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extreme headache after sex

  this question may sound silly my family has a history of anuerysms my mother died from this and also her father
  each time of late last month or so when ever I have a orgasm i get
  an extremley pounding headache always same side very intense.
  any connection to family history??? thanks jill
Dear Jill:
No, this isn't a silly question.  I am sorry that your having headaches.  Yes, a positive family history is of concern for there are types of aneurysms or vascular malformations that are genetic.  I guess we see a few people every year who have a bleed after having sex.  There is an entity called orgasmic headache.  There seems to be two forms, a benign and malignant.  The malignant form was manifested by a subarachnoid hemorrhage.  However, in the review by Adams et al., this accounted for only 5% of the cases.  THe benign form is described as occuring either during or immediately after orgasm and the headache was often behind the eyes, bilateral or occipital and of varying intensity, although usually rather short lived.  The pain wa almost always throbbing.  Orgasmic headaches can occur in individuals with migraine headaches.  So, I guess your question would be do I think that you have orgasmic cephalgia?  The answer would be yes.  Do I think that since you have a family history of aneurysms, should you see a neurologist?  The answer is yes, just to rule out the possibility of bleeding.  Do I think that it is the latter, probably not.  But, I think you need a CT scan to rule out it's possibility.  I hope your headaches resolve.  Let us know if you need our help, if in the Cleveland area you can call 1-800-CCF-care.  

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