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Q. I get a severe migraine after sex for more than 4 hours. Why?

Answered by
Dr. Afifa Nighat
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Sep 22, 2020 and last reviewed on: Feb 10, 2021

Hi doctor,

I am a 21-year-old female with a weight of 47 kilograms and a height of five feet. I have severe migraine after sex and it lasted for four hours. What to do?

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Hi,

Welcome to icliniq.com.

It seems to be a sexual headache. It usually lasts for 24 to 72 hours. It usually occurs in the occipital area and it is unilateral. You can take Zolmitriptan nasal spray 5 mg. If you have repetitive attacks, then you need to take preventive therapy. If it lasts for more than 72 hours with associated signs such as loss of consciousness, confusion, and visual disturbance, then you need to seek medical help immediately.


The Probable causes:

You have exertion or excessive muscular contractions.

Investigations to be done:

You need to do a CT (computed tomography) scan brain if the problem continues to rule out an aneurysm.

Differential diagnosis:

You can have a sexual headache or reversible cerebral vasoconstriction syndrome (RCVS).

Probable diagnosis:

You can have a sexual headache.

Treatment plan:

You can use Zolmitriptan nasal spray 5 mg. For preventive therapy, you can take tablet Indomethacin 25 mg once daily before having sexual activity.

Preventive measures:

Avoid having excessive muscle contractions due to sexual activity. Being consciously relaxed during intercourse can help you to prevent it.

Regarding follow up:

You can have a follow up at any time.


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