From the Research
Management of Orgasmic Headaches
- The management of orgasmic headaches, also known as primary headache associated with sexual activity (PHASA), can be achieved through various treatments 1, 2.
- Indomethacin at doses of 25-50 mg/day taken 30-60 minutes prior to sexual activity may prevent headaches 1.
- Propranolol and metoprolol have been used for headaches that consistently emerge during frequent sexual activity of any type 1.
- Topiramate has been shown to be effective in treating PHASA, particularly in cases where propranolol and indomethacin are contraindicated 1, 2.
- Triptans administered prior to sexual activity may also be used as a preemptive treatment for PHASA 2.
- Beta-blockers, topiramate, and calcium channel blockers may be used as prophylactic treatments for PHASA 2.
- CGRP-targeted therapies may provide relief in PHASA, although more research is needed to confirm their efficacy 2.
Treatment Approaches
- A thorough workup, including imaging, should be conducted to rule out potentially life-threatening etiologies such as subarachnoid hemorrhage, reversible cerebral vasoconstrictive syndrome (RCVS), vasospasm, and dissection 2.
- PHASA can be treated preemptively or prophylactically, depending on the frequency and severity of the headaches 2.
- A multidisciplinary team approach, including physical and occupational therapy, may be useful in treating chronic daily headaches, including PHASA 3.