Current Pain and Headache Reports

, Volume 5, Issue 3, pp 275–278

Symptoms and therapies: Exertional and sexual headaches

  • Luiz Paulo Queiroz


This article discusses the headache disorders associated with physical and sexual activity, highlighting their differences and similarities. The place of exertional and sexual headaches in the classification of the International Headache Society and in the proposed classification of Indomethacin-Responsive Headache Disorders is addressed here. The Valsalva’s maneuver as a shared pathophysiologic mechanism is mentioned as well.

Exertional headaches are divided into two subtypes, according to the pattern of physical exercises. Sexual headaches are divided into three subtypes, based on the onset time, related to orgasm. The clinical characteristics of each type are presented, and their etiologies pointed out. The diagnostic approach is discussed, as well as the nonpharmacologic and pharmacologic treatment options.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Tinel J: Un syndrome d’algie veineuse intracranienne. La cephalee a l’effort. Prat Med Fr 1932, 13:113–119.Google Scholar
  2. 2.
    Symonds C: Cough headache. Brain 1956, 79:557–568.PubMedCrossRefGoogle Scholar
  3. 3.
    Rooke ED: Benign exertional headache. Med Clin North Am 1968, 52:801–808.PubMedGoogle Scholar
  4. 4.
    Kriz K: Coitus as a factor in the pathogenesis of neurological complications. Cesk Neurol Neurochir 1970, 33:162–167.Google Scholar
  5. 5.
    Rasmussen BK: Epidemiology of headache. Cephalalgia 1995, 15:45–68.PubMedGoogle Scholar
  6. 6.
    Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society [no authors listed]. Cephalalgia 1988, 8(suppl 7):1-96.Google Scholar
  7. 7.
    Queiroz LP: Cefaleias indometacina-responsivas. Rev Neurociencias 1998, 6:47–51. This article has a practical review of indomethacin-responsive headache disorders. A classification for this syndrome was proposed [in Portuguese].Google Scholar
  8. 8.
    Calandre L, Hernandez-Lain A, Lopez-Valdes E: Benign Valsalva’s maneuver-related headache: an MRI study of six cases. Headache 1996, 36:251–253. The eponym "benign Valsalva’s maneuver-related headache" was first suggested, for all types of exertional headaches.PubMedCrossRefGoogle Scholar
  9. 9.
    D’Onofrio H, Saavedra EJ, Otero S, et al.: Coughing headache syndrome and internal jugular valves competency. Neurology 2000, 54(suppl 3):A129-A130.Google Scholar
  10. 10.
    Sands GH, Newman L, Lipton R: Cough, exertional, and other miscellaneous headaches. Med Clin North Am 1991, 75:733–747. A classical and comprehensive review of exertional and sexual headaches, including some pathophysiologic theories.PubMedGoogle Scholar
  11. 11.
    Paulson GW: Weightlifters headache. Headache 1983, 23:193–194.PubMedCrossRefGoogle Scholar
  12. 12.
    Indo T, Takahashi A: Swimmer’s migraine. Headache 1990, 30:485–487.PubMedCrossRefGoogle Scholar
  13. 13.
    Massey EW: Effort headache in runners. Headache 1982, 22:99–100.PubMedCrossRefGoogle Scholar
  14. 14.
    Pascual J, Iglesias F, Oterino A, et al.: Cough, exertional, and sexual headaches: an analysis of 72 benign and symptomatic cases. Neurology 1996, 46:1520–1524. A large series of patients with exertional and sexual headaches, with a good description of their clinical characteristics.PubMedGoogle Scholar
  15. 15.
    Diamond S: Prolonged benign exertional headache: its clinical characteristics and response to indomethacin. Headache 1982, 22:96–98.PubMedCrossRefGoogle Scholar
  16. 16.
    Silbert PL, Edis RH, Stewart-Wynne EG, Gubbay SS: Benign vascular sexual headache and exertional headache: interrelationship and long term prognosis. J Neurol Neurosurg Psychiatry 1991, 54:417–421.PubMedCrossRefGoogle Scholar
  17. 17.
    Lipton RB, Lowonkopf T, Bajwa ZH, et al.: Cardiac cephalgia: a treatable form of exertional headache. Neurology 1997, 49:813–816. Two cases of this interesting subtype of exertional headache were described, with a review of the literature.PubMedGoogle Scholar
  18. 18.
    Ostergaard JR, Kraft M: Benign coital headache. Cephalalgia 1992, 12:353–355.PubMedCrossRefGoogle Scholar
  19. 19.
    Akpunonu BE, Ahrens J: Sexual headaches: case report, review, and treatment with calcium blocker. Headache 1991, 31:141–145.PubMedCrossRefGoogle Scholar
  20. 20.
    Lambert Jr RW, Burnet DL: Prevention of exercise induced migraine by quantitative warm-up. Headache 1985, 25:317–319.PubMedCrossRefGoogle Scholar

Copyright information

© Current Science Inc 2001

Authors and Affiliations

  • Luiz Paulo Queiroz
    • 1
  1. 1.Clinica do CerebroFlorianopolisBrazil

Personalised recommendations