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If the headache is due to sub-arachnoid haemorrhage then medical treatment needs to be sought urgently; the patient will need an urgent operation to close the bleeding artery inside the skull.

Where the headache is an exacerbation of tension headache, all the treatments for tension headache will be helpful. And if the headache is related to neck or spinal injury, treating the underlying injury itself will reduce trouble in the future.

True coital headache (i.e. neither a tension headache nor a sub-arachnoid haemorrhage) will go away of its own accord. On the other hand, knowing that you’re going to get a belter of a headache is not conducive to marital intimacy, and is likely to turn you off sex altogether! So something needs to be done. In fact, the drug propranolol, a beta-blocker, is very effective in preventing these headaches occurring. It’s not available over the counter, so your doctor will need to prescribe it. Taking a small dose regularly is all that is needed, and from then on intercourse should be pain free. This type of drug interferes with the contraction of the muscles inside the blood vessels, which suggests that the cause of true coital headache originates from the blood vessels in the brain.


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