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Orgasm and Migraine
... Orgasm can trigger a migraine attack in some people but, in some, it can be a relieving factor (1,2). In this report, I present the unusual case of a patient with migraine who was using masturbation habitually to alleviate the pain attack. ...
... The report of Couch and Bearss (1990) suggested a beneficial effect of sexual intercourse compared to triptans (1). Evans and Couch (2001) reported a case with migraine headache relieved within minutes after orgasm (2). Unlike the previous reports, the patient presented here is a unique case considering the use of orgasm as a therapeutic option. ...
... The report of Couch and Bearss (1990) suggested a beneficial effect of sexual intercourse compared to triptans (1). Evans and Couch (2001) reported a case with migraine headache relieved within minutes after orgasm (2). Unlike the previous reports, the patient presented here is a unique case considering the use of orgasm as a therapeutic option. ...
... Much data on orgasmic headache come from retrospective studies and anecdotal reports. The relationship is complex, as orgasm may also relieve headaches (14). A retrospective study in 83 women at a United States headache clinic demonstrated that orgasm provided migraine relief in 50% of their population, compared with 30% relief with triptans (4). ...
Background:
Paroxysmal neurological symptoms occurring with sex cause considerable anxiety and sometimes have a serious cause. Thunderclap headache is the most well-known and requires urgent investigation at first presentation for subarachnoid haemorrhage and other significant pathologies. After exclusion of underlying causes, many prove to be primary headache associated with sexual activity. Orgasmic migraine aura without headache is not currently recognised as a clinical entity.
Case reports:
We report two patients with acephalgic orgasmic neurological symptoms fulfilling the criteria for migraine aura.
Conclusions:
The incidence of acephalgic orgasmic migraine aura is unknown. It should be considered as part of the differential of paroxysmal sex-related neurological symptoms, and clinically differentiated from fixed deficits, reversible cerebral vasoconstriction syndrome and post-orgasmic illness syndrome.
... In clinical experience, high levels of oxytocin have been anecdotally linked to a reduction in migraine frequency. For example, female patients with migraine report a reduction in migraine attacks while pregnant [86,87]; those who breast feed their babies demonstrate a lower rate of postpartum migraine recurrence than those who bottle feed [88,89]; and 46% of women report that sex can provide migraine relief [90,91]. Furthermore, in one particular case study of a woman with severe migraine, oxytocin infusion to induce uterine contraction alleviated migraine pain [92]. ...
The hypothalamus is involved in the regulation of homeostatic mechanisms and migraine-related trigeminal nociception and as such has been hypothesized to play a central role in the migraine syndrome from the earliest stages of the attack. The hypothalamus hosts many key neuropeptide systems that have been postulated to play a role in this pathophysiology. Such neuropeptides include but are not exclusive too orexins, oxytocin, neuropeptide Y, and pituitary adenylate cyclase activating protein, which will be the focus of this review. Each of these peptides has its own unique physiological role and as such many preclinical studies have been conducted targeting these peptide systems with evidence supporting their role in migraine pathophysiology. Preclinical studies have also begun to explore potential therapeutic compounds targeting these systems with some success in all cases. Clinical efficacy of dual orexin receptor antagonists and intranasal oxytocin have been tested; however, both have yet to demonstrate clinical effect. Despite this, there were limitations in these cases and strong arguments can be made for the further development of intranasal oxytocin for migraine prophylaxis. Regarding neuropeptide Y, work has yet to begun in a clinical setting, and clinical trials for pituitary adenylate cyclase activating protein are just beginning to be established with much optimism. Regardless, it is becoming increasingly clear the prominent role that the hypothalamus and its peptide systems have in migraine pathophysiology. Much work is required to better understand this system and the early stages of the attack to develop more targeted and effective therapies aimed at reducing attack susceptibility with the potential to prevent the attack all together.
Electronic supplementary material
The online version of this article (10.1007/s13311-017-0602-3) contains supplementary material, which is available to authorized users.
... 13 Additionally, both men and women show strong surges in oxytocin during intercourse and orgasm, 15 and 47% of women report that sex provides at least some relief from their migraines. 16 Finally, Phillips et al 17 described a case study in which they gave oxytocin postpartum to a woman with severe migraine in order to induce uterine contraction. By the end of the infusion, her headache was gone. ...
