Headaches can be associated with sexual activity, especially with orgasm. There are two types of these headaches. In the first type, the excitement accompanying intercourse causes muscle contraction in the head and neck, thus leading to head pain.
The second type is a vascular headache. It is a very intense, severe headache usually occurring just before orgasm. It has been called an "orgasmic headache" or "orgasmic cephalalgia." In some instances, the headache is a response to an increase in blood pressure, in which the blood vessels dilate. The headache is not usually related to the amount of physical exertion involved in intercourse. The pain may be located around or behind the eyes. It usually lasts a few minutes, but can last for hours. The headache is usually made worse by movement. The headache most often is a "benign" orgasmic headache; however, the possibility of organic disease should be thoroughly investigated.
A headache occurring with orgasm could be a symptom of a brain hemorrhage (bleeding around or inside the brain), stroke or tumor. An accompanying stiffness in the neck may be an indication of bleeding into the spinal fluid. The benign orgasmic headache occurs more frequently in men than women and usually strikes migraine sufferers.