Sex and Intimacy

“Not tonight, dear, I have a headache” is perhaps the most common and clichéd excuse for bedroom boredom. The reality is that, when in the throes of a major migraine attack, most people do not want to be touched, bounced, jostled, or otherwise engaged in physical intimacy. Putting aside the issue of sex, many migraineurs prefer to let the migraine pass while they are in a dark room, isolated from other people. Intimacy, as well as sex, is put on hold.

Just Saying Yes

For others, though, sex plays an interesting role in the life of a migraineur. While enduring an acute migraine attack is a surefire way to kill desire, some research indicates that migraine sufferers may actually have higher levels of sexual desire than people who do not have frequent headaches.

A 2006 Wake Forest study found that self-reported levels of sexual desire among migraineurs were 20 percent higher than those of tension headache sufferers. This may be due to the role that the neurotransmitter serotonin plays in both migraine and libido. Migraineurs are thought to have a deficiency of serotonin, while high levels of the neurotransmitter are associated with decreased sex drive.

A handful of small studies have indicated that orgasm can actually relieve migraine pain for some people. This may be due to the increased levels of endorphins and corticosteroids that are released with orgasm, two substances that may have an analgesic action on migraine pain.

Just Saying Maybe

The bad news: in some people, orgasm can cause a migraine rather than relieve one. One type of migraine, called an “exertional migraine,” can result from any sort of strenuous activity. Exertional migraines can come with or without aura and may last as long as 24 hours. They are more common in women than men, and the pain typically affects both sides (or front and back) of the head.

Those who find themselves with exertional migraines may want to refrain from sexual activity until the migraine has receded. Visiting a physician is also recommended, as postcoital headaches could potentially have other causes.


Sex also releases serotonin, the brain chemical that sends “feel-good” messages to your body. Low levels of serotonin have historically been observed in migraine sufferers; migraine treatment with ergotamine derivatives affects serotonin levels.

In an effort to avoid a migraine trigger, some migraineurs may stop having sex altogether. Let your health care provider know if fear of migraine is causing you to avoid sexual activity. Preventative medications, or a change of your current migraine treatment regimen, may be in order. It is also important not to confuse sex with intimacy.

While some relationships can survive without sex, few will withstand the test of time without intimacy. Both partners in a relationship need to feel valued, respected, and special to each other; intimacy is an important tool in separating your partner from everyone else in your life. Consider nonsexual ways of remaining intimate, or work alternate sexual activities into your lovemaking life.

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