This article reviews material presented at the 2016 Scottsdale Headache Symposium. This presentation provided scientific results and rationale for the use of intranasal oxytocin for the treatment of migraine headache. Results from preclinical experiments are reviewed, including in vitro experiments demonstrating that trigeminal ganglia neurons possess oxytocin receptors and are inhibited by oxytocin. Furthermore, most of these same neurons contain CGRP, the release of which is inhibited by oxytocin. Results are also presented which demonstrate that nasal oxytocin inhibits responses of trigeminal nucleus caudalis neurons to noxious stimulation using either noxious facial shock or nitroglycerin infusion. These studies led to testing the analgesic effect of intranasal oxytocin in episodic migraineurs—studies which did not meet their primary endpoint of pain relief at 2 h, but which were highly informative and led to additional rat studies wherein inflammation was found to dramatically upregulate the number of oxytocin receptors available on trigeminal neurons. This importance of inflammation was supported by a series of in vivo rat behavioral studies, which demonstrated a clear craniofacial analgesic effect when a pre-existing inflammatory injury was present. The significance of inflammation was further solidified by a small single-dose clinical study, which showed analgesic efficacy that was substantially stronger in chronic migraine patients that had not taken an anti-inflammatory drug within 24 h of oxytocin dosing. A follow-on open label study examining effects of one month of intranasal oxytocin dosing did show a reduction in pain, but a more impressive decrease in the frequency of headaches in both chronic and high frequency episodic migraineurs. This study led to a multicountry double blind, placebo controlled study studying whether, over 2 months of dosing, “as needed” dosing of intranasal oxytocin by chronic and high frequency migraineurs would reduce the frequency of their headaches compared to a 1-month baseline period. This study failed to meet its primary endpoint, due to an extraordinarily high placebo rate in the country of most of the patients (Chile), but was also highly informative, showing strong results in other countries and strong post hoc indications of efficacy. The results provide a strong argument for further development of intranasal oxytocin for migraine prophylaxis.
... 13 Additionally, both men and women show strong surges in oxytocin during intercourse and orgasm, 15 and 47% of women report that sex provides at least some relief from their migraines. 16 Finally, Phillips et al 17 described a case study in which they gave oxytocin postpartum to a woman with severe migraine in order to induce uterine contraction. By the end of the infusion, her headache was gone. ...
... In these cases post-coital headache and transient global amnesia were diagnosed. Both are common in patients presenting themselves with neurological symptoms after sexual intercourse [3,18]. According to a study by Kirz et al. on coitus as a predisposing factor for neurological symptoms about 50% of all patients suffer from post-coital headache [19]. ...
Sexuality is an essential aspect of human function, well-being and quality of life. Many people have sex without complications. However, there are some people who need to seek emergency medical help for related health problems. The aim of this study was to present a first overview of patients who received a radiological examination related to sexual intercourse based emergency department admission.Our centralized electronic patient record database was reviewed for patients who had been admitted to our emergency department with an emergency after sexual intercourse between 2000 and 2011. The database was scanned for the standardized key words 'sexual intercourse' or 'coitus' retrospectively. For all patients identified in the electronic patient record database the radiological examinations were searched for manually in our Radiology Information System, and reviewed by three independent radiologists.One hundred and twenty nine out of 445 (29,0%) patients received a radiological examination after immediate emergency department admission related to sexual intercourse. Fifty two out of 129 (40.3%) patients had positive radiological findings while 77 (59.7%) did not. Eighty point seven percent (n = 42) of the radiological findings were a sexual intercourse-associated pathology and 19.2% (n = 10) were considered to be incidental findings. Age and male sex positively correlated with radiological imaging workup (p
... Experimental studies provide evidence that physical intimacy can have lasting effects on somatic symptoms. Positive touch and sexual arousal showed immediate and lasting pain-relieving effects (73,74,82,83) and induced muscle relaxation for several hours (84). In addition, physical intimacy and touch promoted better sleep (73,85), thus increasing restorative function with positive effects for health (86). ...
To review research on close relationships and health in daily life, with a focus on physiological functioning and somatic symptoms, and to present data on the within-person effects of physical intimacy on somatic symptoms in committed couples' daily life. The empirical study tested whether prior change in physical intimacy predicted subsequent change in symptoms, over and above their concurrent association. In addition, the study tested if increasing and decreasing intimacy had asymmetric effects on symptom change.
In this study, 164 participants in 82 committed couples reported physical intimacy and somatic symptoms once a day for 33 days.
Prior within-person change in intimacy predicted a subsequent reduction in symptoms; when a person's intimacy increased from one day to the next day, then symptoms decreased over the following days (B = -0.098, standard error [SE] = 0.038, p = .013). This lagged effect of intimacy held over and above the association of concurrent change in intimacy and symptoms (B = -0.122, SE = 0.041, p = .004). The study found asymmetric effects of prior increase and decrease in intimacy; prior intimacy increase predicted reduced subsequent symptoms (B = -0.189, SE = 0.068, p = .047), whereas prior intimacy decrease was unrelated to subsequent symptoms (B = -0.003, SE = 0.063, not significant). There was no evidence for asymmetric effects of intimacy increase and decrease on concurrent symptom change.
