My Girlfriend Gets Headaches When She is About to Orgasm??!?

Dear Couch,

My girlfriend gets bad headaches when she is about to orgasm. Other than that aspect, everything else in our relationship--both sexually and emotionally-- is great. My question is why does this occur? Is she concentrating too hard? Am I doing something incorrectly? And what can we do about it?

Thanx in advance,

Dear Paul,

Try to remember to put a pillow between her head and the bed's headboard (just kidding). Your girlfriend has an interesting, albeit fairly rare phenomenon called benign coital headache or orgasmic headache or Orgasmic Cephalgia. It occurs in about 1 of people and is caused by dilation of arteries during arousal. In most people, compensating mechanisms in the head don't allow the head arteries to act the same way as the rest of the body, but your girlfriend must have some very potent dilation going on.

You can try common headache vasoconstriction things like medicines or beverages with caffeine, but taking these 30 minutes before intercourse decreases your spontaneity about as much as going to the store to buy condoms. Another thing she can try is to use a nasal decongestant just before sex. Think of it as a new kind of foreplay. She shouldn't use it more than three days in a row, however, as you can get chronic sinus drainage from using this medication too much, although that could help with fellatio. As always, we suggest a quick trip to the doctor to make sure this is not something else.

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