior to sex. Now this is NOT a substitute for seeing your doctor but if it worked for you, could help in his/her diagnosis. Give it a shot, making sure you take them far enough in advance (at least an hour) and let us know how they worked and what your doc says via the Message Boards.

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