Primary headache associated with sexual activity: A case report

Abstract

Headaches provoked by triggering factors have been recognized for many decades. In many cases, the development of such headaches is secondary to an underlying pathology. However, in some cases, no abnormality can be identified. Primary headache associated with sexual activity (PHASA) is one of the subgroups of primary headaches. PHASA is a benign form of headache and lifetime prevalence is estimated to be 1% to 1.6% in the general population. A 38-year-old man was admitted to outpatient clinic reporting history of severe headaches during sexual intercourse for the last 2 months. Headaches occurred bilaterally in occipital area just after orgasm and lasted for about 2 hours. Propranolol 40 mg/day was initiated and on followup, patient reported dramatic improvement in 2 weeks. Treatment was maintained for 6 months. Patient has been on regular follow-up for a year and had no recurrence of headache. This is a rare case PHASA. In this patient, prophylactic treatment with low dosage of propranolol was successful.