Objectives:
To present a rare case of primary headache associated with sexual activity.
Clinical presentation and intervention:
A 48-year-old man presented with a severe headache during sexual intercourse, particularly at the time of orgasm. A diagnosis of type 2 primary headache associated with sexual activity was made, and he was started on indomethacin 25 mg to be taken 30 min before intercourse and propranolol 40 mg twice a day, following which he noted a dramatic improvement within in a week.
Conclusions:
The case highlights the importance of paying attention to the differential diagnosis. For this patient, prophylactic treatment with beta-blockers and/or preemptive therapy with indomethacin was successful.