Sex File: I get a headache when I orgasm 

"Sex headaches are not common, but are well documented and well researched. Men are nearly twice as likely to have them as women and they can occur at any age."

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Sometimes I get a really terrible headache after I've had an orgasm. I'm in my late 50s, but seem to have got through menopause without many issues, so I don't think it's that. It's making me reluctant to have sex, or feel stressed about it if we do, so I wonder if it has become a vicious circle. Should I worry?

Headaches after sexual activity, including after an orgasm, are known as sex headaches or coital cephalalgia. In most cases the pain increases in intensity as sexual excitement builds or, as you describe, comes on very suddenly and intensely just before or after orgasm. In about a third of cases, the pain is only on one side or in a specific or localised area. It is typically severe for between a few minutes and 24 hours, and can then sustain at a milder intensity for up to 72 hours.