Primary headache associated with sexual activity: 15 new cases and therapeutic outcomes

Abstract

To explore the clinical manifestations, diagnosis, treatment and prognostic features of primary headache associated with sexual activity (PHASA) . Fifteen patients were prospectively analyzed over the past 7 years at our hospital. There were 11 males and 4 females with a mean age of (42 ± 11) (26-56) years. Their mean ages of onset were 38 ± 7 (26-44) years. For preemptive therapy, 8 patients had received indomethacin (25-50 mg, 30-60 min prior to sexual activity). Among them, 7 patients reported good outcomes and there was one case of limited success. Four patients received sumatriptan (50-100 mg, 30-60 min prior to sexual activity). And 2 patients reported good outcomes and the remaining 2 had no response. They received ibuprofen for preemptive therapy with a complete success. Prophylactic treatment of propranolol 60 mg was indicated for 8 patients. The outcomes were good (n = 6) and non-successful (n = 0). Among 4 patients with a prophylaxis of nimodipine, there were successful (n = 2) and non-successful (n = 2). The first-line option for PHASA should be indomethacin. Other drugs may be used for preemptive therapy if there is no relief or adverse effects are intolerable.