Orgasm instead of ibalgin? How sex affects migraines, stress and anxiety
"Not today, I have a headache. "The joke, which has been around for decades in various permutations, perhaps more than anything else shows how deeply ingrained in us is the idea that headaches and sex are opposed to each other. But the reality is far more complex. For some people, it is sex - and orgasm in particular - that can relieve the pain. For others, it can make it worse. And sometimes it can even trigger it directly.
The topic, which oscillates between intimate experience and hard neuroscience, is beginning to be the subject of serious research. It turns out that the body has its own "pharmacy" - and that orgasm plays a surprisingly important role in it.
When sex really helps
A 2013 study by the University of Münster yielded interesting data. Researchers approached 1,000 patients with migraine or cluster headaches and asked them, among other things, how their problems were related to sexual activity. Approximately sixty percent of migraine sufferers said their pain eased after sex. For some of them, this effect became so reliable that they began to use sexual activity consciously as a kind of alternative therapy. The change in pain often came shortly after orgasm or peak arousal - regardless of the type of sex, position, partner or phase of the attack.
In other words, for some people, sex is not an obstacle during a migraine, but a potential solution.
The chemistry of pleasure
The reason is purely biological. Orgasm activates areas of the brain that overlap with pain perception centres, such as the cortex or hypothalamus. It also triggers a massive release of endorphins, substances that act as natural opiates. Their analgesic effect has been compared to morphine in some studies. In addition, during sex, levels of dopamine and serotonin - neurotransmitters whose low levels are associated not only with migraine but also with depressive and anxiety states - increase. And there's one more effect to add to the mix: distraction. An intense experience can distract from the pain, at least for a while.
All of this together creates an environment in which the body can actually "switch" the pain.
When the pain gets worse
But there is a flip side to the idyll. About a third of migraine sufferers in the same study said that sex, on the other hand, makes their pain worse. There's even a specific diagnosis that goes by the telling name: headaches associated with sexual activity. So-called orgasmic headaches can occur with any sexual arousal, including masturbation. In most cases, it affects both sides of the head and is described as a violent, explosive pressure - a feeling that "the head is going to burst". In a significant proportion of people it comes on suddenly, often just at the moment of climax.
According to expert data, this type of pain is significantly more common inmen and typically occurs around the age of 40. People who have a history of migraines or headaches during physical exertion are at greater risk. In most cases, the condition is harmless and will resolve itself over time - half of patients only have problems for a few months, while some experience a once-in-a-lifetime attack. Still, caution is necessary. Sudden onset, extremely severe pain can rarely be a symptom of a more serious problem, such as a vascular disorder in the brain. The first such seizure should therefore always be assessed by a doctor.
Why it happens
Researchers agree that orgasmic, exertional and coughing headaches are probably related. All three situations are linked by a sharp rise in blood pressure and subsequent dilation of blood vessels. One theory works on the idea that some people have a disrupted ability of blood vessels to regulate blood flow - they dilate "too much" during excitement or exertion. The other points to activation of the sympathetic nervous system. During orgasm and intense movement, adrenaline is released, the body goes into fight or flight mode - and the vascular system may not respond ideally.
Sex, drugs and silence in the office
One more factor comes into play: the treatment of the migraine itself. Certain preventive medications, such as antidepressants, antiepileptics or blood pressure medications, can reduce libido, delay orgasm or cause erectile problems. For many people, this is a double stigma. Not only do they struggle with the pain, but they are afraid to talk about it in connection with sex. Yet it is often open communication with a doctor that allows dosage adjustments or changes in medication to alleviate side effects.
Intimacy despite pain
Experts agree that sex need not be excluded from a migraine sufferer's life. You just need to find your own way. It can help to choose times of day when the pain is at its mildest, try gentler forms of intimacy during milder attacks, choose positions that don't increase pressure in problem areas, or don't be afraid to take a more passive role if it's more comfortable. Open communication with your partner is essential, as is a willingness to seek professional advice if necessary, from a neurologist to a sex therapist.
Sex can thus become not only a source of pleasure but also a tool for self-discovery. For some it is a relief, for others a warning sign. One thing is certain: the body and the brain have a much more complex dialogue than the old joke about headaches would suggest.
