Is it possible to get a headache during sex?

Everything you need to know about the three kinds of head-throbbers that hit when you're in the sack.

Sex should be all pleasure, right? But for some guys, it comes with an unpleasant side effect: a throbbing headache.

If that sex headache hits you, you’re not alone. It's not super common, but about one percent of people experience headaches during sex, and around three quarters of them are men, says Michael Reitano, M.D., physician in residence at Roman.

There are three main kinds of sex headaches. One is fairly mild, starting as you get turned on. This kind of headache also causes pain that also affects your neck, too. While disruptive, it's likely not serious. Some people find that analgesics like ibuprofen make these go away, says Dr. Reitano, but others will require prescription drugs. Though beta blockers are usually considered blood pressure meds, they can sometimes treat headaches, too.

The second kind of sex headache is called a “thunderclap” headache. This kind of headache comes on during orgasm and can sometimes continue for several hours afterward. It's generally much more painful that the first kind and requires immediate medical treatment, says Dr. Reitano.

While this isn't usually the case, a thunderclap headache can be a sign of a serious condition like a brain hemorrhage. Recurring thunderclap headaches can be treated with the same meds as the first kind.

About half of people who suffer from them also get headaches while they exercise, says Dr. Reitano. That gives us a hint to a potential cause: The headaches may just result from the rise in blood pressure that happens with physical activity—and yes, and as your rise in heart rate during sex shows, getting busy is considered a form of physical activity.

What's more, the adrenaline released during sex might also contribute by increasing pressure in your brain, says integrative medicine physician Bindiya Gandhi, M.D.. Contraction of the neck muscles is sometimes a culprit as well.

Certain over-the-counter drugs like Sudafed can also contribute to these headaches by causing restriction and over-dilation of blood vessels, says Dr. Reitano. There's also anecdotal evidence of marijuana, red wine, cheese, and other foods contributing to them, though it's not clear why. Smoking, drinking, and being sedentary or obese can increase your risk, too.

There’s also a third type of sex headache that’s extremely rare, affecting only around one in every 20,000 people, according to Dr. Reitano.

This kind starts after sex and get worse when you stand up, and it can be all over the place on the pain scale. People who experience this often have thin brain lining, and the rise in blood pressure that comes from the physical activity of sex causes spinal fluid to leak, which in turn causes the brain to droop when you stand. To prevent chronic headaches, you may need to get the leak surgically sealed, says Dr. Reitano.

You should talk to your doctor if you get headaches during sex—not only to get treatment but also because in some rare cases, they could point toward issues like bleeding in the brain, artery swelling, or blood clots, says Dr. Reitano (Here are 6 signs you might have a blood clot).

You should definitely get them checked out if they’re accompanied by other symptoms like nausea and vomiting, Dr. Gandhi adds.

In the short-term, many find that the headaches go away when they stop the sexual activity causing them, says Reitano. But you don’t have to be celibate or constantly cutting sex short—most cases are treatable with the right medications.