Q. What could be giving me throbbing headaches when I have sex? I've also experienced this during the last few reps of a total weight workout. The pain is so severe that it makes me stop, and my head pounds for hours.
 

A. There may be no more powerful mood-killer than the benign sexual headache. About 1% of people -- mostly men (surprise!) -- are often forced to say, "Not tonight dear, I might get a headache."

Sex should be pure joy. The fact that you also get these thunderclaps when you work out suggests you have a class of headache known as exertional. When you exert yourself, muscle contractions or a temporary, harmless blood pressure rise may be involved.

Although this type of headache doesn't usually signal an underlying medical problem, the lingering pain can certainly discourage you from doing two beneficial activities: having sex and working out.

See your doctor to rule out any big bad stuff, and treat the small bad stuff. Because these headaches seem to be related to tension ones, try including a neck massage in your foreplay. If that doesn't work, there are a few prescription meds that relieve headaches related to sex in about 80% of people who get them. These include a small dose of a nonsteroidal inflammatory drug called indomethacin and a blood pressure drug (typically, a beta blocker or calcium channel blocker), usually taken together. Migraine drugs taken 30 minutes before sex also help some people avoid the pain.

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