Close relationships exert influences on health in daily life, and part of this influence is due to intimacy.
High-risk sexual behavior consists of activities and habits that put a person at increased risk of sexually transmitted infections (STIs) or unplanned pregnancy. Poland is currently experiencing a problem with increased STI rates, largely due to poor sexual education. Our exploratory study aims to evaluate the sexual behavior of students attending universities across Poland. The study covered 7678 students from 50 different faculties and universities across the country. The authors created an original questionnaire which consists of 31 questions which, among others, included demographic factors, sexual initiation, high-risk sexual behavior, STI's and religious beliefs. 78% of students have participated in sexual activity, among them 19% of students had 'casual sex' consisting of intercourse without the use of a condom, 27% had participated in sexual intercourse after the consumption of alcohol. Our study found that students who are influenced by religious belief tend to engage in sexual activity into their later years. The groups most exposed to the consequences of risky sexual behavior are mostly homosexual men, bisexual women, art students, and military students. Alcohol consumption is a strong factor contributing to risky sexual behavior. Sexual education in Poland should be improved.
Migraine is the most common neurological disorder worldwide and it has been shown to have complex polygenic origins with a heritability of estimated 40-70%. Both common and rare genetic variants are believed to underlie the pathophysiology of the prevalent types of migraine, migraine with typical aura and migraine without aura. However, only common variants have been identified so far. Here we identify for the first time a gene module with rare mutations through a systems genetics approach integrating RNA sequencing data from brain and vascular tissues likely to be involved in migraine pathology in combination with whole genome sequencing of 117 migraine families. We found a gene module in the visual cortex, based on single nuclei RNA sequencing data, that had increased rare mutations in the migraine families and replicated this in a second independent cohort of 1930 patients. This module was mainly expressed by interneurons, pyramidal CA1, and pyramidal SS cells, and pathway analysis showed association with hormonal signalling (thyrotropin-releasing hormone receptor and oxytocin receptor signalling pathways), Alzheimer's disease pathway, serotonin receptor pathway and general heterotrimeric G-protein signalling pathways. Our results demonstrate that rare functional gene variants are strongly implicated in the pathophysiology of migraine. Furthermore, we anticipate that the results can be used to explain the critical mechanisms behind migraine and potentially improving the treatment regime for migraine patients.
Migraine is a common and disabling neurological disorder, with a significant socioeconomic burden. Its pathophysiology involves abnormalities in complex neuronal networks, interacting at different levels of the central and peripheral nervous system, resulting in the constellation of symptoms characteristic of a migraine attack. Management of migraine is individualised and often necessitates the commencement of preventive medication. Recent advancements in the understanding of the neurobiology of migraine have begun to account for some parts of the symptomatology, which has led to the development of novel target-based therapies that may revolutionise how migraine is treated in the future. This review will explore recent advances in the understanding of migraine pathophysiology, and pharmacotherapeutic developments for migraine prevention, with particular emphasis on novel treatments targeted at the calcitonin gene-related peptide (CGRP) pathway.
An overriding mental preventology mission in a healthy lifestyle integration and moral purpose of life has been justified in the article. The following instruments and factors of mental resilience were accentuated: neuroplasticity and spirituality, music and signing therapy, dance therapy and physical therapy, somnology and sexual management. A polymodal formula for happiness and multiple logistics of the destiny path abbreviated to SINAPS have been suggested. Major lines of mental preventology have been systematized.
An idiopathic headache disorder associated with sexual activity is known for many years and has been introduced in the current classification of the International Headache Society. In this review, the clinical picture and the therapeutic options for this headache disorders are described. Further, sexual activity can lead to headache relief (in particular migraine) in single patients. The epidemiological background for this phenomenon and possible mechanisms are presented and discussed.
A 41-year-old man was admitted to the general emergency room (ER) because of an extremely severe headache of instantaneous onset (1 min at most), probably the worst ever in his life. He had described of having two previous similar episodes within a few days all during sexual intercourse, including the final one that brought him to the ER.
This is a report of an unusual case, where the patient used clitoral and/or vaginal masturbation and orgasm for treatment of migraine attack. While the non drug treatment was effective, she subsequently developed depression. The orgasm from masturbation, resulting in the rush of endorphins, probably relieved the migraine. However, as demonstrated in our patient, the patient also had sexual aversion, tiredness, feeling of shame and guilt, followed by depression from the alternative non-drug treatment.
