Duane Hoffmann / MSNBC
By msnbc.com contributor
msnbc.com contributor
updated 9/19/2005 11:22:04 AM ET 2005-09-19T15:22:04

What's an explosive headache and why does sex bring it on? Are heart troubles tied to poor sexual performance? Sexploration answers your queries.

Have an intimate question? To e-mail us, click here . He'll tackle select questions in future columns.

Q:What's the deal with explosive headaches? As someone who has experienced them, I'd like to know more about what they are and why they're associated with sex.

A: Honestly, I’d never heard of an explosive headache. So I researched it, which, come to think of it, is why they pay me.

And here’s what I found out: Explosive headaches cause intense head pain just before or at the moment of orgasm. Doctors are unsure of the mechanism but it seems related to a spike in blood pressure from the heat of passion. And, importantly, explosive headaches are either nothing to worry about, or they’ll kill you.

Dr. Brett Cucchiara, an assistant professor of neurology at the University of Pennsylvania in Philadelphia, says explosive headache “is not a super-rare event, but the major issue is that in a small subset of people it will be a sign of a brain aneurysm.”

So what to do? “If somebody experiences headache like that for the first time, they should go and have it evaluated right away on an emergency basis,” Cucchiara advises. (Remember, this advice applies to headaches that earn the name “explosive.” If your head hurts because you had sex after drinking Two Buck Chuck, stay home and go to sleep.)

Come in right away because the longer you wait, the tougher the detection. When you show up in the ER, doctors will probably perform a CT scan and possibly a spinal tap.

If it doesn’t turn out to be life-threatening, the headaches may resolve on their own after a few months, or your doctor may prescribe medications like calcium-channel blockers or beta-blockers.

Q:After having open-heart surgery to replace the aortic valve and receive three bypasses, two of which have since collapsed, I have had a problem with erection and ejaculation. Could there be a connection?

A: Do ya think maybe Mr. Willie troubles are the least of your worries? I mean, there is that small matter of two collapsed bypasses, no? 

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But you are right. There probably is a connection.

Good old Mr. Willie can be a great canary in a coal mine for all of us. If he’s getting a little sluggish, it could be a sign of cardiovascular disease or some other health issue. Good sex is related to good health.   

Go see your cardiologist. While you’re there, ask about any precautions you should take, and whether you can use a little chemical helper for perking up your canary.

Q:A co-worker recently described this problem to me: Her husband had a vasectomy within the past year. Since then, he feels severe pain at the end of his penis whenever he ejaculates during intercourse. However, he does not have any pain when he ejaculates during masturbation or oral sex. Although neither of us can conceive of anything that would explain his pain under these circumstances, I warned her against jumping to the conclusion that her husband's pain is psychosomatic. Have you ever heard of anything similar, and if so, do you have an explanation?

A: “Oh, come on now!” was the way Dr. Anthony Thomas, a urologist at the Cleveland Clinic and an expert in post-vasectomy pain, reacted to this question.

“A very small number of men,” Thomas says, do have post-vasectomy pain during intercourse, but in their testicle area. Pain at the tip of the penis is almost always related to the prostate. Pain during intercourse, but not during masturbation or oral sex is something “I cannot conceptualize and I have dealt with a lot of post-vasectomy pain syndrome cases,” Thomas says.

But on the other hand, he says, “we believe what patients tell us until we have a reason not to believe it.”

So what's the solution? That's unclear, but it's worth trying a different sexual position to see if that minimizes or eliminates the pain.

Brian Alexander is a California-based writer who covers sex, relationships and health. He is a contributing editor at Glamour and the author of "Rapture: How Biotech Became the New Religion" (Basic Books).

Sexploration appears every other Thursday.

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