Headache Associated with Sexual Activity-A Narrative Review of Literature.

Piotr Ściślicki,Aleksandra Klimkowicz-Mrowiec,Karolina Sztuba,Agnieszka Gorzkowska

doi:10.3390/medicina57080735

Abstract

Headache associated with sexual activity (HAWSA) has accompanied humanity since ancient times. However, it is only since the 1970s that it has become the subject of more extensive and detailed scientific interest. The purpose of this review is to provide an overview of the development of the concept of HAWSA, its clinical presentation, etiopathogenesis, diagnosis and treatment especially from the research perspective of the last 20 years. Primary HAWSA is a benign condition, whose etiology is unknown; however, at the first occurrence of headache associated with sexual activity, it is necessary to exclude conditions that are usually immediately life-threatening. Migraine, hypnic headache or hemicrania continua have been reported to co-occur with HAWSA, but their common pathophysiologic basis is still unknown. Recent advances in the treatment of HAWSA include the introduction of topiramate, progesterone, and treatments such as greater occipital nerve injection, arterial embolization, and manual therapy. Whether these new therapeutic options will stand the test of time remains to be seen.

Highlights

The condition of headache associated with sexual activity (HAWSA) is hardly a new phenomenon
HAWSA may be accompanied by other complaints, such as migraine, hypnic headache or hemicrania continua
A headache that occurs for the first time in connection with sexual activity always needs to be differentiated from symptomatic headaches

Summary

Introduction

The condition of headache associated with sexual activity (HAWSA) is hardly a new phenomenon. In medieval times the issue of HAWSA was the subject of Avicenna’s Canon of Medicine and traditional. Initiated by Avicenna, the famous manuscript was written during the Islamic Golden Age (9th–12th century), translated into Latin, and taught in medical schools up until 18th century. In the first chapter of the third volume of Canon, entitled On the diseases of the head, Avicenna discusses different kinds of headaches, including HAWSA. The headache was categorized into over twenty different types, and HAWSA was referred to as “headache associated with sexual intercourse,” which was a fairly modern term for that time [3]

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