Sports- and exercise-related headaches are not unusual. Despite their frequent occurrence in this context, there are little epidemiologic data concerning sports-related headache. The recent attention of concussive injuries and associated post-traumatic headache has renewed interest in the study of those headaches occurring after head trauma; however, any primary headache type can also occur in the setting of contact and/or collision sports. The nonspecific nature of headaches provides unique challenges to clinicians encountering this complaint. It is, therefore, imperative that physicians treating athletes are able to distinguish the various headache types and presentations often seen in this population.
Background
Headache associated with sexual activity is a well-known primary headache disorder. In contrast, some case reports in the literature suggest that sexual activity during a migraine or cluster headache attack might relieve the pain in at least some patients. We performed an observational study among patients of a tertiary headache clinic.MethodsA questionnaire was sent to 800 unselected migraine patients and 200 unselected cluster headache patients. We asked for experience with sexual activity during a headache attack and its impact on headache intensity. The survey was strictly and completely anonymous.ResultsIn total, 38% of the migraine patients and 48% of the patients with cluster headache responded. In migraine, 34% of the patients had experience with sexual activity during an attack; out of these patients, 60% reported an improvement of their migraine attack (70% of them reported moderate to complete relief) and 33% reported worsening. In cluster headache, 31% of the patients had experience with sexual activity during an attack; out of these patients, 37% reported an improvement of their cluster headache attack (91% of them reported moderate to complete relief) and 50% reported worsening. Some patients, in particular male migraine patients, even used sexual activity as a therapeutic tool.Conclusions
The majority of patients with migraine or cluster headache do not have sexual activity during headache attacks. Our data suggest, however, that sexual activity can lead to partial or complete relief of headache in some migraine and a few cluster headache patients.
Principals:
Most people enjoy sexual intercourse without complications, but a significant, if small, number need to seek emergency medical help for related health problems. The true incidence of these problems is not known. We therefore assessed all admissions to our emergency department (ED) in direct relation to sexual intercourse.
Methods:
All data were collected prospectively and entered into the ED's centralised electronic patient record database (Qualicare, Switzerland) and retrospectively analysed. The database was scanned for the standardised key words: 'sexual intercourse' (German 'Geschlechtsverkehr') or 'coitus' (German 'Koitus').
Results:
A total of 445 patients were available for further evaluation; 308 (69.0%) were male, 137 (31.0%) were female. The median age was 32 years (range 16-71) for male subjects and 30 years (range 16-70) for female subjects. Two men had cardiovascular emergencies. 46 (10.3%) of our patients suffered from trauma. Neurological emergencies occurred in 55 (12.4%) patients: the most frequent were headaches in 27 (49.0%), followed by subarachnoid haemorrhage (12, 22.0%) and transient global amnesia (11, 20.0%). 154 (97.0%) of the patients presenting with presumed infection actually had infections of the urogenital tract. The most common infection was urethritis (64, 41.0%), followed by cystitis (21, 13.0%) and epididymitis (19, 12.0%). A sexually transmitted disease (STD) was diagnosed in 43 (16.0%) of all patients presenting with a presumed infection. 118 (43.0%) of the patients with a possible infection requested testing for an STD because of unsafe sexual activity without underlying symptoms.
Conclusions:
Sexual activity is mechanically dangerous, potentially infectious and stressful for the cardiovascular system. Because information on ED presentation related to sexual intercourse is scarce, more efforts should be undertaken to document all such complications to improve treatment and preventative strategies.
Headache associated with sexual activity is an idiopathic headache disorder and regarded to be a vascular headache but no pathophysiological studies have been performed to date to elucidate the underlying mechanisms. We investigated 12 patients with the explosive type of sexual headache according to the criteria of the International Headache Society during a headache-free state by means of acetazolamide test and of stress Doppler sonography. Twelve age-matched migraine patients and 14 healthy subjects served as control groups. Changes of blood pressure, cerebral blood flow velocity (CBFV), and pulsatility index (PI) were evaluated. Patients with sexual headache showed a significantly higher increase of blood pressure during standardized physical exercise as compared to healthy subjects and migraine patients. Changes of CBFV by physical exercise were not different between the three examination groups. After 1g acetazolamide, CBFV showed a significantly higher increase in patients with sexual headache (plus 66%+/-16%) than in healthy subjects (plus 46%+/-18%), and PI showed a significantly lower decrease as compared to healthy subjects and migraine patients. These data suggest that in patients with sexual headache the metabolic rather than the myogenic component of the cerebral vasoneuronal coupling is impaired.
