II. Symptoms

  1. Bilateral throbbing, pulsating or pressure Headache
  2. Headache duration: minutes to 2 days
  3. Provocative factors
    1. Exercise
    2. Coughing, sneezing, blowing
    3. Lifting weight
    4. Straining at stool
    5. Crying
    6. Singing
    7. Sexual activity (intercourse, masturbation)
      1. May peak with orgasm
      2. May also be trigger in Migraine Headache

III. Differential Diagnosis

IV. Evaluation

  1. Exertional Headache is a Headache Red Flag
  2. Rule-out Organic Headache in all cases

V. Imaging

  1. CT Head or MRI Head (consider with CT angiogram or MR angiogram)

VI. Management

  1. Evaluate all cases for Organic Headache first
  2. Consider prophylaxis prior to exertion or intercourse
    1. Indomethacin
    2. Ergotamine

VII. References

  1. Cutrer in Goldman (2000) Cecil Medicine, p. 2066
  2. Goetz (1999) Clinical Neurology, p. 1101
  3. (2004) Cephalgia 24(suppl 1): 9-160 [PubMed]

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Ontology: Orgasmic headache (C2349429)

Concepts Pathologic Function (T046)
ICD10 G44.82
English Orgasmic headache

Ontology: Exertional headache (C2363911)

Concepts Sign or Symptom (T184)
English Exertional headache
Spanish Cefalea de esfuerzo
Dutch hoofdpijn bij inspanning
Italian Mal di testa da sforzo
German Kopfschmerz unter koerperlicher Belastung
French Mal de tête à l'effort
Portuguese Cefaleia de esforço
Czech Námahová bolest hlavy
Japanese 労作性頭痛, ロウサセイズツウ
Hungarian Terheléskori fejfájás