The present study examined the relationship between the diagnosis of migraine and self-reported sexual desire.
There is evidence for a complex relationship between sexual activity and headache, particularly migraine. The current headache diagnostic criteria even distinguish between several types of primary headaches associated with sexual activity.
Members of the community or students at the Illinois Institute of Technology (N = 68) were administered the Brief Headache Diagnostic Interview and the Sexual Desire Inventory (SDI). Based on the revised diagnostic criteria established by the International Headache Society (ICHD-II), participants were placed in 1 of the 2 headache diagnostic groups: migraine (n = 23) or tension-type (n = 36).
Migraine subjects reported higher SDI scores, and rated their own perceived level of desire higher than those suffering from tension-type headache. The presence of the symptom "headache aggravated by routine physical activity" significantly predicted an elevated SDI score.
Migraine headaches and sexual desire both appear to be at least partially modulated by serotonin (5-HT). The metabolism of 5-HT has been shown to covary with the onset of a migraine attack, and migraineurs appear to have chronically low systemic 5-HT. As sexual desire also has been linked to serotonin levels, the results are consistent with the hypothesis that migraine and sexual desire both may be modulated by similar serotonergic phenomena.
Evidence from animal experiments shows that the brain stem is involved in the pathophysiology of migraine. To investigate human migraine, we used positron emission tomography to examine the changes in regional cerebral blood flow as an index of neuronal activity in the human brain during spontaneous migraine attacks. During the attacks, increased blood flow was found in the cerebral hemispheres in cingulate, auditory and visual association cortices and in the brain stem. However, only the brain stem activation persisted after the injection of sumatriptan had induced complete relief from headache and phono- and photophobia. These findings support the idea that the pathogenesis of migraine is related to an imbalance in activity between brain stem nuclei regulating antinociception and vascular control.
Vaginocervical stimulation (VS) releases multiple neurotransmitters into superfusates of the spinal cord; these can stimulate both nociceptive (e.g., glutamate, and glycine acting at the NMDA site), and antinociceptive (e.g., GABA, norepinephrine, 5-HT, and glycine acting at the strychnine-sensitive receptor) systems. Although the balance between these two opposing systems can determine the nature, magnitude, and duration of the response to VS, the characteristic prevailing response to VS is analgesia. We hypothesized that by counteracting the nociceptive component of this system, the magnitude and duration of the response to VS would be augmented. In the present study, the NMDA receptor antagonist AP5 [10 μg injected intrathecally (IT)] significantly increased the magnitude and duration of the analgesia (measured as tail flick latency to radiant heat) produced by VS (200 g force). At several time points the analgesic effect of AP5 combined with VS was greater than the sum of the effects of AP5 and VS separately, suggesting that they act synergistically. We propose that AP5 potentiates the analgesic effect of VS by two mechanisms: (a) antagonizing the putative pain-producing action of glutamate and glycine acting jointly at the NMDA receptor, and consequently, (b) permitting the unimpeded expression of the analgesic action of inhibitory neurotransmitters released by VS (e.g., glycine at the strychnine-sensitive receptor, and GABA).
SYNOPSIS
Ray and Wolff in a landmark study of human patients under local anesthesia, concluded that the brain was not sensitive to pain; however, at the time of their study, the anatomy and physiology of pain transmission and modulation were largely unknown and their stimulating electrodes were not implanted in the brainstem or thalamic cells or projections now known to be important to pain perception. We now report 15 patients, previously headache-free, who underwent electrode implantation in the periaqueductal gray between 1977 and 1982 who immediately at implantation or in the few days subsequent to implantation reported severe continuous head pain usually with florid “migrainous” feature that persisted for 2 months to 10 years. Ten of these patients were treated with reserpine and all were dramatically responsive to it, but 8 patients rapidly became tolerant. Seven patients who were treated with dihydroergotamine rapidly became headache-free; 2 of the 7 became tolerant quickly. One patient developed the “cough headache” syndrome after implantation, was responsive to indomethacin, the syndrome abating in 6 months. These data suggest that perturbation of brain may generate head pain.
Relief of migraine with sexual intercourse [abstract].
- Couch J
Couch J, Bearss C. Relief of migraine with sexual in-tercourse [abstract]. Headache. 1990;30:302.
Relief of migraine with sexual intercourse
- J Couch
- C Bearss
Couch J, Bearss C. Relief of migraine with sexual intercourse [abstract]. Headache. 1990;30:302.